Journal of multimorbidity and comorbidity最新文献

{"title":"Prevalence of multimorbidity and its associated risk factors among population of Mechinagar municipality of Nepal.","authors":"Suman Lohani, Sanjib Kumar Sharma, Suman Bahadur Singh, Surendra Uranw, Anup Ghimire","doi":"10.1177/26335565241237892","DOIUrl":"10.1177/26335565241237892","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is a group of conditions, it has significant impact on the population as a whole, resulting in lower quality of life, higher mortality, frequent use of medical services, and consequently higher healthcare costs. The objective of this study is to document the prevalence of common multimorbidity and its associated risk factors among population of Mechinagar Municipality.</p><p><strong>Methods: </strong>Community-based cross-sectional study was conducted where selected multimorbidity were assessed in selected areas of Mechinagar municipality of Jhapa District . Systematic random sampling technique was used to select 590 adult participants from three pre-defined pocket areas. Pre-designed semi-structured multimorbidity assessment questionnaire for primary care (MAQ-PC)was used to assess prevalence of multimorbidity. Multiple logistic regression was conducted to identify the strongest determinants of multimorbidity.</p><p><strong>Results: </strong>The prevalence of multimorbidity was 22.4%.Hypertension, Diabetes mellitus and COPD was seen in 39.2%, 7.8.% and 4.4% of the participants respectively . Participants with advancing age i. e. 40-49yrs were 12.62 times (AOR) more likely to have multimorbidity compared to their counterparts who were 20-29yrs old( p=<0.01,CI3.01-15.28) after adjusting for occupation, physical activity and family history of kidney disease. Working individuals, Physical inactivity and positive family history of kidney disease were the strongest determinates of multimorbidity.</p><p><strong>Conclusions: </strong>The study revealed that participants with increasing age, working individuals, physical inactivity and family history of kidney disease were more vulnerable of having multimorbidity. The findings of our study indicate need of intervention strategies and community-based health promotion programs in reducing burden of chronic disease among adult population.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241237892"},"PeriodicalIF":0.0,"publicationDate":"2024-03-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10943707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140144746","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 chronic pain management with opioids and other therapies among adults in the United States: A cross-sectional study.","authors":"Rolake A Neba, Hao Wang, Misozi Kolala, Usha Sambamoorthi","doi":"10.1177/26335565241237889","DOIUrl":"10.1177/26335565241237889","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity, defined as the concurrent presence of ≥ 2 chronic conditions, and chronic pain (i.e., pain lasting ≥3 months) often co-exist. Multimodal pain management that includes non-pharmacologic treatment and non-opioid therapy is recommended to prevent serious risks associated with opioids.</p><p><strong>Purpose: </strong>Estimate the prevalence of types of pain treatment and analyze their associations with multimorbidity using a nationally representative survey in the United States (US).</p><p><strong>Methods: </strong>Data was collected from the 2020 National Health Interview Survey among adults with chronic pain and chronic conditions (N= 12,028). Chronic pain management was grouped into four categories: opioid therapy; non-opioid multimodal pain treatment<i>;</i> pain treatment with monotherapy; and no pain treatment. Chi-square tests and multivariable multinomial logistic regressions were used to analyze the association of multimorbidity with types of pain treatment after controlling for age, sex, social determinants of health (SDoH), and lifestyle characteristics.</p><p><strong>Results: </strong>Among NHIS respondents, 68% had multimorbidity. In adjusted multinomial logistic regressions with \"pain management with monotherapy\" as the reference group, those with multimorbidity were more likely to utilize opioids (AOR=1.63, 95% CI=1.23, 2.17). Those with severe pain were also more likely to use opioid therapy (AOR=19.36, 95% CI=13.35, 28.06) than those with little pain. Those with low income and education were less likely to have multimodal pain management without opioids.</p><p><strong>Conclusion: </strong>Seven in 10 adults had multimorbidity. Those with multimorbidity reported severe pain and relied on opioids for pain control. Regardless of multimorbidity status, SDoH was associated with types of chronic pain management.