Itai M Magodoro, Alison C Castle, Ndumiso Tshuma, Julia H Goedecke, Ronel Sewpaul, Justen Manasa, Jennifer Manne-Goehler, Ntobeko Ab Ntusi, Moffat J Nyirenda, Mark J Siedner
{"title":"Associations of HIV and prevalent type 2 diabetes mellitus in the context of obesity in South Africa.","authors":"Itai M Magodoro, Alison C Castle, Ndumiso Tshuma, Julia H Goedecke, Ronel Sewpaul, Justen Manasa, Jennifer Manne-Goehler, Ntobeko Ab Ntusi, Moffat J Nyirenda, Mark J Siedner","doi":"10.1177/26335565241293691","DOIUrl":"10.1177/26335565241293691","url":null,"abstract":"<p><strong>Background: </strong>It is unclear how rising obesity among people with HIV (PWH) impacts their risk of type 2 diabetes mellitus (diabetes). We examined associations between HIV, prevalent diabetes and adiposity among South African PWH and their peers without HIV (PWOH).</p><p><strong>Methods: </strong>HIV status was ascertained by antibody testing. Diabetes was defined as current use of oral hypoglycemics, insulin, and/or HbA1c ≥6.5%. Adiposity was measured by body mass index (BMI), waist circumference and waist-to-height ratio. Their associations were examined using sex-stratified multivariable fractional polynomial generalized linear models, reporting adjusted prevalence and prevalence ratios (adjPR).</p><p><strong>Results: </strong>The mean age among 1,254 PWH and 4,381 PWOH was 41 years (95%CI 28, 56). The prevalence of diabetes among males was similar between PWH [11.3% (7.1, 15.5)] and PWOH [9.8% (8.5, 11.1); p=0.740]. By contrast, diabetes prevalence was higher among female PWOH [15.7% (14.4, 17.0)] than female PWH [10.5 (8.3, 12.8)%; adjPR: 0.67 (0.51, 0.82); p<0.001]. This difference was accentuated with obesity but reversed with leanness. At BMI ≥25 kg/m<sup>2</sup>, female PWH had lower diabetes prevalence [adjPR: 0.58 (0.41, 0.76); p<0.001] than female PHIV. In contrast, at BMI <18 kg/m<sup>2</sup>, female PWH had higher prevalence [adjPR: 1.72 (-1.53, 4.96); p=0.756] than female PWOH.</p><p><strong>Conclusion: </strong>We found sex-specific differences in the relationship between adiposity and diabetes prevalence by HIV serostatus in South Africa. Notably, females living with obesity and HIV had lower prevalence of diabetes than females living with obesity and without HIV, which may have particular implications for diabetes prevention programs in the region.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241293691"},"PeriodicalIF":0.0,"publicationDate":"2024-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528680/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570529","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dalhatu Muhammad Ahmad, Haruna Rashid Muhammad, Shuaibu Aliyu, Don Eliseo Lucero-Prisno
{"title":"Comparison of the quality of life of comorbid and non-comorbid people living with HIV/AIDS in a Nigerian secondary healthcare facility.","authors":"Dalhatu Muhammad Ahmad, Haruna Rashid Muhammad, Shuaibu Aliyu, Don Eliseo Lucero-Prisno","doi":"10.1177/26335565241293930","DOIUrl":"10.1177/26335565241293930","url":null,"abstract":"<p><strong>Introduction: </strong>Quality of life (QoL) is a vital healthcare indicator among people living with human immunodeficiency virus (PLWHA). Assessing the effects of comorbidities on QoL among PLWHA is of clinical and public health importance. This study compared the QoL of comorbid and non-comorbid PLWHA at St. Gerard's Catholic Hospital (SGCH), Kaduna.</p><p><strong>Methods: </strong>This was a prospective cross-sectional study of 178 conveniently selected and stratified comorbid PLWHA and 172 non-comorbid PLWHA receiving care at the facility. Data was collected using a structured, interviewer-administered instrument. The QoL scores were statistically compared using the Mann‒Whitney U test. <i>P</i><0.05 was considered statistically significant for all the analyses.</p><p><strong>Results: </strong>Most respondents were aged 35 - 54 years (65.2% and 66.4% for comorbid and non-comorbid patients respectively), were female (70.8% and 69.2% for comorbid and non-comorbid patients respectively) and married (67.4% and 59.3% for comorbid and non-comorbid patients respectively). For all QoL domains (perception of QoL and general health, physical health, psychological health, level of independence, social relationship, environment, and spirituality/religion/personal beliefs), there was evidence the distribution of values was significantly lower in the comorbid PLWHA compared to the non-comorbid PLWHA (p<0.001), with the largest difference seen for physical health. The mean physical health (interquartile range) was 9 (7-10) and 17 (15-19) for comorbid and non-comorbid PLWHA respectively. The most prevalent comorbidities among the PLWHA were hypertension 97 (54.49%) and diabetes 36 (20.22%).