Journal of multimorbidity and comorbidity最新文献

{"title":"Association of Care Fragmentation with Polypharmacy and Inappropriate Medication Among Older Adults with Multimorbidity","authors":"T. Ando, Yukiko Abe, Y. Arai, Takashi Sasaki, Seitarou Fujishima","doi":"10.1370/afm.21.s1.3570","DOIUrl":"https://doi.org/10.1370/afm.21.s1.3570","url":null,"abstract":"Context: Fragmentation of care is associated with worse prognosis and higher health care costs in several conditions such as malignancy. Caring for older adults with multimorbidity often requires the involvement of multiple specialists, but the impact of fragmentation of care in older adults with multimorbidity remains unclear. In Japan, the healthcare insurance system guarantees free access, allowing patients to freely see specialists, which can easily lead to fragmentation of care. Objective: To determine how the fragmentation of care is associated with polypharmacy, potentially inappropriate prescribing, and health care costs in older adults. Study Design: An observational cross-sectional study using the baseline survey and claims data of the Cohort study. (The Kawasaki Aging and Wellbeing Project ） Setting or Dataset: Community-dwelling people. Population studied: Independent elderly aged 85-89 living in Kawasaki city, Japan. Outcome Measures: The primary outcome was the number of regularly prescribed drugs extracted from claims data. The number of potentially inappropriate drugs for the elderly and the outpatient medical care cost were used as secondary outcomes. Results: There were a total of 1026 study participants, with a 1:1 sex ratio; the mean age was 86.6 years. 650(63.4%) participants regularly visited two or more outpatient clinics. The average number of prescribed drugs was 5.3, and the more clinics a patient visited, the more drugs were prescribed. The odds ratio for polypharmacy, defined as six or more regular prescribed medications, tended to be significantly higher with more visiting clinics, even after adjusted with the number of comorbid chronic illnesses. The number of potentially inappropriate drug prescriptions for the elderly increased with the number of clinics visited. When adjusted for the number of chronic conditions, there was no significant correlation between the fragmentation of care and the number of potentially inappropriate","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79608457","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":"Convergence of four measures of multi-morbidity.","authors":"Brandon R Grossardt,&nbsp;Alanna M Chamberlain,&nbsp;Cynthia M Boyd,&nbsp;William V Bobo,&nbsp;Jennifer L St Sauver,&nbsp;Walter A Rocca","doi":"10.1177/26335565221150124","DOIUrl":"https://doi.org/10.1177/26335565221150124","url":null,"abstract":"<p><strong>Objectives: </strong>To compare the agreement between percentile ranks from 4 multi-morbidity scores.</p><p><strong>Design: </strong>Population-based descriptive study.</p><p><strong>Setting: </strong>Olmsted County, Minnesota (USA).</p><p><strong>Participants: </strong>We used the medical records-linkage system of the Rochester Epidemiology Project (REP; http://www.rochesterproject.org) to identify all residents of Olmsted County, Minnesota who reached one or more birthdays between 1 January 2005 and 31 December 2014 (10 years).</p><p><strong>Methods: </strong>For each person, we calculated 4 multi-morbidity scores using readily available diagnostic code lists from the US Department of Health and Human Services, the Clinical Classifications Software, and the Elixhauser Comorbidity Index. We calculated scores using diagnostic codes received in the 5 years before the index birthday and fit quantile regression models across age and separately by sex to transform unweighted, simple counts of conditions into percentile ranks as compared to peers of same age and of same sex. We compared the percentile ranks of the 4 multi-morbidity scores using intra-class correlation coefficients (ICCs).</p><p><strong>Results: </strong>We assessed agreement in 181,553 persons who reached a total of 1,075,433 birthdays at ages 18 years through 85 years during the study period. In general, the percentile ranks of the 4 multi-morbidity scores exhibited high levels of agreement in 6 score-to-score pairwise comparisons. The agreement increased with older age for all pairwise comparisons, and ICCs were consistently greater than 0.65 at ages 50 years and older.</p><p><strong>Conclusions: </strong>The assignment of percentile ranks may be a simple and intuitive way to assess the underlying trait of multi-morbidity across studies that use different measures.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"13 ","pages":"26335565221150124"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/0a/f6/10.1177_26335565221150124.PMC9813979.