Journal of multimorbidity and comorbidity最新文献

{"title":"Protocol for the development and validation of a Core Set for exercise-based rehabilitation of adults with multiple long-term conditions (multimorbidity) based on the World Health Organization's International Classification of Functioning, Disability, and Health (ICF) framework.","authors":"Fanuel M Bickton, James R Manifield, Felix Limbani, Justin Dixon, Anne E Holland, Rod S Taylor, Claire Calderwood, Walter Wittich, Celia L Gregson, Martin Heine, Zahira Ahmed, Ronel Roos, Sally J Singh","doi":"10.1177/26335565251343923","DOIUrl":"10.1177/26335565251343923","url":null,"abstract":"<p><strong>Background: </strong>Core outcome sets for people with multiple long-term conditions (multimorbidity) intervention studies offer an opportunity to compare data across studies and countries. However, a key research gap remains: the development of the World Health Organization (WHO) International Classification of Functioning, Disability and Health (ICF) Core Set for multimorbidity rehabilitation. ICF Core Sets are a selection of essential categories from the full ICF classification that are considered most relevant for describing the functioning of a person with a specific health condition or in a specific healthcare context. This study aims to develop and validate an ICF Core Set for exercise-based multimorbidity rehabilitation. Unlike system- or disease-specific rehabilitation, multimorbidity rehabilitation entails using a modified structure that accommodates all conditions that an individual with multimorbidity has.</p><p><strong>Methods: </strong>The three-phase, multi-method process created by the WHO and ICF Research Branch will be followed. The process will involve conducting four preparatory studies (phase 1), including (i) a systematic literature review (to examine researcher perspectives), (ii) a qualitative study (to examine patient perspectives), (iii) an expert survey (to examine health professional perspectives), and (iv) an empirical study (to examine clinical perspectives). This will be followed by an international consensus conference (phase 2) where lists of ICF categories resulting from phase 1 studies will be consolidated into a first version of an ICF Core Set for multimorbidity rehabilitation, which will be validated using an international comparative data analysis (phase 3).</p><p><strong>Conclusion: </strong>An ICF Core Set created for multimorbidity rehabilitation will (1) benefit patients with multimorbidity who are often excluded from clinical trials of single-disease rehabilitation programs, (2) ensure precise and comprehensive assessment and documentation of functioning and disability relevant to this patient population, (3) help rehabilitation providers and their patients and/or caregivers when setting rehabilitation goals and planning rehabilitative interventions to achieve those goals, (4) help researchers in the synthesis of evidence for multimorbidity rehabilitation and facilitate the comparability of data across studies and countries, and (5) provide the scientific basis from which assessment tools can be derived for use in clinical and research settings and health care administration.</p><p><strong>Trial registration: </strong>COMET database (https://www.comet-initiative.org/Studies/Details/3266).</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251343923"},"PeriodicalIF":0.0,"publicationDate":"2025-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12093010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144121565","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":"Dietary patterns and metabolic morbidities correlate among adolescents and young adults with HIV in Lagos, Nigeria: A cross-sectional study design.","authors":"Mobolaji Olagunju, Abideen Olurotimi Salako, Titilola Abike Gbaja-Biamila, Tomilola Musari-Martins, Priscilla Ngozi Ezemelue, Babasola Opaneye, Abubakar AhmadRufai Abubakar, Ibukun Oluwatomisin Odusote, Feyikemi Fasina, Adeniyi Adeyinka, Oreoluwa Alabi, Agatha Nkiru David, Lilian Ezechi, Oluwatosin O Odubela","doi":"10.1177/26335565251341388","DOIUrl":"https://doi.org/10.1177/26335565251341388","url":null,"abstract":"<p><strong>Background: </strong>The relationship between dietary patterns (DP) and health outcomes (elevated blood pressure, dyslipidaemia, hyperglycaemia, and body mass index) among adolescents and young adults (AYA) with HIV is not well understood. We aimed to identify dietary patterns and determinants associated with metabolic syndrome components among adolescents and young adults living with HIV in Lagos, Nigeria.</p><p><strong>Methods: </strong>We conducted a cross-sectional study among 180 participants at an ART clinic in Lagos. Information on sociodemographic and clinical characteristics, as well as 72-hour dietary recall were collected. Anthropometric measurements (BMI (kg/m²)) and blood pressure readings were collected. Blood samples were assayed for fasting blood sugar and lipid profiles. Statistical analysis was done using SPSS version 27, WHO Anthro Plus software.</p><p><strong>Results: </strong>The male-to-female ratio was 1:1. Four major DPs identified were DP 1 (higher consumption of beverages, vitamins, and vegetables); DP 2 (high intake of minerals, and fruits); DP3 (higher intake of carbohydrates, fat and oil); and DP4 (higher intake alcohol and vegetables). DP1 was associated with dyslipidaemia, underweight BMI and hyperglycaemia were associated with DP4, while DP2 had lower odds of overweight and elevated blood pressure.