</p><p><strong>Conclusion: </strong>Non-comorbid PLWHA had better QoL than comorbid PLWHA in all the QoL domains and the greatest difference was observed in physical health. Special efforts should be made to improve the QoL of comorbid PLWHA.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241293930"},"PeriodicalIF":0.0,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11528646/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142570530","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to \"Eliciting and prioritising determinants of improved care in multimorbidity: A modified online Delphi study\".","authors":"","doi":"10.1177/26335565241279342","DOIUrl":"10.1177/26335565241279342","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/26335565231194552.].</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241279342"},"PeriodicalIF":0.0,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457175/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142395749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Frances S Mair, Farnaz Nickpour, Barbara Nicholl, Sara MacDonald, Dan W Joyce, Jonathan Cooper, Nic Dickson, Isobel Leason, Qammer H Abbasi, Izzettin F Akin, Fani Deligianni, Elizabeth Camacho, Jennifer Downing, Hilary Garrett, Martina Johnston Gray, David J Lowe, Muhammad A Imran, Sandosh Padmanabhan, Colin McCowan, P John Clarkson, Lauren E Walker, Iain Buchan
{"title":"Developing SysteMatic: Prevention, precision and equity by design for people living with multiple long-term conditions.","authors":"Frances S Mair, Farnaz Nickpour, Barbara Nicholl, Sara MacDonald, Dan W Joyce, Jonathan Cooper, Nic Dickson, Isobel Leason, Qammer H Abbasi, Izzettin F Akin, Fani Deligianni, Elizabeth Camacho, Jennifer Downing, Hilary Garrett, Martina Johnston Gray, David J Lowe, Muhammad A Imran, Sandosh Padmanabhan, Colin McCowan, P John Clarkson, Lauren E Walker, Iain Buchan","doi":"10.1177/26335565241272682","DOIUrl":"10.1177/26335565241272682","url":null,"abstract":"<p><strong>Background: </strong>The number of individuals living with multiple (≥2) long term conditions (MLTCs) is a growing global challenge. People with MLTCs experience reduced life expectancy, complex healthcare needs, higher healthcare utilisation, increased burden of treatment, poorer quality of life and higher mortality. Evolving technologies including artificial intelligence (AI) could address some of these challenges by enabling more preventive and better integrated care, however, they may also exacerbate inequities.</p><p><strong>Objective: </strong>We aim to deliver an equity focused, action-ready plan for transforming MLTC prevention and care, co-designed by people with lived experience of MLTCs and delivered through an Innovation Hub: SysteMatic.</p><p><strong>Design: </strong>Our Hub is being co-designed by people with lived experience of MLTCs, practitioners, academics and industry partners in Liverpool and Glasgow, UK. This work builds on research into mental-physical health interdependence across the life-course, and on mobilisation of large-scale quantitative data and technology validation in health and care systems serving deprived populations in Glasgow and Liverpool. We work with 3 population segments: 1) Children & Families: facing psychosocial and environmental challenges with lifetime impacts; 2). Working Life: people with poorly integrated mental, physical and social care; and 3) Pre-Frailty: older people with MLTCs. We aim to understand their experiences and in parallel look at routinely collected health data on people with MLTCs to help us identify targets for intervention. We are co-identifying opportunities for systems transformation with our patient partners, healthcare professionals and through discussion with companies and public-sector organisations. We are co-defining 3/5/7-year MLTC innovation/transition targets and sustainable learning approaches<b>.</b></p><p><strong>Discussion: </strong>SysteMatic will deliver an actionable MLTC Innovation Hub strategic plan, with investment from the UK National Health Service, civic health and care partners, universities, and industry, enabling feedback of well-translated, patient and public prioritised problems into the engineering, physical, health and social sciences to underpin future equitable innovation delivery.