Journal of multimorbidity and comorbidity最新文献

{"title":"Associations between bullous pemphigoid and comorbidities: A Swedish nationwide cohort study of 5,738 patients.","authors":"Zeyad Albadri, Henrike Häbel, Kristofer Thorslund, Carina Grönhagen, Oliver Seifert","doi":"10.1177/26335565261455676","DOIUrl":"10.1177/26335565261455676","url":null,"abstract":"<p><strong>Background: </strong>Bullous pemphigoid (BP) has been linked to neurological and psychiatric disorders, but no nationwide population-based study has comprehensively examined the association of various comorbidities in BP patients in Sweden.</p><p><strong>Objectives: </strong>To investigate the associations between BP and various comorbidities, comparing these conditions before and after BP diagnosis with a matched control group.</p><p><strong>Methods: </strong>A nationwide cohort study was conducted in Sweden from 2005 to 2016, including 5,738 BP cases and 17,167 age, sex and county of residence matched controls. Multivariable Cox proportional hazard regression models were used to calculate hazard ratios (HR). Univariable logistic regression assessed pre-diagnosis comorbidities, generating prevalence odds ratios (POR) with 95% confidence intervals (CI).</p><p><strong>Results: </strong>BP was associated with a significantly higher overall HR for comorbidity (HR: 2.20, 95% CI: 2.08-2.33). Before BP diagnosis, the overall comorbidity was significantly increased POR 2.72 (95% CI: 2.56-2.90). Pre-diagnosis association included dementia, Parkinson's disease, epilepsy, amyotrophic lateral sclerosis, multiple sclerosis, schizophrenia, unipolar/bipolar disorders, suicide, diabetes, stroke, systemic lupus erythematosus, systemic sclerosis, psoriasis, lichen planus, alopecia areata, and vitiligo. After diagnosis, the overall hazard ratio (HR) for comorbidities was highest within the first year (HR 2.88, 95% CI: 2.68-3.10) and remained elevated beyond one year (HR 1.57, 95% CI: 1.44-1.71). Post-diagnosis associations remained elevated for dementia, Parkinson's disease, epilepsy, schizophrenia, unipolar/bipolar, diabetes, psoriasis, lichen planus and autoimmune diseases such as systemic sclerosis and Sjögren's syndrome.</p><p><strong>Conclusion: </strong>BP is strongly associated with neurodegenerative, psychiatric, autoimmune, and metabolic comorbidities before and after diagnosis, highlighting their clinical significance as predisposing and prognostic factors in BP patients.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261455676"},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13198647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148019188","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":"Magnitude of multimorbidity and associated factors among stroke survivors in public hospitals of Ethiopia.","authors":"Getachew Azeze Eriku, Chalachew Mersha, Tesfa Kasa, Destaw Marie Merawie, Ermias Solomon Yalew, Mihret Dejen Takele","doi":"10.1177/26335565261455727","DOIUrl":"10.1177/26335565261455727","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is a growing global challenge, associated with premature death, impaired activities of daily living, reduced capacity for independent living, poor functional outcomes, and lower quality of life. However, there is limited evidence on multimorbidity and their determining factors among stroke survivors in the Ethiopian context. This study aimed to assess the prevalence of multimorbidity and its associated factors among stroke survivors in public hospitals of Amhara Regional State Northwest Ethiopia.</p><p><strong>Methods: </strong>A multi-center, institution-based cross-sectional study was conducted from June 26 to August 30, 2024. Systematic random sampling was used to select 292 study participants. Data were collected using a structured, interviewer-administered questionnaire and chart review. Bivariable and multivariable logistic regression analyses were performed to identify factors associated with multimorbidity. Variables with a p-value < 0.05 in multivariable analysis were considered statistically significant.</p><p><strong>Result: </strong>The prevalence of multimorbidity was 72.9%. Hypertension was the most frequently reported comorbidity. Significant factors associated with multimorbidity included age 50 and above (AOR: 2.48, 95% CI: 1.29, 4.74), having no formal education (AOR: 3.72, 95% CI: 1.49, 9.26), secondary education (AOR: 3.76, 95% CI: 1.46, 9.73), use of assistive technology (AOR: 2.60, 95% CI: 1.32, 5.09), duration of hospitalization (AOR:3.08,95%CI:1.37,6.95)<b>,</b> and post-stroke disability (AOR: 4.47, 95% CI: 2.23,8.93).</p><p><strong>Conclusions: </strong>Multimorbidity is highly prevalent. Targeted interventions particular focus on aged population, educational status, assistive technology provision, and post-stroke disability are essential to improve health outcomes.