Journal of comorbidity最新文献

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Experiences of older primary care patients with multimorbidity and their caregivers in navigating the healthcare system: A qualitative study protocol. 老年多病初级保健患者及其护理人员在医疗保健系统导航中的经验:一项定性研究方案。
Journal of comorbidity Pub Date : 2020-12-29 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20984064
Eng Sing Lee, Gayathri Muthulingam, Evelyn Ai Ling Chew, Poay Sian Sabrina Lee, Hui Li Koh, Stephanie Xin En Quak, Yew Yoong Ding, Mythily Subramaniam, Janhavi Ajit Vaingankar
{"title":"Experiences of older primary care patients with multimorbidity and their caregivers in navigating the healthcare system: A qualitative study protocol.","authors":"Eng Sing Lee,&nbsp;Gayathri Muthulingam,&nbsp;Evelyn Ai Ling Chew,&nbsp;Poay Sian Sabrina Lee,&nbsp;Hui Li Koh,&nbsp;Stephanie Xin En Quak,&nbsp;Yew Yoong Ding,&nbsp;Mythily Subramaniam,&nbsp;Janhavi Ajit Vaingankar","doi":"10.1177/2235042X20984064","DOIUrl":"https://doi.org/10.1177/2235042X20984064","url":null,"abstract":"<p><strong>Background: </strong>Patients with multimorbidity must bear not just the burden of their illness, but also the burden of treatment which is, in part, induced by their interactions with the healthcare system. The need to shuttle between different healthcare institutions and multiple healthcare providers can make navigating the healthcare system challenging, and this may be even more so for older patients with limited resources and support.</p><p><strong>Objectives: </strong>Few qualitative studies have explored the experiences of patients with multimorbidity in navigating the healthcare system. This study will explore the experiences of older patients with multimorbidity and their caregivers as they navigate through the healthcare system. We aim to arrive at a better understanding of patient experiences of possible gaps in the continuity of care and how the current system can be modified and adapted to better address the needs of older patients with multimorbidity.</p><p><strong>Method: </strong>Semi-structured, in-depth interviews will be conducted with purposively sampled older patients with multimorbidity, aged 60 and above seen in primary care, together with their caregivers. Interviews will be transcribed verbatim and analysed by the study team using inductive thematic analysis.</p><p><strong>Conclusions: </strong>Our study seeks to explore the navigational experiences within the healthcare system for older patients with multimorbidity in an Asian, multi-ethnic society. The findings will be shared with decision-makers in the healthcare setting in order to improve patient care for this population and ultimately maximise their positive health outcomes, and will add to better understanding how the burden of treatment arising from navigational challenges within the healthcare system may be reduced for older patients with multimorbidity.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20984064"},"PeriodicalIF":0.0,"publicationDate":"2020-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20984064","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38828570","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}
引用次数: 4
Bi-directional association between depression and HF: An electronic health records-based cohort study. 抑郁症与心衰之间的双向关联:一项基于电子健康记录的队列研究
Journal of comorbidity Pub Date : 2020-12-24 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20984059
William V Bobo, Euijung Ryu, Tanya M Petterson, Kandace Lackore, Yijing Cheng, Hongfang Liu, Laura Suarez, Martin Preisig, Leslie T Cooper, Veronique L Roger, Jyotishman Pathak, Alanna M Chamberlain
{"title":"Bi-directional association between depression and HF: An electronic health records-based cohort study.","authors":"William V Bobo,&nbsp;Euijung Ryu,&nbsp;Tanya M Petterson,&nbsp;Kandace Lackore,&nbsp;Yijing Cheng,&nbsp;Hongfang Liu,&nbsp;Laura Suarez,&nbsp;Martin Preisig,&nbsp;Leslie T Cooper,&nbsp;Veronique L Roger,&nbsp;Jyotishman Pathak,&nbsp;Alanna M Chamberlain","doi":"10.1177/2235042X20984059","DOIUrl":"https://doi.org/10.1177/2235042X20984059","url":null,"abstract":"<p><strong>Objective: </strong>To determine whether a bi-directional relationship exists between depression and HF within a single population of individuals receiving primary care services, using longitudinal electronic health records (EHRs).</p><p><strong>Methods: </strong>This retrospective cohort study utilized EHRs for adults who received primary care services within a large healthcare system in 2006. Validated EHR-based algorithms identified 10,649 people with depression (depression cohort) and 5,911 people with HF (HF cohort) between January 1, 2006 and December 31, 2018. Each person with depression or HF was matched 1:1 with an unaffected referent on age, sex, and outpatient service use. Each cohort (with their matched referents) was followed up electronically to identify newly diagnosed HF (in the depression cohort) and depression (in the HF cohort) that occurred after the index diagnosis of depression or HF, respectively. The risks of these outcomes were compared (vs. referents) using marginal Cox proportional hazard models adjusted for 16 comorbid chronic conditions.