Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study
AuthorDeruaz-Luyet, A; N'Goran, AA; Senn, N; Bodenmann, P; Pasquier, J; Widmer, D; Tandjung, R; Rosemann, T; Frey, P; Streit, S; ...
Source TitleBMJ Open
PublisherBMJ PUBLISHING GROUP
University of Melbourne Author/sHaller-Hester, Dagmar
Document TypeJournal Article
CitationsDeruaz-Luyet, A., N'Goran, A. A., Senn, N., Bodenmann, P., Pasquier, J., Widmer, D., Tandjung, R., Rosemann, T., Frey, P., Streit, S., Zeller, A., Haller, D. M., Excoffier, S., Burnand, B. & Herzig, L. (2017). Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study. BMJ OPEN, 7 (6), https://doi.org/10.1136/bmjopen-2016-013664.
Access StatusOpen Access
OBJECTIVE: To characterise in details a random sample of multimorbid patients in Switzerland and to evaluate the clustering of chronic conditions in that sample. METHODS: 100 general practitioners (GPs) each enrolled 10 randomly selected multimorbid patients aged ≥18 years old and suffering from at least three chronic conditions. The prevalence of 75 separate chronic conditions from the International Classification of Primary Care-2 (ICPC-2) was evaluated in these patients. Clusters of chronic conditions were studied in parallel. RESULTS: The final database included 888 patients. Mean (SD) patient age was 73.0 (12.0) years old. They suffered from 5.5 (2.2) chronic conditions and were prescribed 7.7 (3.5) drugs; 25.7% suffered from depression. Psychological conditions were more prevalent among younger individuals (≤66 years old). Cluster analysis of chronic conditions with a prevalence ≥5% in the sample revealed four main groups of conditions: (1) cardiovascular risk factors and conditions, (2) general age-related and metabolic conditions, (3) tobacco and alcohol dependencies, and (4) pain, musculoskeletal and psychological conditions. CONCLUSION: Given the emerging epidemic of multimorbidity in industrialised countries, accurately depicting the multiple expressions of multimorbidity in family practices' patients is a high priority. Indeed, even in a setting where patients have direct access to medical specialists, GPs nevertheless retain a key role as coordinators and often as the sole medical reference for multimorbid patients.
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