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261455727"},"PeriodicalIF":2.7,"publicationDate":"2026-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199702/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148038556","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":"The content and processes of patient-derived quality of care indicators for people living with multiple long-term conditions (MLTC): A scoping review.","authors":"Sara Tavares, Thomas Beaney, Arad Reisberg, Ania Henley, David Belsey, Angela Edwards, Laura E Downey","doi":"10.1177/26335565261451686","DOIUrl":"10.1177/26335565261451686","url":null,"abstract":"<p><strong>Background: </strong>The growing prevalence of multiple long-term conditions (MLTC) poses a public health challenge. Existing quality of care (QoC) indicators are poorly suited to the needs of MLTC populations with limited clarity on how quality should be measured. This scoping review aimed to map QoC indicators for MLTC in primary care developed with patient and caregiver input, and to characterise the methods and extent of that involvement.</p><p><strong>Methods: </strong>Scoping review following the six-stage framework by Arksey and O'Malley refined by Levac et al. Searches were conducted on six databases. Studies were included if adults with two or more chronic conditions were involved. Data were charted on indicator content (name, quality domain, data sources, measurement characteristics) and development processes (methodological approaches and stakeholders involved). Where indicators were not specified, qualitative findings were synthesised to identify QoC domains and mapped to the Donabedian model and Institute of Medicine quality domains. Community partners with lived experience of MLTC were involved.</p><p><strong>Results: </strong>Twenty-five studies were included, 78 QoC indicators were identified and a further 33 quality domains were synthesised through thematic analysis. Quality was predominately measured through patient-experience surveys rather than indicators. Studies articulated quality through care processes such as care coordination, shared decision-making and holistic assessments. Outcomes focused on functional capacity, social participation and quality of life.</p><p><strong>Conclusion: </strong>Despite robust evidence on what matters to people living with MLTC, few patient-derived QoC indicators have been developed into measurable indicators. Further work is needed to co-produce indicators suitable to existing primary care settings.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261451686"},"PeriodicalIF":2.7,"publicationDate":"2026-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13180098/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147977687","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":"Validation of the Global Treatment Burden Question (GTBQ): A novel single-item measure for use in clinical and research settings.","authors":"Chloe Gamlin, Rachel Johnson, Lauren J Scott, Anastasiia Kovalenko, Rebecca Goulding, Thomas Brain, Simon Chilcott, Thomas Blakeman, Jose M Valderas, Simon D S Fraser, Polly Duncan","doi":"10.1177/26335565261443779","DOIUrl":"10.1177/26335565261443779","url":null,"abstract":"<p><strong>Background: </strong>A single-item, global measure could be valuable for identifying patients with high treatment burden within clinical practice and research.</p><p><strong>Aim: </strong>To validate a novel single-item global measure, named the 'Global Treatment Burden Question' (GTBQ).</p><p><strong>Methods: </strong>GTBQ: \"how hard have you found the work of looking after your health conditions?\" (responses \"not hard\", \"slightly hard\", \"moderately hard\", \"very hard\", \"extremely hard\"). Included participants: 18-65 years, ≥2 long-term conditions. Baseline survey: GTBQ, socio-demographics, Multimorbidity Treatment Burden Questionnaire (MTBQ), quality of life, health literacy. Follow-up survey: GTBQ. Electronic health records data: long-term conditions, consultations. Spearman's Rank correlation (R_s) and intraclass correlation coefficient (ICC) assessed construct validity and test-retest reliability. GTBQ performance was examined against global MTBQ scores to determine optimal thresholds.</p><p><strong>Results: </strong>974 (mean age 51) and 97 participants returned baseline and follow-up surveys, respectively. Responses were positively skewed with 22% reporting no burden at baseline. GTBQ scores were positively associated with global MTBQ scores (R_s 0.70); weakly associated with health literacy (R_s 0.36) and healthcare use (R_s 0.27); and negatively associated with physical health (R_s -0.66) and mental health (R_s -0.65). ICC was 0.66. GTBQ demonstrated excellent ability to discriminate between high and non-high treatment burden (area under the curve 0.838). Applying a GTBQ threshold of ≥3 yielded specificity 90%, sensitivity 53%, positive-predictive-value 82%, and negative-predictive-value 69%, indicating utility in 'ruling in' high treatment burden.</p><p><strong>Conclusion: </strong>This novel single-item measure has demonstrated good content and construct validity, moderate test-retest reliability, and strong ability to discriminate between high and non-high treatment burden.