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10540556","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 DynAIRx Project Protocol: Artificial Intelligence for dynamic prescribing optimisation and care integration in multimorbidity.","authors":"Lauren E Walker, Aseel S Abuzour, Danushka Bollegala, Andrew Clegg, Mark Gabbay, Alan Griffiths, Cecil Kullu, Gary Leeming, Frances S Mair, Simon Maskell, Samuel Relton, Roy A Ruddle, Eduard Shantsila, Matthew Sperrin, Tjeerd Van Staa, Alan Woodall, Iain Buchan","doi":"10.1177/26335565221145493","DOIUrl":"10.1177/26335565221145493","url":null,"abstract":"<p><strong>Background: </strong>Structured Medication Reviews (SMRs) are intended to help deliver the NHS Long Term Plan for medicines optimisation in people living with multiple long-term conditions and polypharmacy. It is challenging to gather the information needed for these reviews due to poor integration of health records across providers and there is little guidance on how to identify those patients most urgently requiring review.</p><p><strong>Objective: </strong>To extract information from scattered clinical records on how health and medications change over time, apply interpretable artificial intelligence (AI) approaches to predict risks of poor outcomes and overlay this information on care records to inform SMRs. We will pilot this approach in primary care prescribing audit and feedback systems, and co-design future medicines optimisation decision support systems.</p><p><strong>Design: </strong>DynAIRx will target potentially problematic polypharmacy in three key multimorbidity groups, namely, people with (a) mental and physical health problems, (b) four or more long-term conditions taking ten or more drugs and (c) older age and frailty. Structured clinical data will be drawn from integrated care records (general practice, hospital, and social care) covering an ∼11m population supplemented with Natural Language Processing (NLP) of unstructured clinical text. AI systems will be trained to identify patterns of conditions, medications, tests, and clinical contacts preceding adverse events in order to identify individuals who might benefit most from an SMR.</p><p><strong>Discussion: </strong>By implementing and evaluating an AI-augmented visualisation of care records in an existing prescribing audit and feedback system we will create a learning system for medicines optimisation, co-designed throughout with end-users and patients.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"12 ","pages":"26335565221145493"},"PeriodicalIF":0.0,"publicationDate":"2022-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9761229/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10785864","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":"Physician-led in-hospital multidisciplinary team conferences with multiple medical specialities present - A scoping review.","authors":"Daniel Pilsgaard Henriksen, Zandra Nymand Ennis, Vasiliki Panou, Jørgen Hangaard, Per Bruno Jensen, Sofie Lock Johansson, Subagini Nagarajah, Marianne Kjær Poulsen, Mette Juel Rothmann, Karoline Schousboe, Stine Jorstad Bugge, Louise Brügmann Jessen, Ida Ransby Schneider, Ann Dorthe Olsen Zwisler, Kurt Højlund, Per Damkier","doi":"10.1177/26335565221141745","DOIUrl":"10.1177/26335565221141745","url":null,"abstract":"<p><strong>Introduction: </strong>Multidisciplinary Team Conferences (MDTs) are complex interventions in the modern healthcare system and they promote a model of coordinated patient care and management. However, MDTs within chronic diseases are poorly defined. Therefore, the aim of this scoping review was to summarise the current literature on physician-led in-hospital MDTs in chronic non-malignant diseases.</p><p><strong>Method: </strong>Following the PRISMA-ScR guideline for scoping reviews, a search on MDT interventions in adult patients, with three or more medical specialties represented, was performed.</p><p><strong>Results: </strong>We identified 2790 studies, from which 8 studies were included. The majority of studies were non-randomised and focused on a single disease entity such as infective endocarditis, atrial fibrillation, IgG4-related disease, or arterial and venous thrombosis. The main reason for referral was confirmation or establishment of a diagnosis, and the MDT members were primarily from medical specialties gathered especially for the MDT. Outcomes of the included studies were grouped into process indicators and outcome indicators. Process indicators included changes in diagnostic confirmation as well as therapeutic strategy and management. All studies reporting process indicators demonstrated significant changes before and after the MDT.</p><p><strong>Conclusion: </strong>MDTs within chronic diseases appeared highly heterogeneous with respect to structure, reasons for referral, and choice of outcomes. While process indicators, such as change in diagnosis, and treatment management/plan seem improved, such have not been demonstrated through outcome indicators.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"12 ","pages":"26335565221141745"},"PeriodicalIF":0.0,"publicationDate":"2022-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f3/9f/10.1177_26335565221141745.PMC9742578.