</p><p><strong>Results: </strong>2,024 occurrences of newly diagnosed HF were observed in the depression cohort and 944 occurrences of newly diagnosed depression were observed in the HF cohort over approximately 4-6 years of follow-up. People with depression had significantly increased risk for developing newly diagnosed HF (HR 2.08, 95% CI 1.89-2.28) and people with HF had a significantly increased risk of newly diagnosed depression (HR 1.34, 95% CI 1.17-1.54) after adjusting for all 16 comorbid chronic conditions.</p><p><strong>Conclusion: </strong>These results provide evidence of a bi-directional relationship between depression and HF independently of age, sex, and multimorbidity from chronic illnesses.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20984059"},"PeriodicalIF":0.0,"publicationDate":"2020-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20984059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38855189","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}
引用次数: 6
The association between clusters of chronic conditions and psychological well-being in younger and older people-A cross-sectional, population-based study from the Lolland-Falster Health Study, Denmark. 慢性疾病群与年轻人和老年人心理健康之间的关系——来自丹麦Lolland-Falster健康研究的一项横断面、基于人群的研究。
Journal of comorbidity Pub Date : 2020-12-17 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20981185
Lars Hermann Tang, Lau Caspar Thygesen, Tora Grauers Willadsen, Randi Jepsen, Karen la Cour, Anne Frølich, Anne Møller, Lars Bo Jørgensen, Søren T Skou
{"title":"The association between clusters of chronic conditions and psychological well-being in younger and older people-A cross-sectional, population-based study from the Lolland-Falster Health Study, Denmark.","authors":"Lars Hermann Tang,&nbsp;Lau Caspar Thygesen,&nbsp;Tora Grauers Willadsen,&nbsp;Randi Jepsen,&nbsp;Karen la Cour,&nbsp;Anne Frølich,&nbsp;Anne Møller,&nbsp;Lars Bo Jørgensen,&nbsp;Søren T Skou","doi":"10.1177/2235042X20981185","DOIUrl":"https://doi.org/10.1177/2235042X20981185","url":null,"abstract":"<p><strong>Aim: </strong>To investigate the association between clusters of conditions and psychological well-being across age groups.</p><p><strong>Method: </strong>This cross-sectional study used data collected in the Danish population-based Lolland-Falster Health Study. We included adults over the age of 18 years. Self-reported chronic conditions were divided into 10 groups of conditions. The primary outcome was psychological well-being (the WHO-5 Well-Being Index). Factor analysis constructed the clusters of conditions, and regression analysis investigated the association between clusters and psychological well-being.</p><p><strong>Results: </strong>Of 10,781 participants, 31.4% were between 18 and 49 years, 35.7% were between 50 and 64 years and 32.9% were above ≥65 years. 35.2% had conditions represented in 1 and 32.9% in at least 2 of 10 condition groups. Across age groups, living with one or more chronic conditions was associated with poorer psychological well-being. Two chronic condition patterns were identified; one comprised cardiovascular, endocrine, kidney, musculoskeletal and cancer conditions, the second mental, lung, neurological, gastrointestinal and sensory conditions. Both patterns were associated with poorer psychological well-being (Pattern 1: -4.5 (95% CI: -5.3 to -3.7), Pattern 2: -9.1 (95% CI -13.8 to -8.2). For pattern 2, participants ≥65 years had poorer psychological well-being compared to younger (-12.6 (95% CI -14.2 to -11.0) vs -6.6 (95% CI: -7.8 to -5.4) for 18-49 years and -8.7 (95% CI: -10.1 to -7.3) for 50-64 years, interaction: p ≤ 0.001).</p><p><strong>Conclusion: </strong>Living with one or more chronic conditions is associated with poorer psychological well-being. Findings point toward a greater focus on supporting psychological well-being in older adults with both mental and somatic conditions.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20981185"},"PeriodicalIF":0.0,"publicationDate":"2020-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20981185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38796873","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}
引用次数: 5
The complexity of caregiving for community-living older adults with multiple chronic conditions: A qualitative study. 社区生活老年人多重慢性疾病护理的复杂性:一项定性研究。
Journal of comorbidity Pub Date : 2020-12-14 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20981190
Jenny Ploeg, Anna Garnett, Kimberly D Fraser, Lisa Garland Baird, Sharon Kaasalainen, Carrie McAiney, Maureen Markle-Reid, Sinéad Dufour