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261443779"},"PeriodicalIF":2.7,"publicationDate":"2026-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13153489/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147870668","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":"Childhood socioeconomic disadvantage and adult multimorbidity: A systematic review and meta-analysis.","authors":"Philip Broadbent, Alistair Carr, Erik Igelström, Valerie Wells, Anna Pearce, Daniel Kopasker, Srinivasa Vittal Katikireddi","doi":"10.1177/26335565261447702","DOIUrl":"10.1177/26335565261447702","url":null,"abstract":"<p><strong>Background: </strong>Childhood socioeconomic disadvantage is linked to individual chronic diseases in adulthood, but its relationship with multimorbidity remains unclear. Understanding this is crucial for informing prevention strategies and the economic case for investment. This review and meta-analysis evaluated the association between childhood disadvantage and adult multimorbidity.</p><p><strong>Methods: </strong>Following pre-registration (PROSPERO: CRD42024588657), we searched MEDLINE, SocIndex, ASSIA, and ProQuest Public Health to March 2025 for studies assessing childhood socioeconomic circumstances (SECs) and adult multimorbidity (≥2 chronic conditions). Risk of bias was assessed using ROBINS-E and evidence certainty using GRADE. Random-effects meta-analysis and synthesis without meta-analysis (SWiM) were conducted. Subgroup analyses explored heterogeneity by region, design, and exposure type.</p><p><strong>Results: </strong>From 5,617 records, 10 studies met inclusion criteria. Most were cross-sectional, using retrospective reports of exposure and self-reported outcomes. Exposures included perceived childhood economic adversity (n=6), parental education (n=4), parental occupation (n=1), and composite measures (n=3). Meta-analyses found no clear associations for perceived adversity (OR 1.08, 95% CI 0.87-1.23; I² = 94.4%) or parental education (father's (Odds ratio (OR) 0.95, 95% CI 0.66-1.37; I² = 66.8%); mother's (OR 1.07, 95% CI 0.70-1.61; I² = 36.9%)). Relative Index of Inequality estimates generally indicated higher mortality risk with greater childhood disadvantage, though effect sizes varied widely and some studies suggested the reverse.. All studies were high/very high risk of bias with very low certainty.</p><p><strong>Conclusions: </strong>Evidence for an association between childhood socioeconomic disadvantage and adult multimorbidity is limited and uncertain. Findings suggest possible harmful effects but remain constrained by methodological weaknesses and heterogeneity. High-quality longitudinal studies with standardised multimorbidity definitions are needed.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261447702"},"PeriodicalIF":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847148","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":"The impact of multiple long-term conditions on engaging with and maintaining behaviour change in older people with mild frailty: A qualitative study.","authors":"Tasmin Alanna Rookes, Jessica Catchpole, Kate Walters, Yolanda Barrado-Martín, Sarah Kalwarowsky, Christina Avgerinou, Benjamin Gardner, Rebecca L Gould, Paul Chadwick, Jane Hopkins, Vari M Drennan, Kalpa Kharicha, Louise Marston, Claire Jowett, Rashmi Kumar, Rekha Elaswarapu, Rachael Frost","doi":"10.1177/26335565261448335","DOIUrl":"10.1177/26335565261448335","url":null,"abstract":"<p><p>Managing multiple long-term conditions (MLTCs) is a growing priority for health and social care systems, as MLTCs often lead to frailty and reduced resilience to adverse health events. Behaviour change interventions for this population have shown limited effectiveness. We developed HomeHealth, a home-based behaviour change intervention for older adults with mild frailty and evaluated it in a randomised controlled trial in England. As part of the process evaluation, we conducted a qualitative sub-study to examine barriers and facilitators to engagement, approaches to goal setting, and strategies for tailoring future interventions. Forty-nine participants with MLTCs who received HomeHealth were interviewed, within 6-months of their final intervention session. Participants had an average age of 80.3 years, 65% female, 76% white British, and lived with an average of 5.1 health conditions (range 2-11). Data were thematically analysed. Three themes were developed: (1) prioritising symptoms over conditions; (2) coping with and adapting to symptoms; and (3) tailoring goal setting for MLTCs. Impacts were driven by cumulative symptom burden rather than diagnoses, with mobility-related impairment being the primary concern. Symptom-focused goal setting supported engagement, but symptom fluctuations hindered progress. Findings underscore the importance of person-centred approaches. Targeting goals around functional impairment and symptom management may improve engagement compared to condition-focused strategies. Supporting adaptive behaviours during symptom exacerbations and providing positive feedback on effort, rather than completion, could sustain motivation and promote long-term behaviour change.