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241272682"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11447698/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142373728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Corrigendum to \"Epidemiology and impact of chronic disease multimorbidity in India: a systematic review and meta-analysis\".","authors":"","doi":"10.1177/26335565241283936","DOIUrl":"https://doi.org/10.1177/26335565241283936","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/26335565241258851.].</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241283936"},"PeriodicalIF":0.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Abhinav Sinha, S Shradha Suman, Narayan Subedi, Krushna Chandra Sahoo, Mukesh Poudel, Arohi Chauhan, Banamber Sahoo, Marjan van den Akker, David Weller, Stewart W Mercer, Sanghamitra Pati
{"title":"Epidemiology of multimorbidity in Nepal: A systematic review and meta-analysis.","authors":"Abhinav Sinha, S Shradha Suman, Narayan Subedi, Krushna Chandra Sahoo, Mukesh Poudel, Arohi Chauhan, Banamber Sahoo, Marjan van den Akker, David Weller, Stewart W Mercer, Sanghamitra Pati","doi":"10.1177/26335565241284022","DOIUrl":"https://doi.org/10.1177/26335565241284022","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is rising in low-and middle-income countries such as Nepal, yet the research has not gained pace in this field. We aimed to systematically review the existing multimorbidity literature in Nepal and estimate the prevalence and map its risk factors and consequences.</p><p><strong>Methods: </strong>We reviewed data collated from PubMed, Embase and CINAHL by including original studies that reported prevalence of multimorbidity in Nepal. The quality of included studies was assessed using the Appraisal Tool for Cross-sectional Studies. The summary of the review is presented both qualitatively as well as through meta-analysis to give pooled prevalence. We prospectively registered in PROSPERO (CRD42024499598).</p><p><strong>Results: </strong>We identified 423 studies out of which seven were included in this review. All studies were conducted in a community setting except one which was hospital based. The prevalence reported across various studies ranged from 13.96% to 70.1%. The pooled prevalence of multimorbidity was observed to be 25.05% (95% CI: 16.99 to 34.09). The number of conditions used to assess multimorbidity ranged from four to nine. The major risk factors identified were increasing age, urban residence, and lower literacy rates.</p><p><strong>Conclusion: </strong>A wide variance in the prevalence of multimorbidity was observed. Moreover, multimorbidity assessment tool/conditions considered for assessing multimorbidity were heterogeneous.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241284022"},"PeriodicalIF":0.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409287/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142302669","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christine Loyd, Lauren Picken, Richelle Sanders, Yue Zhang, Richard E Kennedy, Cynthia J Brown
{"title":"Changes in multimorbidity among hospitalized adults in the US.","authors":"Christine Loyd, Lauren Picken, Richelle Sanders, Yue Zhang, Richard E Kennedy, Cynthia J Brown","doi":"10.1177/26335565241283436","DOIUrl":"10.1177/26335565241283436","url":null,"abstract":"<p><strong>Objective: </strong>This investigation examines burden of comorbidity measured by the Charlson Comorbidity Index (CCI) and Elixhauser Comorbidity Index (ECI) among inpatients based on age, sex, and race.</p><p><strong>Methods: </strong>Cross-sectional analysis of 2012-2018 US NIS datasets. Participants were inpatients 55y+. ICD-9/10 codes for admitting diagnoses were used to calculate disease burden using the CCI and ECI. Unweighted mean CCI and ECI scores were compared across demographic variables.</p><p><strong>Results: </strong>An increase in mean CCI and ECI scores across age, sex, and races (p<.001) was identified. Compared to the youngest age group (55-59y), all age groups had higher mean CCI and ECI adjusting for time (p<.001). Increases were greatest in older age groups until age 80-84 for CCI and 85-89 for ECI. The female group had lower CCI adjusting for time (p<.001) compared to males. There was no difference between sex groups in mean ECI (p=.409). Compared with the White group, all other race groups had higher mean CCI adjusting for time (p<.001). Black inpatients had the highest CCI followed by Native American inpatients. Findings were similar for ECI, but with no difference between Hispanic and White groups (p=.434).