{"title":"The complexity of caregiving for community-living older adults with multiple chronic conditions: A qualitative study.","authors":"Jenny Ploeg,&nbsp;Anna Garnett,&nbsp;Kimberly D Fraser,&nbsp;Lisa Garland Baird,&nbsp;Sharon Kaasalainen,&nbsp;Carrie McAiney,&nbsp;Maureen Markle-Reid,&nbsp;Sinéad Dufour","doi":"10.1177/2235042X20981190","DOIUrl":"https://doi.org/10.1177/2235042X20981190","url":null,"abstract":"<p><strong>Background: </strong>Older adults with multiple chronic conditions (MCC) rely heavily on caregivers for assistance with care. However, we know little about their psychosocial experiences and their needs for support in managing MCC. The purpose of this study was to explore the experiences of caregivers of older adults living in the community with MCC.</p><p><strong>Methods: </strong>This qualitative study was a secondary analysis of previously collected data from caregivers in Ontario and Alberta, Canada. Participants included caregivers of older adults (65 years and older) with three or more chronic conditions. Data were collected through in-depth, semi-structured interviews. Interview transcripts were coded and analyzed using Thorne's interpretive description approach.</p><p><strong>Results: </strong>Most of the 47 caregiver participants were female (76.6%), aged 65 years of age or older (61.7%), married (87.2%) and were spouses to the care recipient (68.1%). Caregivers' experiences of caring for community-living older adults with MCC were complex and included: (a) dealing with the demands of caregiving; (b) prioritizing chronic conditions; (c) living with my own health limitations; (d) feeling socially isolated and constrained; (e) remaining committed to caring; and (f) reaping the rewards of caregiving.</p><p><strong>Conclusions: </strong>Healthcare providers can play key roles in supporting caregivers of older adults with MCC by providing education and support on managing MCC, actively engaging them in goal setting and care planning, and linking them to appropriate community health and social support services. Communities can create environments that support caregivers in areas such as social participation, social inclusion, and community support and health services.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20981190"},"PeriodicalIF":0.0,"publicationDate":"2020-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20981190","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38784969","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}
引用次数: 11
Synergistic effects of hip/knee osteoarthritis and comorbidities on mobility and self-care limitations among older adults: Cross-sectional analysis of the Oxford pain, Activity and Lifestyle study. 髋关节/膝关节骨关节炎和合并症对老年人活动能力和自我保健限制的协同作用:牛津疼痛、活动和生活方式研究的横断面分析
Journal of comorbidity Pub Date : 2020-12-04 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20974529
Philippa Ja Nicolson, Esther Williamson, Hopin Lee, Alana Morris, Angela Garrett, Maria T Sanchez-Santos, Sarah E Lamb
{"title":"Synergistic effects of hip/knee osteoarthritis and comorbidities on mobility and self-care limitations among older adults: Cross-sectional analysis of the Oxford pain, Activity and Lifestyle study.","authors":"Philippa Ja Nicolson, Esther Williamson, Hopin Lee, Alana Morris, Angela Garrett, Maria T Sanchez-Santos, Sarah E Lamb","doi":"10.1177/2235042X20974529","DOIUrl":"10.1177/2235042X20974529","url":null,"abstract":"<p><strong>Objective: </strong>To estimate synergistic effects of hip/knee osteoarthritis (OA) and comorbidities on mobility or self-care limitations among older adults.</p><p><strong>Methods: </strong>We used baseline, cross-sectional data from the Oxford Pain, Activity and Lifestyle (OPAL) study. Participants were community-dwelling adults aged 65 years or older who completed a postal questionnaire. Participants reported demographic information, hip/knee OA, comorbidities and mobility and self-care limitations. We used modified Poisson regression models to estimate the independent and combined relative risks (RR) of mobility or self-care limitations, the relative excess risk due to interaction (RERI) between hip/knee OA and comorbidities, attributable proportion of the risk due to the interaction and the ratio of the combined effect and the sum of the individual effects, known as the synergy index.</p><p><strong>Results: </strong>Of the 4,972 participants included, 1,532 (30.8%) had hip/knee OA, and of them 42.9% reported mobility limitations and 8.4% reported self-care limitations. Synergistic effects impacting self-care limitations were observed between hip/knee OA and anxiety (RR: 3.09, 95% Confidence Interval (CI): 2.00 to 4.78; RERI: 0.93, 95% CI: 0.01 to 1.90), and between hip/knee OA and depressive symptoms (RR: 2.71, 95% CI: 1.75 to 4.20; RERI: 0.58, 95% CI: 0.03 to 1.48). The portion of the total RR attributable to this synergism was 30% and 22% respectively.</p><p><strong>Conclusions: </strong>This study demonstrates that synergism between hip/knee OA and anxiety or depressive symptoms contribute to self-care limitations. These findings highlight the importance of assessing and addressing anxiety or depressive symptoms when managing older adults with hip/knee OA to minimize self-care limitations.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20974529"},"PeriodicalIF":0.0,"publicationDate":"2020-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20974529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38723314","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}