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10361274","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":"Multidimensional trajectories of multimorbidity, functional status, cognitive performance, and depressive symptoms among diverse groups of older adults.","authors":"Ana R Quiñones, Corey L Nagel, Anda Botoseneanu, Jason T Newsom, David A Dorr, Jeffrey Kaye, Stephen M Thielke, Heather G Allore","doi":"10.1177/26335565221143012","DOIUrl":"10.1177/26335565221143012","url":null,"abstract":"<p><strong>Background: </strong>Inter-relationships between multimorbidity and geriatric syndromes are poorly understood. This study assesses heterogeneity in joint trajectories of somatic disease, functional status, cognitive performance, and depressive symptomatology.</p><p><strong>Methods: </strong>We analyzed 16 years of longitudinal data from the Health and Retirement Study (HRS, 1998-2016) for n = 11,565 older adults (≥65 years) in the United States. Group-based mixture modeling identified latent clusters of older adults following similar joint trajectories across domains.</p><p><strong>Results: </strong>We identified four distinct multidimensional trajectory groups: (1) <i>Minimal Impairment with Low Multimorbidity</i> (32.7% of the sample; mean = 0.60 conditions at age 65, 2.1 conditions at age 90) had limited deterioration; (2) <i>Minimal Impairment with High Multimorbidity</i> (32.9%; mean = 2.3 conditions at age 65, 4.0 at age 90) had minimal deterioration; (3) <i>Multidomain Impairment with Intermediate Multimorbidity</i> (19.9%; mean = 1.3 conditions at age 65, 2.7 at age 90) had moderate depressive symptomatology and functional impariments with worsening cognitive performance; (4) <i>Multidomain Impairment with High Multimorbidity</i> (14.1%; mean = 3.3 conditions at age 65; 4.7 at age 90) had substantial functional limitation and high depressive symptomatology with worsening cognitive performance. Black and Hispanic race/ethnicity, lower wealth, lower education, male sex, and smoking history were significantly associated with membership in the two <i>Multidomain Impairment</i> classes.</p><p><strong>Conclusions: </strong>There is substantial heterogeneity in combined trajectories of interrelated health domains in late life. Membership in the two most impaired classes was more likely for minoritized older adults.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":"12 ","pages":"26335565221143012"},"PeriodicalIF":0.0,"publicationDate":"2022-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/3e/eb/10.1177_26335565221143012.PMC9720836.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10260374","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":"Persistent pain and long-term physical and mental conditions and their association with psychological well-being; data from 10,744 individuals from the Lolland-Falster health study.","authors":"Lars H Tang,&nbsp;Karen H Andreasson,&nbsp;Lau C Thygesen,&nbsp;Randi Jepsen,&nbsp;Anne Møller,&nbsp;Søren T Skou","doi":"10.1177/26335565221128712","DOIUrl":"https://doi.org/10.1177/26335565221128712","url":null,"abstract":"<p><strong>Introduction: </strong>Persistent pain (PP) and long-term conditions are all associated with psychological well-being. Less is known about their associations with reduced psychological well-being when co-occurring. We investigated how PP and long-term physical and mental conditions relate to psychological well-being when occurring together.</p><p><strong>Method: </strong>Data collected in the Danish population-based Lolland-Falster Health study were used in this cross-sectional study. Participants aged ≥18 years completing questions concerning PP, long-term conditions and psychological well-being were included. PP and long-term conditions were defined as conditions lasting 6 months or longer. Psychological well-being was assessed by the World Health Organization Well-Being Index (WHO-5). Multiple linear regression investigated combinations of PP and physical and mental long-term conditions and their associations with WHO-5.</p><p><strong>Results: </strong>Of 11,711 participants, 10,744 had available data. One third had PP (<i>n</i> = 3250), while 6144 (57%), 213 (2%) and 946 (9%) reported having only physical conditions, only mental conditions or both, respectively. All combinations of PP and long-term conditions were negatively associated with WHO-5. PP in combination with mental (-23.1 (95% CI -28.3 to -17.8)) or both physical and mental conditions (-25.1 (-26.7 to -23.52) yielded the strongest negative associations. Two or more pain sites together with long-term physical and mental conditions was associated with a lower WHO-5 score (-6.2 (-8.9 to -3.5) compared to none or one pain site.</p><p><strong>Conclusion: </strong>The presence of PP and long-term conditions, in particular mental conditions, were strongly associated with worse psychological well-being. This highlights the importance of assessing psychological well-being in individuals with PP and long-term conditions.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":" ","pages":"26335565221128712"},"PeriodicalIF":0.0,"publicationDate":"2022-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/29/88/10.1177_26335565221128712.PMC9659769.