Intended for healthcare professionals


Multimorbidity's many challenges

BMJ 2007; 334 doi: (Published 17 May 2007) Cite this as: BMJ 2007;334:1016
  1. Martin Fortin, professor1,
  2. Hassan Soubhi, assistant professor1,
  3. Catherine Hudon, assistant professor1,
  4. Elizabeth A Bayliss, assistant professor2,
  5. Marjan van den Akker, assistant professor3
  1. 1Department of Family Medicine, University of Sherbrooke, J1H 5N4, Quebec, Canada
  2. 2Department of Family Medicine, University of Colorado Health Sciences Center, Denver, CO, 80237, USA
  3. 3Department of General Practice, Maastricht University, 6200 MD, Netherlands
  1. Martin.Fortin{at}

    Time to focus on the needs of this vulnerable and growing population

    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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