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261448335"},"PeriodicalIF":2.7,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145010/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147847228","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":"Multimorbidity and health related quality of life in U.S. adults: A population-based study.","authors":"Monira Alwhaibi, Bander Balkhi","doi":"10.1177/26335565261446084","DOIUrl":"10.1177/26335565261446084","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity, having two or more chronic conditions, is a growing public health concern associated with substantial health and societal burdens. However, evidence on its impact on health-related quality of life (HRQoL) among U.S. adults remains limited. This study fills a major research gap by examining the association between multimorbidity and HRQoL among U.S. adults, a population often overlooked in prior research and provides evidence to inform policies aligned with national and global health goals for reducing the chronic disease burden.</p><p><strong>Methods: </strong>A cross-sectional study was conducted among adults aged 18 to 64 years. Data from the Medical Expenditure Panel Survey was used in this study for years 2019 to 2021. The primary study outcome was the HRQoL; it was evaluated using the 12-item Veterans RAND 12. Descriptive analysis was used to describe the characteristics of the study sample. The adjusted relationship between Multimorbidity and HRQoL was assessed using the multivariable linear regression after other factors were adjusted in the regression analysis.</p><p><strong>Results: </strong>The study sample consists of 30,827 adults. Multimorbidity was prevalent among 23.4% of adults. It was higher among women, unemployed, poor, and physically inactive adults. Adults with multimorbidity had a lower mean HRQoL score than those without multimorbidity (Physical health = 46.06 vs. 53.29, Mental health = 47.62 vs. 52.37). Results from the adjusted linear regression model found that adults with multimorbidity have a significantly lower HRQoL in both the physical domain (β = -2.658, p-value<0.0001), and the mental domain (β = -3.119, p-value<0.0001).</p><p><strong>Conclusions: </strong>Multimorbidity has a substantial negative impact on both physical and mental aspects of HRQoL in U.S. adults. These findings highlight the need for targeted public health strategies and clinical interventions, such as promoting integrated chronic disease management to address the burden of multimorbidity. Future research should explore specific condition clusters most strongly associated with reduced HRQoL to better inform policy and care models.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261446084"},"PeriodicalIF":2.7,"publicationDate":"2026-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13110340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791407","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":"Patient and public involvement in clinical trials to improve outcomes for adults with multimorbidity in primary care and community settings: A systematic review protocol.","authors":"Elizabeth A O'Donnell, Zara Khwaja, Susan M Smith, Carmel P Geoghegan, Martin Quinn, Laura J Sahm, Edel Burton, Ann Sinéad Doherty, Emma Wallace","doi":"10.1177/26335565261427228","DOIUrl":"10.1177/26335565261427228","url":null,"abstract":"<p><strong>Background: </strong>Patient and public involvement (PPI) in clinical trials for adults with multimorbidity (multiple long-term conditions) in primary care is essential to ensure research is person-centred. However, PPI is often underreported, limiting understanding of its application and impact. This protocol describes a systematic review examining the uptake, impact and reporting quality of PPI in clinical trials of interventions to improve mental health, clinical or quality-of-life outcomes for adults with multimorbidity in primary care.</p><p><strong>Methods: </strong>The review will be guided by the Cochrane Handbook and reported according to PRISMA-P guidelines. Eligible studies include completed and ongoing randomised and non-randomised controlled trials. Multimorbidity is defined as the co-existence of two or more long-term conditions. Electronic databases (MEDLINE, CINAHL, Embase, Cochrane) will be searched from 2019 to update Smith et al. (2021) without language restrictions. Trial registries and grey literature will identify protocols and supplementary data. Inclusion criteria - Population: adults with multimorbidity; Interventions: targeted at this population; Comparison: usual care; Outcomes: mental health, clinical or quality-of-life; Setting: primary or community care. Studies will be included irrespective of whether PPI was reported. Data extraction will capture PPI presence, characteristics, activities, training and acknowledgement. A narrative synthesis will describe reported PPI in clinical trials. Two PPI partners will contribute throughout the review. The protocol is registered with PROSPERO (CRD420251090082).</p><p><strong>Discussion/conclusion: </strong>This review will enhance understanding of PPI in trials aiming to improve outcomes for adults with multimorbidity in primary and community care, identify gaps in reporting, and inform future trials to support person-centred research.