</p><p><strong>Conclusion: </strong>This outcome provides valuable insights into DPs and their association with metabolic co-morbidity among AYA with HIV. This will inform nutritional counselling and interventions to promote quality of life and health.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251341388"},"PeriodicalIF":0.0,"publicationDate":"2025-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12066859/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055665","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":"A systematic review of the use of burden of treatment theory.","authors":"Rachel C Smyth, Georgia Smith, Emily Alexander, Carl R May, Frances S Mair, Katie I Gallacher","doi":"10.1177/26335565251314828","DOIUrl":"https://doi.org/10.1177/26335565251314828","url":null,"abstract":"<p><strong>Background: </strong>Treatment burden describes the workload undertaken by people with chronic illness and multimorbidity to manage their healthcare demands and the impact on their wellbeing. Burden of Treatment Theory (BOTT) describes the work that people with multimorbidity do to self-manage chronic illness/multimorbidity and the factors that affect capacity (personal and healthcare resources, support network) to meet treatment demands. Here we aim to identify and characterise the different applications of Burden of Treatment Theory in research; to explore the contribution of Burden of Treatment Theory to advancing knowledge and understanding of treatment burden and capacity issues and to identify critiques or limitations of Burden of Treatment Theory in research.</p><p><strong>Methods: </strong>Systematic review of BOTT research published in the English language. Databases searched were Web of Science, Scopus, Medline, CINAHL and medRxiv.org. We also consulted with experts in the field. Two reviewers screened titles, abstracts and papers and undertook data extraction. Quality appraisal was undertaken using adapted CASP checklists for qualitative studies and systematic reviews and a Mixed Studies Review checklist.</p><p><strong>Results: </strong>Thirty papers included: 16 qualitative studies; 5 systematic reviews; 3 protocols; 3 discussion papers, a theory conceptual paper, a realist review and a feasibility trial. Most (n=17) originated in UK, with 3 from Australia and Argentina, 2 from Norway and one each from United States and Malawi. Nine papers mentioned use of BOTT constructs but 21 additionally provided rationale for BOTT use and demonstrated engagement with the theory. Two papers adapted/refined BOTT to the context of their research focus. Twenty-seven studies prospectively outlined use of BOTT, with only 3 applying BOTT retrospectively to report study outputs and 'inform analysis' of findings.</p><p><strong>Conclusion: </strong>BOTT provides a useful conceptual, analytical and sensitising lens in studies focusing on both the characterisation and alleviation of treatment burden through healthcare interventions, and the constructs discussed are stable and applicable across multiple settings. Future research could include use by empirical researchers in contexts needing more adaptation and critical assessment.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251314828"},"PeriodicalIF":0.0,"publicationDate":"2025-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064904/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044072","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":"Associations of built environment features with multimorbidity: A systematic review protocol.","authors":"Alistair L Carr, Philip Broadbent, Frederick K Ho, Bhautesh Jani, Jonathan R Olsen, Valerie Wells, Frances Mair","doi":"10.1177/26335565251333278","DOIUrl":"https://doi.org/10.1177/26335565251333278","url":null,"abstract":"<p><strong>Introduction: </strong>Preventing or delaying multimorbidity (people living with two or more chronic conditions) is a public health priority. It is currently uncertain if multimorbidity is associated with features of the built environment, a term describing human-made or modified features of the surroundings in which humans live.</p><p><strong>Aims: </strong>To undertake a systematic review of the literature to determine if built environment features and interventions are associated with multimorbidity and to review the analytical methods used and their implications for causal inference.</p><p><strong>Methods: </strong>Four databases will be searched (Medline, Embase, Science Citation Index Expanded, and Social Sciences Citation Index) using a prespecified search strategy that incorporates terms for both multimorbidity and the built environment, which includes aspects of neighbourhood design, transport interventions, natural environment, food environments, and housing. Inclusion criteria will include: 1) involves community-based adult populations not selected based on an index condition; and 2) a built environment exposure or intervention was assessed; and 3) outcomes include multimorbidity prevalence, incidence, or trajectory. Reference lists of included studies and previous reviews will also be searched. Two reviewers will independently screen, data extract, and quality appraise (using the ROBINS-E or RoB 2 tool). Results will be synthesised by meta-analysis or, if heterogeneity is too great, according to Synthesis without meta-analysis (SWiM) guidelines. Results will be grouped by type of exposure or intervention and by study quality.