引用次数: 2
Home care rehabilitation therapy services for individuals with multimorbidity: A rapid review. 多病个体的家庭护理康复治疗服务:快速回顾。
Journal of comorbidity Pub Date : 2020-12-01 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20976282
Amanda Mofina, Jordan Miller, Joan Tranmer, Catherine Donnelly
{"title":"Home care rehabilitation therapy services for individuals with multimorbidity: A rapid review.","authors":"Amanda Mofina,&nbsp;Jordan Miller,&nbsp;Joan Tranmer,&nbsp;Catherine Donnelly","doi":"10.1177/2235042X20976282","DOIUrl":"https://doi.org/10.1177/2235042X20976282","url":null,"abstract":"<p><p>Multimorbidity refers to the co-occurrence of two or more chronic conditions, where no one disease is considered the central disease. Individuals with multimorbidity experience increased patient health complexity, increased disability and functional decline, and increased health care utilization. Rehabilitation therapists are well positioned to address the complex functional needs that can contribute to disability for people living with multimorbidity; however, it is not well understood how they address these needs within the home care setting. A rapid review was conducted to identify and synthesize the existing literature on home care rehabilitation services for clients with multimorbidity and the effect of those services. Two electronic databases (Medline and CINAHL) were searched. The Journal of Comorbidity was hand-searched for thoroughness because this journal focuses on populations with multiple chronic conditions. This rapid review included observational and experimental studies that focused on rehabilitation therapy interventions embedded within existing home care systems for adults with multimorbidity. Four studies were included in the final review. The results revealed that therapists delivered interventions aimed towards improving functional outcomes related to activities of daily living and instrumental activities of daily living. Physical therapy interventions were the only therapy delivered in three of the four studies included. Furthermore, 50% of these studies explicitly included people with chronic conditions impacting the musculoskeletal system only. This review offers an important perspective on how home care rehabilitation therapy interventions and outcomes are operationalized for individuals with multimorbidity. Despite the varying definitions of multimorbidity, therapeutic intervention supported functional improvements.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20976282"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20976282","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38367678","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}
引用次数: 2
The inequity of morbidity: Disparities in the prevalence of morbidity between ethnic groups in New Zealand. 发病率的不平等:新西兰各族裔之间发病率的差异。
Journal of comorbidity Pub Date : 2020-11-10 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20971168
Jason Gurney, James Stanley, Diana Sarfati
{"title":"The inequity of morbidity: Disparities in the prevalence of morbidity between ethnic groups in New Zealand.","authors":"Jason Gurney,&nbsp;James Stanley,&nbsp;Diana Sarfati","doi":"10.1177/2235042X20971168","DOIUrl":"https://doi.org/10.1177/2235042X20971168","url":null,"abstract":"<p><strong>Objective: </strong>The burden of chronic disease is not evenly shared within our society. In this manuscript, we use comprehensive national-level data to compare morbidity burden between ethnic groups in New Zealand.</p><p><strong>Methods: </strong>We investigated the prevalence of morbidity among all New Zealanders aged 18+ (n = 3,296,837), stratified by ethnic group (Māori, Pacific, Asian, Middle Eastern/Latin American/African, European/Other), using national-level hospitalisation and pharmaceutical data and two measures of morbidity (the M3 and P3 indices).</p><p><strong>Results and conclusions: </strong>We observed substantial disparities for Māori and Pacific peoples compared to other ethnic groups for the vast majority of commonly-diagnosed morbidities. These disparities appeared strongest for the most-common conditions - meaning that Māori and Pacific peoples disproportionately shoulder an increased burden of these key conditions. We also observed that prevalence of these conditions emerged at earlier ages, meaning that Māori and Pacific peoples also experience a disproportionate impact of individual conditions on the quality and quantity of life. Finally, we observed strong disparities in the prevalence of conditions that may exacerbate the impact of COVID-19, such as chronic pulmonary, liver or renal disease. The substantial inequities we have presented here have been created and perpetuated by the social determinants of health, including institutionalised racism: thus solutions will require addressing these systemic issues as well as addressing inequities in individual-level care.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20971168"},"PeriodicalIF":0.0,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20971168","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38641147","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}