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40688864","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":"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":"10.1177/26335565221134017","DOIUrl":"10.1177/26335565221134017","url":null,"abstract":"<p><strong>Objectives: </strong>To categorize and examine the effectiveness regarding health-related quality of life (HRQoL), mental health, and mortality of care models for persons with multimorbidity in primary care, community care, and hospitals through a systematic review.</p><p><strong>Methods: </strong>We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials up to May 2020. One author screened titles and abstracts, and to validate, a second author screened 5% of the studies. Two authors independently extracted data and assessed risk of bias using the tool by the Cochrane Effective Practice and Organisation of Care group. Study inclusion criteria were (1) participants aged ≥ 18 years with multimorbidity; (2) referred to multimorbidity or two or more specific chronic conditions in the title or abstract; (3) randomized controlled design; and (4) HRQoL, mental health, or mortality as primary outcome measures. We used the Foundation Framework to categorize the models and the PRISMA-guideline for reporting.</p><p><strong>Results: </strong>In this study, the first to report effectiveness of care models in patients with multimorbidity in hospital settings, we included 30 studies and 9,777 participants with multimorbidity. 12 studies were located in primary care, 9 in community care, and 9 in hospitals. HRQoL was reported as the primary outcome in 12 studies, mental health in 17 studies, and mortality in three studies-with significant improvements in 5, 14, and 2, respectively. The studies are presented according to settings.</p><p><strong>Conclusions: </strong>Although 20 of the care models reported positive effects, the variations in populations, settings, model elements, and outcome measures made it difficult to conclude on which models and model elements were effective.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":" ","pages":"26335565221134017"},"PeriodicalIF":0.0,"publicationDate":"2022-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/14/66/10.1177_26335565221134017.PMC9618762.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40663895","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":"Conceptualising comorbidity and multimorbidity in dementia: A scoping review and syndemic framework.","authors":"Rosie Dunn, Eleanor Clayton, Emma Wolverson, Andrea Hilton","doi":"10.1177/26335565221128432","DOIUrl":"10.1177/26335565221128432","url":null,"abstract":"<p><strong>Background: </strong>Older people and people with dementia experience a high prevalence of multiple health conditions. The terms 'comorbidity' and 'multimorbidity' are often used interchangeably to describe this, however there are key conceptual differences between these terms and their definitions. This has led to issues in the validity and comparability of research findings, potentially inappropriate intervention development and differences in quality of health care.</p><p><strong>Objective: </strong>To review how the terms 'comorbidity' and 'multimorbidity' are defined within peer-reviewed dementia research and propose an operational framework.</p><p><strong>Design: </strong>A scoping review of definitions within dementia research was carried out. Searches took place across five databases: Academic Search Premier, CINAHL Complete, MEDLINE, PsycARTICLES and PsycINFO. PRISMA-ScR guidelines were followed.</p><p><strong>Results: </strong>Content analysis revealed five key themes, showing significant overlap and inconsistencies from both within, and between, the comorbidity and multimorbidity definitions; 1. Number of conditions; 2. Type of health conditions; 3. The co-occurrence of conditions; 4. The inclusion of an index disease (or not); 5. Use of medical language. The analysis also revealed gaps in how the underlying concepts of the definitions relate to people with dementia living with multiple health conditions.</p><p><strong>Conclusion: </strong>This scoping review found that current definitions of comorbidity and multimorbidity are heterogeneous, reductionist and disease-focussed. Recommendations are made on the design of research studies including transparency and consistency of any terms and definitions used. A syndemic framework could be a useful tool for researchers, clinicians and policy makers to consider a more holistic picture of a person with dementia's health and wellbeing.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":" ","pages":"26335565221128432"},"PeriodicalIF":0.0,"publicationDate":"2022-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/c0/10.1177_26335565221128432.PMC9520180.