</p><p><strong>Conclusions: </strong>This systematic review will improve understanding of built environment associations with multimorbidity. It could identify aetiological pathways that support the development of multimorbidity-preventative strategies.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251333278"},"PeriodicalIF":0.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053215/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059410","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":"Outpatients' perceptions of collaboration across clinics and health literacy among patients with diabetes and at least one comorbidity: A hospital-level cross-sectional study.","authors":"Ida-Marie Dons Graversen, Steen Bønløkke Pedersen, Trine Boje Møller, Mikkel Aagaard, Charlotte Gjørup Pedersen","doi":"10.1177/26335565251333877","DOIUrl":"https://doi.org/10.1177/26335565251333877","url":null,"abstract":"<p><p><b>Background:</b> Patients with multiple chronic conditions often face fragmented care and inconsistent information, increasing their risk of serious health issues. Their perceived collaboration across clinics may be shaped by difficulties in accessing and using information for informed decision-making. This study explored the association between patient-perceived collaboration across clinics and health literacy among outpatients with diabetes and at least one comorbidity at the hospital level. <b>Methods:</b> This cross-sectional study at the outpatient clinic at Steno Diabetes Center Aarhus included all patients with diabetes and at least one comorbidity who were simultaneously receiving treatment at another outpatient clinic within the hospital. The association between patient-perceived extensive collaboration across clinics (exposure) and patient health literacy (outcome) was assessed using four selected scales and regression models. Results were presented as both unadjusted and adjusted, accounting for potential confounders. <b>Results:</b> A total of 3,435 outpatients received a survey, with 1,655 responses. Of these, 686 reported receiving cross-clinic treatment. Among the 552 respondents who answered the exposure-related question, 44.7% perceived extensive collaboration across clinics, while 55.3% perceived limited collaboration. Statistically significant differences were found in three out of four health literacy scales, with those who perceived limited collaboration scoring lower in areas related to managing their health and engaging with healthcare providers. <b>Conclusion:</b> The findings suggest that outpatients with comorbidities and perceived poor clinic collaboration may have low health literacy, highlighting the need to address this in their treatment and communication with healthcare providers. Future research is needed to determine whether limited perception arises from personal challenges, elements of the treatment process, or relational and organizational issues across clinics, in order to improve the perception of collaboration and clinical outcomes.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251333877"},"PeriodicalIF":0.0,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12044271/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043257","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":"Experiences of and reactions to race-based differential treatment with multiple chronic conditions by race: Evidence from the South Carolina behavioral risk factor surveillance systems surveys prior to the COVID-19 pandemic.","authors":"Kellee White Whilby, Kaitlynn Robinson-Ector","doi":"10.1177/26335565251339236","DOIUrl":"https://doi.org/10.1177/26335565251339236","url":null,"abstract":"<p><strong>Background: </strong>Multiple chronic conditions (MCCs) are of increasing public health concern. There remain significant gaps in understanding the relationship between racial discrimination as a determinant of MCC burden. This study examines the association between race-based differential treatment and MCC prevalence by race.</p><p><strong>Methods: </strong>We analyzed data from Black and White adults who completed the South Carolina Behavioral Risk Factor Surveillance System (2016-2017) survey Reactions to Race optional module (n=18,047). MCCs were summed and categorized (0; 1; 2-3; 4+ conditions). Racial discrimination was operationalized across multiple domains: experiences of race-based differential treatment in work settings and in healthcare settings, and emotional and physical reactions to race-based differential treatment. Multinomial logistic regression models were stratified by race and adjusted for confounders.</p><p><strong>Results: </strong>Overall, 63.7% of Black and 60.4% of White adults had ≥2 MCC. Experiences of race-based differential treatment in work and health care settings and emotional reactions to race-based differential treatment were associated with a higher risk of MCCs among Black and White adults.