引用次数: 18
Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review. 低收入和中等收入国家慢性非传染性疾病的多病性:范围综述。
Journal of comorbidity Pub Date : 2020-10-16 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20961919
Fantu Abebe, Marguerite Schneider, Biksegn Asrat, Fentie Ambaw
{"title":"Multimorbidity of chronic non-communicable diseases in low- and middle-income countries: A scoping review.","authors":"Fantu Abebe, Marguerite Schneider, Biksegn Asrat, Fentie Ambaw","doi":"10.1177/2235042X20961919","DOIUrl":"10.1177/2235042X20961919","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity is rising in low- and middle-income countries (LMICs). However, the evidence on its epidemiology from LMICs settings is limited and the available literature has not been synthesized as yet.</p><p><strong>Objectives: </strong>To review the available evidence on the epidemiology of multimorbidity in LMICs.</p><p><strong>Methods: </strong>PubMed, Scopus, PsycINFO and Grey literature databases were searched. We followed the PRISMA-ScR reporting guideline.</p><p><strong>Results: </strong>Of 33, 110 articles retrieved, 76 studies were eligible for the epidemiology of multimorbidity. Of these 76 studies, 66 (86.8%) were individual country studies. Fifty-two (78.8%) of which were confined to only six middle-income countries: Brazil, China, South Africa, India, Mexico and Iran. The majority (n = 68, 89.5%) of the studies were crosssectional in nature. The sample size varied from 103 to 242, 952. The largest proportion (n = 33, 43.4%) of the studies enrolled adults. Marked variations existed in defining and measuring multimorbidity. The prevalence of multimorbidity in LMICs ranged from 3.2% to 90.5%.</p><p><strong>Conclusion and recommendations: </strong>Studies on the epidemiology of multimorbidity in LMICs are limited and the available ones are concentrated in few countries. Despite variations in measurement and definition, studies consistently reported high prevalence of multimorbidity. Further research is urgently required to better understand the epidemiology of multimorbidity and define the best possible interventions to improve outcomes of patients with multimorbidity in LMICs.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20961919"},"PeriodicalIF":0.0,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/88/ff/10.1177_2235042X20961919.PMC7573723.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38540144","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}
引用次数: 0
Self-management program versus usual care for community-dwelling older adults with multimorbidity: A pragmatic randomized controlled trial in Ontario, Canada. 自我管理计划与常规护理对社区居住的多病老年人:加拿大安大略省的一项实用随机对照试验。
Journal of comorbidity Pub Date : 2020-10-16 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20963390
Kathryn Fisher, Maureen Markle-Reid, Jenny Ploeg, Amy Bartholomew, Lauren E Griffith, Amiram Gafni, Lehana Thabane, Marie-Lee Yous
{"title":"Self-management program versus usual care for community-dwelling older adults with multimorbidity: A pragmatic randomized controlled trial in Ontario, Canada.","authors":"Kathryn Fisher,&nbsp;Maureen Markle-Reid,&nbsp;Jenny Ploeg,&nbsp;Amy Bartholomew,&nbsp;Lauren E Griffith,&nbsp;Amiram Gafni,&nbsp;Lehana Thabane,&nbsp;Marie-Lee Yous","doi":"10.1177/2235042X20963390","DOIUrl":"https://doi.org/10.1177/2235042X20963390","url":null,"abstract":"<p><strong>Background: </strong>Multimorbidity, the co-existence of 2+ (or 3+) chronic diseases in an individual, is an increasingly common global phenomenon leading to reduced quality of life and functional status, and higher healthcare service use and mortality. There is an urgent need to develop and test new models of care that incorporate the components of multimorbidity interventions recommended by international organizations, including care coordination, interdisciplinary teams, and care plans developed with patients that are tailored to their needs and preferences.</p><p><strong>Purpose: </strong>To determine the effectiveness of a 6-month, community-based, multimorbidity intervention compared to usual home care services for community-dwelling older adults (age 65+ years) with multimorbidity (3+ chronic conditions) that were newly referred to and receiving home care services.