Multimorbidity's many challenges
BMJ 2007; 334 doi: https://doi.org/10.1136/bmj.39201.463819.2C (Published 17 May 2007) Cite this as: BMJ 2007;334:1016
- Martin Fortin, professor1,
- Hassan Soubhi, assistant professor1,
- Catherine Hudon, assistant professor1,
- Elizabeth A Bayliss, assistant professor2,
- Marjan van den Akker, assistant professor3
- 1Department of Family Medicine, University of Sherbrooke, J1H 5N4, Quebec, Canada
- 2Department of Family Medicine, University of Colorado Health Sciences Center, Denver, CO, 80237, USA
- 3Department of General Practice, Maastricht University, 6200 MD, Netherlands
- Martin.Fortin{at}USherbrooke.ca
Patients with multiple conditions are the rule rather than the exception in primary care.1 In a recent study of 21 family practices in the Saguenay region, Quebec, the prevalence of multimorbidity was 69% in 18-44 year olds, 93% in 45-64 year olds, and 98% in those aged over 65, and the number of chronic conditions varied from 2.8 in the youngest to 6.4 in the oldest.1 Other countries report a similar burden.2 3 The number of Americans with multimorbidity is estimated to rise from 60 million in 2000 to 81 million by 2020.4
Having multiple chronic medical conditions is associated with poor outcomes: patients have decreased quality of life,5 psychological distress,6 longer hospital stays, more postoperative complications, a higher cost of care, and higher mortality. Multimorbidity also affects processes of care and may result in complex self care needs7; challenging organisational problems …
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