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241237889"},"PeriodicalIF":0.0,"publicationDate":"2024-03-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140061470","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":"Variation in multimorbidity by sociodemographics and social drivers of health among patients seen at community-based health centers.","authors":"Wyatt P Bensken, Suparna M Navale, Brenda M McGrath, Nicole Cook, Yui Nishiike, Gretchen Mertes, Rose Goueth, Matthew Jones, Anna Templeton, Stephen J Zyzanski, Siran M Koroukian, Kurt C Stange","doi":"10.1177/26335565241236410","DOIUrl":"10.1177/26335565241236410","url":null,"abstract":"<p><strong>Purpose: </strong>Understanding variation in multimorbidity across sociodemographics and social drivers of health is critical to reducing health inequities.</p><p><strong>Methods: </strong>From the multi-state OCHIN network of community-based health centers (CBHCs), we identified a cross-sectional cohort of adult (> 25 years old) patients who had a visit between 2019-2021. We used generalized linear models to examine the relationship between the Multimorbidity Weighted Index (MWI) and sociodemographics and social drivers of health (Area Deprivation Index [ADI] and social risks [e.g., food insecurity]). Each model included an interaction term between the primary predictor and age to examine if certain groups had a higher MWI at younger ages.</p><p><strong>Results: </strong>Among 642,730 patients, 28.2% were Hispanic/Latino, 42.8% were male, and the median age was 48. The median MWI was 2.05 (IQR: 0.34, 4.87) and was higher for adults over the age of 40 and American Indians and Alaska Natives. The regression model revealed a higher MWI at younger ages for patients living in areas of higher deprivation. Additionally, patients with social risks had a higher MWI (3.16; IQR: 1.33, 6.65) than those without (2.13; IQR: 0.34, 4.89) and the interaction between age and social risk suggested a higher MWI at younger ages.</p><p><strong>Conclusions: </strong>Greater multimorbidity at younger ages and among those with social risks and living in areas of deprivation shows possible mechanisms for the premature aging and disability often seen in community-based health centers and highlights the need for comprehensive approaches to improving the health of vulnerable populations.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241236410"},"PeriodicalIF":0.0,"publicationDate":"2024-02-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139992060","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 and adolescence physical activity and multimorbidity later in life: A systematic review.","authors":"Luc Souilla, Anders C Larsen, Carsten B Juhl, Søren T Skou, Alessio Bricca","doi":"10.1177/26335565241231403","DOIUrl":"10.1177/26335565241231403","url":null,"abstract":"<p><strong>Background: </strong>No systematic summary exists on childhood physical activity and later-life multimorbidity risks. We primarily investigated the association of physical activity in childhood and adolescence and the development of multimorbidity in adulthood. Secondarily, we examined whether physical activity level differ in children and adolescents with and without multimorbidity and whether there is a cross-sectional association between physical activity and multimorbidity.</p><p><strong>Methods: </strong>Following Cochrane Handbook guidelines and adhering to PRISMA recommendations, we included cross-sectional, case-control and longitudinal studies that investigated the association between physical activity in children and adolescents and development of multimorbidity. Results were summarized narratively and we assessed the certainty of the evidence using the GRADE approach. The protocol was registered in PROSPERO, CRD42023407063.</p><p><strong>Results: </strong>Of 9064 studies identified, 11 were included in 13 papers. Longitudinals studies suggested that being physically active in childhood and adolescence was associated with a lower risk of multimorbidity in adulthood. Three out of five studies reported lower physical activity level in children and adolescents with multimorbidity compared to those without, and two did not find a between-group difference. Cross-sectional evidence on the association between multimorbidity and lower physical activity was uncertain. Overall, the evidence certainty for all outcomes was considered low due to the indirectness and inconsistency in findings.</p><p><strong>Conclusions: </strong>Childhood and adolescence physical activity appeared to be linked with a reduced risk of later-life multimorbidity but the certainty of the evidence is low. These results support the promotion of physical activity during childhood and adolescence.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565241231403"},"PeriodicalIF":0.0,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139708758","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":"Patterns of multimorbidity in primary care electronic health records: A systematic review.","authors":"Giorgi Beridze, Ahmad Abbadi, Joan Ars, Francesca Remelli, Davide L Vetrano, Caterina Trevisan, Laura-Mónica Pérez, Juan A López-Rodríguez, Amaia Calderón-Larrañaga","doi":"10.1177/26335565231223350","DOIUrl":"10.1177/26335565231223350","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity, the coexistence of multiple chronic conditions in an individual, is a complex phenomenon that is highly prevalent in primary care settings, particularly in older individuals. This systematic review summarises the current evidence on multimorbidity patterns identified in primary care electronic health record (EHR) data.