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261427228"},"PeriodicalIF":2.7,"publicationDate":"2026-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13022320/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147576965","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":"Multimorbidity patterns and their associations with patient-perceived treatment burden: A latent class analysis of 14,344 Danish adults.","authors":"Marie Hauge Pedersen, Mathias Lasgaard, Camilla Palmhøj Nielsen, Anders Prior, Polly Duncan, Stine Schramm, Finn Breinholt Larsen","doi":"10.1177/26335565261417433","DOIUrl":"10.1177/26335565261417433","url":null,"abstract":"<p><strong>Objectives: </strong>To identify population groups with distinct multimorbidity patterns and to examine their associations with high treatment burden.</p><p><strong>Methods: </strong>Latent class analysis was conducted using cross-sectional, self-reported data on 16 long-term conditions from Danish adults aged 25 years and older in treatment (N = 14,344), drawn from the Danish National Health Survey. Treatment burden was assessed using the Multimorbidity Treatment Burden Questionnaire, and associations between identified multimorbidity patterns and high treatment burden (score ≥22) were examined using a bias-adjusted three-step approach.</p><p><strong>Results: </strong>Eight latent classes were identified: 1 <i>Hypertension</i> (31% of the study population); 2 <i>Mental health disorders</i> (21%); 3 <i>Musculoskeletal disorders</i> (17%); 4 <i>Complex</i> <i>cardiometabolic-</i> <i>musculoskeletal</i> <i>disorders</i> (10%); 5 <i>Complex</i> <i>headache-mental-back-disorders</i> (7%); 6 <i>Asthma-</i> <i>allergy</i> (6%); 7 <i>Cataract-</i> <i>respiratory</i> <i>disorders</i> (5%); and 8 <i>Complex</i> <i>respiratory-</i> <i>musculoskeletal</i> <i>disorders</i> (3%). Overall, 13% experienced a high treatment burden. This proportion varied from 0.5% in Class 3 to 48% in Class 5, with the highest proportions associated with Classes 4 (27%), 5 (48%), and 8 (26%). The three complex multimorbidity groups averaged more than four conditions per individual and, compared to Class 1, were associated with a non-Danish background, being temporarily or permanently out of work, low social support, and difficulties engaging with healthcare providers. The prevalence of high treatment burden and the strength of its association with disease patterns decreased with age, while no substantial differences were observed across sexes.</p><p><strong>Conclusion: </strong>Specific multimorbidity patterns were strongly associated with high treatment burden. These findings may inform healthcare planning, resource allocation, and tailored interventions to reduce treatment burden.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261417433"},"PeriodicalIF":2.7,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367399","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 between treatment burden, socio-demographics, clinical factors and use of medicines in adults with polypharmacy: A cross-sectional study.","authors":"Polly Duncan, Chloe Gamlin, Deborah McCahon, Daisy Gaunt, Beenish Ashfaq, Rupert A Payne","doi":"10.1177/26335565261420367","DOIUrl":"10.1177/26335565261420367","url":null,"abstract":"<p><strong>Background: </strong>Understanding relationships between polypharmacy, treatment burden and other factors (e.g. age, knowledge of medicines), could inform interventions to reduce treatment burden.</p><p><strong>Aim: </strong>To explore sociodemographic, clinical and medication factors associated with high treatment burden.</p><p><strong>Design and setting: </strong>Secondary analysis of multi-centre UK primary care baseline clinical trial data.</p><p><strong>Methods: </strong>Participants were ≥18 years, prescribed ≥5 repeat medicines with ≥1 indicator of potentially inappropriate prescribing (PIP). Survey data captured treatment burden (13-item Multimorbidity Treatment Burden Questionnaire; dichotomised with high burden ≥22), sociodemographic characteristics, quality of life, self-reported knowledge of medicines, and medication adherence. Electronic health records provided data on age, gender, long-term conditions, PIP, medicines use (last 3 months), and consultations (last 12 months). Associations between treatment burden and other factors were modelled using multivariable logistic regression.</p><p><strong>Results: </strong>1711 adults from 37 general practices were included (mean age 72 years, 51% male). 381 (23%) reported high treatment burden. Multivariable analysis found high treatment burden was associated with younger age, being unemployed or in paid work, university or high education, multimorbidity, anxiety/depression, polypharmacy (≥8 medicines), lower medication adherence, knowledge of medicines, and quality of life. There was strong evidence (p<0.005) that the association between high treatment burden and polypharmacy was greater in people aged <60 years, those with poor knowledge of medicines, more multimorbidity, and those with low/moderate medication adherence.</p><p><strong>Conclusion: </strong>High treatment burden was more common in adults with polypharmacy who were younger, had multimorbidity, poor medication knowledge, or low adherence. This should inform design of interventions addressing treatment burden.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"16 ","pages":"26335565261420367"},"PeriodicalIF":2.7,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12957598/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147367483","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}