</p><p><strong>Conclusions: </strong>Growing multimorbidity burden among adult inpatients across age, sex, and race supports the continued need for programs for preventing and reducing multimorbidity, especially among communities that experience health inequity including older, Black, and Native American patients.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241283436"},"PeriodicalIF":0.0,"publicationDate":"2024-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11375669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Roja Varanasi, Abhinav Sinha, Meenakshi Bhatia, Debadatta Nayak, Raj K Manchanda, Rajeev Janardhanan, John Tayu Lee, Simran Tandon, Sanghamitra Pati
{"title":"Epidemiology and impact of chronic disease multimorbidity in India: a systematic review and meta-analysis.","authors":"Roja Varanasi, Abhinav Sinha, Meenakshi Bhatia, Debadatta Nayak, Raj K Manchanda, Rajeev Janardhanan, John Tayu Lee, Simran Tandon, Sanghamitra Pati","doi":"10.1177/26335565241258851","DOIUrl":"10.1177/26335565241258851","url":null,"abstract":"<p><strong>Objectives: </strong>This is the first systematic review and meta-analysis of the prevalence of multimorbidity, its risk factors including socioeconomic factors, and the consequences of multimorbidity on health systems and broader society in India.</p><p><strong>Methods: </strong>A systematic review of both published and grey literature from five databases (Medline, Embase, EBSCO, Scopus, and ProQuest) was conducted including original studies documenting prevalence or patient outcomes associated with multimorbidity among adults in India. We excluded studies that did not explicitly mention multimorbidity. Three independent reviewers did primary screening based on titles and abstracts followed by full-text review for potential eligibility. The risk of bias was independently assessed by two reviewers following the Appraisal Tool for Cross-Sectional Studies. We presented both qualitative and quantitative (through meta-analysis) summaries of the evidence. The protocol for this study was prospectively registered with PROSPERO (CRD42021257281).</p><p><strong>Results: </strong>The review identified 5442 articles out of which 35 articles were finally included in this study. Twenty-three studies were based on the primary data while 12 used secondary data. Eleven studies were conducted in hospital/primary care setting while 24 were community-based. The pooled prevalence of multimorbidity based on (n=19) studies included for meta-analysis was 20% (95% CI: 19% to 20%). The most frequent outcomes were increased healthcare utilization, reduced health-related quality of life, physical and mental functioning.</p><p><strong>Conclusion: </strong>We identified a wide variance in the magnitude of multimorbidity across age groups and regions with most of the studies from eastern India. Nation-wide studies, studies on vulnerable populations and interventions are warranted.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241258851"},"PeriodicalIF":0.0,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11155324/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285493","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cecilia Anza-Ramirez, Lizzete Najarro, Antonio Bernabé-Ortiz, Francisco Diez-Canseco, Edward Fottrell, Ibrahim Abubakar, Akram Hernández-Vásquez, Rodrigo M Carrillo-Larco, John R Hurst, Juan Jaime Miranda
{"title":"Multimorbidity and acute infectious diseases in urban and semi-urban settings in Peru: A mixed-methods study.","authors":"Cecilia Anza-Ramirez, Lizzete Najarro, Antonio Bernabé-Ortiz, Francisco Diez-Canseco, Edward Fottrell, Ibrahim Abubakar, Akram Hernández-Vásquez, Rodrigo M Carrillo-Larco, John R Hurst, Juan Jaime Miranda","doi":"10.1177/26335565241256826","DOIUrl":"10.1177/26335565241256826","url":null,"abstract":"<p><strong>Background: </strong>The co-occurrence of chronic diseases and acute infectious events exacerbates disability and diminishes quality of life, yet research in Low- and Middle-Income countries is scarce. We aimed to investigate the relationship between infectious events and multimorbidity in resource-constrained settings.