</p><p><strong>Conclusions: </strong>Our findings suggest that experiences and reactions to race-based differential treatment were associated with greater MCC burden among Black and White adults. This adds to a growing literature highlighting the importance of examining racial discrimination as a key factor contributing to the MCC burden within populations. Future research should interrogate potential social mechanisms identifying high MCC risk within racial groups.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251339236"},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12041679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144036225","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":"Perceived benefits and barriers of multidisciplinary teams in the management of diabetes and comorbidities among physicians: A qualitative double-center study.","authors":"Jonas D Andersen, Stine J Bugge, Mette J Rothmann, Sisse H Laursen, Stine Hangaard","doi":"10.1177/26335565251336425","DOIUrl":"https://doi.org/10.1177/26335565251336425","url":null,"abstract":"<p><strong>Background: </strong>The dynamics of working within multidisciplinary teams (MDTs) to manage diabetes and comorbidities remain underexplored. Investigating physicians' experiences provide insights into the benefits and challenges of MDTs in this complex context, paving the way for improving current practices and shaping future interventions to better address the needs of this patient population.</p><p><strong>Aim: </strong>To explore perceived benefits and barriers of MDTs in the management of people with diabetes and comorbidities among physicians.</p><p><strong>Methods: </strong>Eleven semi-structured interviews (duration 26-38 min) were conducted online among physicians. Criterion sampling of physicians from relevant medical specialties and with experience from MDTs were included. Interviews were analyzed using thematic analysis.</p><p><strong>Results: </strong>Four major themes emerged from the thematic analysis: (1) benefits of MDT, (2) challenges related to MDT, (3) the need for MDTs and cross-sectorial work, and (4) prerequisites for successful MDTs. Improved professional learning and relationships, enhanced capacity leverage, and optimized treatment were some of the major benefits. Siloed healthcare systems and cultures and resource demanding MDTs were considered barriers. Composition and outline of the MDTs, including the role of general practitioners (GPs), were considered important aspects of MDTs. The increase in multimorbidity, polypharmacy, and complexity in patient pathways necessitates MDTs and cross-sectorial work.</p><p><strong>Conclusion: </strong>Our findings indicate several benefits and barriers of MDTs. MDTs and cross-sectorial work are needed prospectively in healthcare and hold the potential to embrace some of the challenges encountered by people with diabetes and comorbidities. Understanding and incorporating experiences of physicians could inform future improvements in care management.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251336425"},"PeriodicalIF":0.0,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035121/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058201","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":"Association of multimorbidity with working life expectancy among adults aged 50 years and older: Findings from two prospective cohort studies.","authors":"Katriina Heikkilä, Jaana Pentti, Holendro Singh Chungkham, Sakari Suominen, Mika Kivimäki, Paola Zaninotto, Jenni Ervasti, Jussi Vahtera, Sari Stenholm","doi":"10.1177/26335565251331187","DOIUrl":"https://doi.org/10.1177/26335565251331187","url":null,"abstract":"<p><strong>Background: </strong>Individual diseases are important risk factors for early exit from the labour force among older adults, but the contribution of multimorbidity to working life expectancy (WLE) is unclear.</p><p><strong>Methods: </strong>We used data from two prospective cohort studies: Finnish Public Sector study (FPS) and Health and Social Support Study (HeSSup). Multimorbidity at baseline was ascertained from a combination of self-reported, physician-diagnosed chronic diseases, and nationwide cancer and medication reimbursement registers. WLE from age 50 up to 68 years was ascertained utilising linked data from a nationwide register of pensionable earnings. WLE was estimated utilising a multi-state models in R.</p><p><strong>Results: </strong>Our findings were based on data from 56,079 women and 17,078 men aged ≥50 years. In FPS, women and men with two chronic diseases could expect to work about 9 months less and those with three or more chronic diseases could expect to work about a year less than those with no chronic disease. In HeSSup, women and men with three or more diseases had about 2-3 years shorter WLEs than those with no disease. In both studies participants with physical-mental multimorbidity had 3-12 months shorter WLEs and individuals with multimorbidity comprising two physical diseases had 8-10 months shorter WLEs than those with no chronic disease. The patterns were similar across the socioeconomic positions.</p><p><strong>Conclusion: </strong>Women and men with multiple chronic diseases could expect to work ∼1 year less than those with no chronic disease. The differences in WLE can have important economic implications to individuals, health services and society.