</p><p><strong>Methods: </strong>A pragmatic, parallel, two-arm randomized controlled trial evaluated the intervention, which included in-home visits by an interdisciplinary team, personal support worker visits, and monthly case conferences. The study took place in two sites in central Ontario, Canada. Eligible and consenting participants were randomly allocated to the intervention and control group using a 1:1 ratio. The participants, statistician/analyst, and research assistants collecting assessment data were blinded. The primary outcome was the Physical Component Summary (PCS) score of the 12-Item Short-Form health survey (SF-12). Secondary outcomes included the SF-12 Mental Component Summary (MCS) score, Center for Epidemiological Studies of Depression (CESD-10), Generalized Anxiety Disorder (GAD-7), Self-Efficacy for Managing Chronic Disease, and service use and costs. Analysis of covariance (ANCOVA) tested group differences using multiple imputation to address missing data, and non-parametric methods explored service use and cost differences.</p><p><strong>Results: </strong>59 older adults were randomized into the intervention (n = 30) and control (n = 29) groups. At baseline, groups were similar for the primary outcome and number of chronic conditions (mean of 8.6), but the intervention group had lower mental health status. The intervention was cost neutral and no significant group differences were observed for the primary outcome of PCS from SF-12 (mean difference: -4.94; 95% CI: -12.53 to 2.66; p = 0.20) or secondary outcomes.</p><p><strong>Conclusion: </strong>We evaluated a 6-month, self-management intervention for older adults with multimorbidity. While the intervention was cost neutral in comparison to usual care, it was not found to improve the PCS from SF-12 or secondary health outcomes. Recruitment and retention challenges were significant obstacles limiting our ability to assess intervention effectiveness. Yet, the intervention was grounded in internationally-endorsed recommendations and implemented in a practice setting (home care) viewed as a key up","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20963390"},"PeriodicalIF":0.0,"publicationDate":"2020-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20963390","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38540142","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}
引用次数: 6
A bibliometric analysis of multimorbidity from 2005 to 2019. 2005 - 2019年多发病文献计量学分析
Journal of comorbidity Pub Date : 2020-10-13 eCollection Date: 2020-01-01 DOI: 10.1177/2235042X20965283
Mohamed Ali Ag Ahmed, José Almirall, Patrice Ngangue, Marie-Eve Poitras, Martin Fortin
{"title":"A bibliometric analysis of multimorbidity from 2005 to 2019.","authors":"Mohamed Ali Ag Ahmed,&nbsp;José Almirall,&nbsp;Patrice Ngangue,&nbsp;Marie-Eve Poitras,&nbsp;Martin Fortin","doi":"10.1177/2235042X20965283","DOIUrl":"https://doi.org/10.1177/2235042X20965283","url":null,"abstract":"<p><strong>Context: </strong>Multimorbidity is frequently seen in primary care. We aimed to identify and analyze publications on multimorbidity, including those that most influenced this field.</p><p><strong>Method: </strong>A bibliometric analysis of publications from 2005 to 2019 in the PubMed database containing \"multimorbidity\" or \"multi-morbidity\" identified with the tool iCite. We analyzed the number of publications, total citations, the article-level metric Relative Citation Ratio (RCR), type of study, and journals with the most cited articles.</p><p><strong>Results: </strong>The number of publications using \"multimorbidity\" has continuously increased since 2005 (2005-2009: 138; 2010-2014: 823; 2015-2019: 3068). The median number of total citations per article was 3. The median RCR was 1.04. Articles with RCR at or above the 97th percentile (RCR = 7.43) were analyzed in detail (n = 104). In 34 publications of this subgroup (33%), the word multimorbidity was used but was not the subject of study. The remaining top 70 publications included 32 observational studies, 22 reviews, five guideline statements, three analysis papers, two randomized trials, three qualitative studies, two measurement development reports, and one conceptual framework development report. The publications were produced by authors from 32 countries. They were published in 37 different journals, ranging from one to four articles in the same journal.</p><p><strong>Conclusions: </strong>We found a continuous increase in the number of publications about multimorbidity since 2005. However, our study suggests that the numbers should be considered only a general trend because multimorbidity was not the main subject in 33% of publications in a subgroup of 104 analyzed in detail.</p>","PeriodicalId":92071,"journal":{"name":"Journal of comorbidity","volume":"10 ","pages":"2235042X20965283"},"PeriodicalIF":0.0,"publicationDate":"2020-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2235042X20965283","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38638037","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}
引用次数: 2
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