</p><p><strong>Methods: </strong>We conducted a sequential mixed-method study in Lima and Tumbes, Peru, with participants having multimorbidity from the CRONICAS Cohort Study. They completed a questionnaire on the occurrence, treatment, and health-seeking behaviour related to acute infectious events. Qualitative interviews explored the perceptions and links between multimorbidity and acute infectious events for a subgroup of participants.</p><p><strong>Findings: </strong>Among individuals with multimorbidity, low awareness of chronic conditions and poor medication adherence. The cumulative incidence for respiratory and gastrointestinal infections, the most reported acute conditions, was 2.0 [95%CI: 1.8-2.2] and 1.6 [1.2-1.9] events per person per year, respectively. Individuals with cancer (6.4 [1.6-11.2] events per person per year) or gastrointestinal reflux (7.2 [4.4-10.1] events per person per year) reported higher cumulative incidence of infectious events than others, such as those with cardiovascular and metabolic conditions (5.2 [4.6-5.8] events per person per year). Those with three or more chronic conditions had a slightly higher cumulative incidence compared with individuals with two conditions (5.7 [4.4-7.0] vs 5.0 [4.4-5.6] events per person per year). Around 40% of individuals with multimorbidity sought healthcare assistance, while others chose drugstores or didn't seek help. Our qualitative analysis showed diverse perceptions among participants regarding the connections between chronic and acute conditions. Those who recognized a connection emphasized the challenges in managing these interactions.</p><p><strong>Interpretation: </strong>Our study advances understanding of multimorbidity challenges in resource-limited settings, highlighting the impact of acute infections on patients' existing multimorbidity burden.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241256826"},"PeriodicalIF":0.0,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11119522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141155251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Co-designing municipal multimorbidity rehabilitation leveraging health literacy and social networks: Protocol for the CURIA study.","authors":"Tina Junge, Gitte Thybo Pihl, Carsten Kronborg Bak, Søren Thorgaard Skou","doi":"10.1177/26335565241258353","DOIUrl":"10.1177/26335565241258353","url":null,"abstract":"<p><strong>Background: </strong>Managing multimorbidity poses significant challenges for individuals, their families, and society due to issues with health information comprehension, communication with healthcare providers, and navigating the healthcare system. These challenges emphasise the critical need to prioritize individual and organisational health literacy. Multimorbidity is associated with a lack of social support for health; however, social networks and community dynamics can enhance health literacy. The \"Co-designing municipal rehabilitation\" (CURIA) project targets enhancing individual and organisational health literacy, and social networks for individuals with multimorbidity, with the overall aim of addressing health inequity through a collaborative local co-design process involving stakeholders.</p><p><strong>Methods: </strong>The CURIA study employs a mixed-method approach that initially explores the health literacy experiences of individuals with multimorbidity participating in rehabilitation programs in selected Danish municipalities and the practices of professionals overseeing these programs. The subsequent co-design process will comprise individuals with multimorbidity, their relatives, municipalities, general practitioners, civil society, and knowledge institutions working together. This iterative and collaborative process involves tailoring and aligning health literacy needs with responsiveness within the context of local healthcare systems and developing supportive social networks.</p><p><strong>Discussion: </strong>Given the increasing burden of multimorbidity, there is an urgent need to develop evidence-based practice for multimorbidity rehabilitation practices, developed in collaboration with municipalities and civil society. Emphasising self-care support for individuals, managing complex rehabilitation needs, and involving individuals in intervention prioritisation and customisation are crucial aspects addressed by CURIA to enhance health literacy and align municipal rehabilitation with identified needs.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241258353"},"PeriodicalIF":0.0,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11110505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141082855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}