</p><p><strong>Methods: </strong>Three databases were searched from inception to April 2022 to identify studies that derived original multimorbidity patterns from primary care EHR data. The quality of the included studies was assessed using a modified version of the Newcastle-Ottawa Quality Assessment Scale.</p><p><strong>Results: </strong>Sixteen studies were included in this systematic review, none of which was of low quality. Most studies were conducted in Spain, and only one study was conducted outside of Europe. The prevalence of multimorbidity (i.e. two or more conditions) ranged from 14.0% to 93.9%. The most common stratification variable in disease clustering models was sex, followed by age and calendar year. Despite significant heterogeneity in clustering methods and disease classification tools, consistent patterns of multimorbidity emerged. Mental health and cardiovascular patterns were identified in all studies, often in combination with diseases of other organ systems (e.g. neurological, endocrine).</p><p><strong>Discussion: </strong>These findings emphasise the frequent coexistence of physical and mental health conditions in primary care, and provide useful information for the development of targeted preventive and management strategies. Future research should explore mechanisms underlying multimorbidity patterns, prioritise methodological harmonisation to facilitate the comparability of findings, and promote the use of EHR data globally to enhance our understanding of multimorbidity in more diverse populations.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565231223350"},"PeriodicalIF":0.0,"publicationDate":"2024-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10829499/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139652386","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 association of self-perceived changes due to COVID-19 with mental and physical health among adult primary care patients with multiple chronic conditions: A US-based longitudinal study.","authors":"Levi N Bonnell, Jessica Clifton, Lisa W Natkin, Juvena R Hitt, Benjamin Littenberg","doi":"10.1177/26335565231222148","DOIUrl":"10.1177/26335565231222148","url":null,"abstract":"<p><strong>Introduction: </strong>This study explores the association between self-perceived personal and community changes due to COVID-19 and health among vulnerable primary care patients experiencing multiple chronic conditions.</p><p><strong>Methods: </strong>Between September 2017 and February 2021, we obtained data from 2,426 primary care patients managing multiple chronic conditions from across the United States. We assessed the relationship between self-perceived personal and community changes due to COVID-19 and change in health measured by the PROMIS-29 mental and physical health summary scores, GAD-7 (anxiety), andPHQ-9 (depression), and DASI (functional capacity) adjusting for relevant demographic, neighborhood characteristics, and county covariates.</p><p><strong>Results: </strong>After adjustment, self-perceived personal and community changes due to COVID-19 were associated with significantly worse mental health summary scores (ß = -0.55; 95% Confidence Interval (CI) = -0.72, -0.37), anxiety (ß = 0.28; 95% CI = 0.16, 0.39), depression (ß = 0.35; 95% CI = 0.22, 0.47), and physical health summary scores (ß = -0.44; 95% CI = 0.88, 0.00). There was no association with functional capacity (ß = - 0.05; 95% CI = -0.16, 0.05).</p><p><strong>Discussion: </strong>Among adults managing multiple chronic conditions, self-perceived personal and community changes due to COVID-19 were associated with health. This vulnerable population may be particularly susceptible to the negative effects of COVID-19. As we do not know the long-term health effects of COVID, this paper establishes a baseline of epidemiological data on COVID-19 burden and health among primary care patients with multiple chronic conditions.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565231222148"},"PeriodicalIF":0.0,"publicationDate":"2024-01-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10798126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139511245","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 and co-prevalence of comorbidities among patients with type 2 diabetes mellitus living in Puerto Rico.","authors":"Enid J García-Rivera, Krystel Ruiz-Serrano, Edgar I Miranda, Luis C Mejía, Adolfo Pinzón, Cecile Marqués-Goyco, José G Quijada, Homero Monsanto, Juan C Orengo","doi":"10.1177/26335565231224570","DOIUrl":"10.1177/26335565231224570","url":null,"abstract":"<p><p>This is a descriptive study using healthcare claims data from patients with T2DM from public and private healthcare insurance companies providing services in Puerto Rico in 2013, aimed to estimate the prevalence of comorbidities in this population. Descriptive analyses were performed by sociodemographic, and type of service variables using frequency and percent for categorical data or means (+/-SD) or median (IQR) for continuous variables. Chi-square, Fisher