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40391608","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":"Relationship between multimorbidity and composite lifestyle status in Shenzhen, China.","authors":"Hua-Lu Yang,&nbsp;Bei-Rong Mo,&nbsp;Alex Molassiotis,&nbsp;Mian Wang,&nbsp;Gui-Lan He,&nbsp;Yao Jie Xie","doi":"10.1177/26335565221123990","DOIUrl":"https://doi.org/10.1177/26335565221123990","url":null,"abstract":"<p><strong>Objective: </strong>The study aimed to understand multimorbidity among adults in a high-tech city in southern coastal China that has undergone rapid economic development and to investigate its relationship with lifestyle status.</p><p><strong>Methods: </strong>A population-based survey was conducted among 24 community centers in the Nanshan District of Shenzhen from February to December of 2018. Participants were recruited using a stratified random sampling approach. A self-administered questionnaire on typical chronic diseases, lifestyle factors, body composition, and social demographics was used to collect data. Multimorbidity was defined as two or more chronic diseases coexisting in a single person. An algorithm on body mass index, physical activity, drinking, smoking, and sleep quality was used to calculate lifestyle scores (0-9), with higher scores predicting a healthier lifestyle.</p><p><strong>Results: </strong>A total of 2,905 participants were included in the analysis, with men accounting for 52.4%, and single for 25%. The prevalence of multimorbidity was 4.8%, and the mean lifestyle score was 4.79 ± 1.55. People who were old, retired, married, and had less education were more likely to have multimorbidity (all P < .05). A higher prevalence of multimorbidity was found among those who were obese, less engaged in physical activity, consumed more alcohol, and had poorer sleep quality (all p < .05). After adjusting for age, employment, education, and marital status, one unit increase in lifestyle score was associated with 0.74 times lower to have multimorbidity (OR: 0.74; 95% CI: 0.63-0.87, p < .05).</p><p><strong>Conclusion: </strong>The prevalence of multimorbidity was relatively low in economically developed Shenzhen. Keeping a healthy lifestyle was related to the lower possibility of suffering from multiple chronic diseases.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":" ","pages":"26335565221123990"},"PeriodicalIF":0.0,"publicationDate":"2022-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/09/e0/10.1177_26335565221123990.PMC9449505.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33459673","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 of communicable and non-communicable diseases in low- and middle-income countries: A systematic review.","authors":"Lucy Kaluvu,&nbsp;Ogechukwu Augustina Asogwa,&nbsp;Anna Marzà-Florensa,&nbsp;Catherine Kyobutungi,&nbsp;Naomi S Levitt,&nbsp;Daniel Boateng,&nbsp;Kerstin Klipstein-Grobusch","doi":"10.1177/26335565221112593","DOIUrl":"https://doi.org/10.1177/26335565221112593","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this systematic review is to analyse existing evidence on prevalence, patterns, determinants, and healthcare challenges of communicable and non-communicable disease multimorbidity in low- and middle-income countries (LMICs).</p><p><strong>Methods: </strong>PubMed, Cochrane, and Embase databases were searched from 1^st January 2000 to 31^st July 2020. The National Institute of Health (NIH) quality assessment tool was used to critically appraise studies. Findings were summarized in a narrative synthesis. The review was registered with PROSPERO (CRD42019133453).</p><p><strong>Results: </strong>Of 3718 articles screened, 79 articles underwent a full text review of which 11 were included for narrative synthesis. Studies reported on 4 to 20 chronic communicable and non-communicable diseases; prevalence of multimorbidity ranged from 13% in a study conducted among 242,952 participants from 48 LMICS to 87% in a study conducted among 491 participants in South Africa. Multimorbidity was positively associated with older age, female sex, unemployment, and physical inactivity. Significantly higher odds of multimorbidity were noted among obese participants (OR 2.33; 95% CI: 2.19-2.48) and those who consumed alcohol (OR 1.44; 95% CI: 1.25-1.66). The most frequently occurring dyads and triads were HIV and hypertension (23.3%) and HIV, hypertension, and diabetes (63%), respectively. Women and participants from low wealth quintiles reported higher utilization of public healthcare facilities.</p><p><strong>Conclusion: </strong>The identification and prevention of risk factors and addressing evidence gaps in multimorbidity clustering is crucial to address the increasing communicable and non-communicable disease multimorbidity in LMICs. To identify communicable and non-communicable diseases trends over time and identify causal relationships, longitudinal studies are warranted.</p>","PeriodicalId":73843,"journal":{"name":"Journal of multimorbidity and comorbidity","volume":" ","pages":"26335565221112593"},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9445468/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33458016","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}