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251331187"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033512/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065209","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":"Prevalence of multimorbidity during 18 years in Denmark. A nationwide register study.","authors":"Rasmus Køster-Rasmussen, Volkert Siersma, Dagny R Nicolaisdóttir, Frederikke A Modin, Asger Waagepetersen, Maarten Rozing, Anne Holm, Susanne Reventlow, Tora G Willadsen","doi":"10.1177/26335565251331182","DOIUrl":"https://doi.org/10.1177/26335565251331182","url":null,"abstract":"<p><p><b>Background:</b> The number of patients with multimorbidity challenges healthcare systems worldwide. <b>Objective:</b> To explore the development of multimorbidity prevalence in the Danish population over the course of 18 years. <b>Design:</b> National registers were used to form eighteen cohorts including all persons aged ≥18 years; one cohort for each separate calendar year from 2000 to 2018. Multimorbidity was defined based on ten diagnosis groups (ICD-codes): lung, musculoskeletal, endocrine, mental, cancer, neurological, gastrointestinal, cardiovascular, genitourinary, and sensory organs. At least two diagnoses from different diagnosis groups had to be present to be considered multimorbidity. The diagnoses were from hospital contacts in the Danish health registers. We report both ≥2 and ≥4 multimorbidity. <b>Results:</b> From 2000-2018, the prevalence of multimorbidity increased from 7.1 % to 16.1 % with a relative increase of 126% and 314% for ≥2 and ≥ 4 diagnosis groups, respectively. The oldest age groups had the highest prevalence. In 2018, half of the population aged ≥80 years had multimorbidity. Young women showed the relatively largest prevalence increase of ≥ 4 multimorbidity. In absolute terms, the number of musculoskeletal diagnoses increased the most, whereas genitourinary, endocrinological, and musculoskeletal diagnoses showed the highest relative increase. <b>Conclusions:</b> In Denmark, the prevalence of patients with multimorbidity is increasing, and it has more than doubled from 2000-2018. The observed development in occurrence of multimorbidity over time may serve as relevant input for governments when rethinking the health care.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251331182"},"PeriodicalIF":0.0,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144055527","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":"Non-communicable disease multi-morbidity in policies from India, Thailand, and South Africa: A comparative document review.","authors":"Linju Joseph, Rakhal Gaitonde, Charutha Retnakumar, Athira Krishnan, Thoniparambil Ravindranathanpillai Lekha, Neethu Sasidharan, André van Rensburg, Naomi Levitt, Nilawan Upakdee, Jissa Vinoda Thulaseedharan, Mathew Joseph Valamparampil, Sivadasanpillai Harikrishnan, Sheila Greenfield, Paramjit Gill, Justine Davies, Semira Manaseki-Holland, Panniyammakal Jeemon","doi":"10.1177/26335565251330371","DOIUrl":"https://doi.org/10.1177/26335565251330371","url":null,"abstract":"<p><strong>Background: </strong>Over the years, non-communicable diseases (NCDs), as well as the number of people with multiple chronic NCDs or multi-morbidity, are on a sharp rise globally, especially in low and middle-income countries (LMICs). This review attempts to deepen the knowledge (policy landscape) of how managing multiple NCDs and associated challenges are addressed across the health systems policies from India, South Africa and Thailand.</p><p><strong>Methods: </strong>We conducted a search of two search engines (PubMed and Google) and the websites of national departments from February 2022 to December 2022. An analytical framework was produced for the qualitative document analysis, focusing on definitions of multi-morbidity, potential policy actions at patient, provider, health system, and macro-level domains, including social determinants of health. We utilised framework analysis of the national-level policies and related documents to explore the co-existent nature of multiple NCDs in India, South Africa, and Thailand.</p><p><strong>Results: </strong>Of the 54 analysed documents, 11 (20.4%) were national policies/ programmes, 15 (27.8%) were operational or implementation or management guidelines, 12 (22.2%) were training manuals, 16 (29.6%) were action plans/ strategic plans/ frameworks. None of the countries had specific policies dealing with NCD multi-morbidity. Findings from the thematic analysis showed that health promotion activities at patient-level targeted multiple risk factors; however self-management support is for specific NCDs such as diabetes.</p><p><strong>Conclusions: </strong>Our study highlights the need for dedicated policies that adopt a patient-centred and integrated approach with appropriate consideration of social determinants of health and health inequalities within these policies to manage NCD multi-morbidity holistically and effectively.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"15 ","pages":"26335565251330371"},"PeriodicalIF":0.0,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144044259","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}