exact or two-sample t-tests were used for comparisons. A total of 3,100,636 claims were identified from 485,866 adult patients with T2DM. Patients older than 65 years represented 48% of the study population. Most patients were women (57%) and had private health insurance (77%). The regions of Metro Area (17%) and Caguas (16%) had the higher number of persons living with T2DM. The overall estimated prevalence of T2DM was 17.4%. The number of claims per patient ranged from 1 to 339. A mean of 6.3 claims (SD±9.99) and a median of 3 claims (Q1 1- Q3 8) per subject were identified. Of the 3,100,636 claims most (74%) were related to the diagnosis of diabetes (59%) and associated to outpatient services (88%). The most prevalent comorbidities were hypertension (48%), hyperlipidemia (41%), neuropathy (21%); renal disease (15%), and retinopathy (13%). A high prevalence and co-prevalence of comorbidities and use of healthcare services were identified in patients with T2DM, especially in older adults. Since most comorbidities were due to diabetes-related conditions, this analysis highlights the importance of early diagnosis and adequate management of T2DM patients to avoid preventable burden to the patient and to the healthcare system.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"14 ","pages":"26335565231224570"},"PeriodicalIF":0.0,"publicationDate":"2024-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10768584/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139378939","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":"Users’ views on the use of a smartwatch app to collect daily symptom data in individuals with multiple long-term conditions (Multimorbidity): A qualitative study","authors":"C. Kenning, Peter Bower, Nicola Small, S. M. Ali, Benjamin Brown, Katherine Dempsey, Elaine Mackey, Brian McMillan, Caroline Sanders, Ilina Serafimova, S. N. van der Veer, W. Dixon, John McBeth","doi":"10.1177/26335565231220202","DOIUrl":"https://doi.org/10.1177/26335565231220202","url":null,"abstract":"Introduction Long-term conditions are a major burden on health systems. One way to facilitate more research and better clinical care among patients with long-term conditions is to collect accurate data on their daily symptoms (patient-generated health data) using wearable technologies. Whilst evidence is growing for the use of wearable technologies in single conditions, there is less evidence of the utility of frequent symptom tracking in those who have more than one condition. Aims To explore patient views of the acceptability of collecting daily patient-generated health data for three months using a smartwatch app. Methods Watch Your Steps was a longitudinal study which recruited 53 patients to track over 20 symptoms per day for a 90-day period using a study app on smartwatches. Semi-structured interviews were conducted with a sub-sample of 20 participants to explore their experience of engaging with the app. Results In a population of older people with multimorbidity, patients were willing and able to engage with a patient-generated health data app on a smartwatch. It was suggested that to maintain engagement over a longer period, more ‘real-time’ feedback from the app should be available. Participants did not seem to consider the management of more than one condition to be a factor in either engagement or use of the app, but the presence of severe or chronic pain was at times a barrier. Conclusion This study has provided preliminary evidence that multimorbidity was not a major barrier to engagement with patient-generated health data via a smartwatch symptom tracking app.","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"125 28","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139453668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to \"Exploring comorbidity and pharmacological treatment patterns in psoriasis - A retrospective population-based cross-sectional study\".","authors":"","doi":"10.1177/26335565231223601","DOIUrl":"https://doi.org/10.1177/26335565231223601","url":null,"abstract":"<p><p>[This corrects the article DOI: 10.1177/26335565231212336.].</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231223601"},"PeriodicalIF":0.0,"publicationDate":"2023-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10731994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833292","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":"Commentary on the systematic review: Models of care for improving health-related quality of life, mental health, or mortality in persons with multimorbidity: A systematic review of randomized controlled trials.","authors":"Christian U Eriksen, Nina Kamstrup-Larsen, Hanne Birke, Sofie A L Helding, Nermin Ghith, John S Andersen, Anne Frølich","doi":"10.1177/26335565231220204","DOIUrl":"10.1177/26335565231220204","url":null,"abstract":"","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565231220204"},"PeriodicalIF":0.0,"publicationDate":"2023-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729638/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138808632","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}