The European General Practice Research Network Presents a Comprehensive Definition of Multimorbidity in Family Medicine and Long Term Care, Following a Systematic Review of Relevant Literature

被引:150
作者
Le Reste, Jean Yves [1 ]
Nabbe, Patrice [1 ]
Manceau, Benedicte [1 ]
Lygidakis, Charilaos [2 ]
Doerr, Christa [3 ]
Lingner, Heidrun [4 ]
Czachowski, Slawomir [5 ]
Munoz, Miguel [6 ,7 ]
Argyriadou, Stella [8 ]
Claveria, Ana [9 ]
Le Floch, Bernard [1 ]
Barais, Marie [1 ]
Bower, Peter [10 ]
Van Marwijk, Harm [11 ]
Van Royen, Paul [12 ]
Lietard, Claire [13 ]
机构
[1] Univ Bretagne Occidentale, Dept Gen Practice, F-29238 Brest 3, France
[2] Assoc Italiana Med Famiglia AIMEF, Bologna, Italy
[3] Univ Med Gottingen, Abt Allgemeinmed, Gottingen, Germany
[4] Allgemein Med Hsch Hannover, Hannover, Germany
[5] Nicholas Copernicus Univ, Dept Family Doctor, Torun, Poland
[6] Inst Catala Salut, Barcelona, Spain
[7] Inst Univ Iinvestigacio Atencio Primaria IDIAP Jo, Barcelona, Spain
[8] Greek Assoc Gen Practitioners ELEGEIA, Thessaloniki, Greece
[9] Xerencia Atenc Primaria Vigo, Vigo, Spain
[10] Univ Manchester, NIHR Sch Primary Care Res, Manchester, Lancs, England
[11] Vrije Univ Amsterdam, Med Ctr, Dept Gen Practice, Amsterdam, Netherlands
[12] Univ Antwerp, Fac Med & Hlth Sci, Dept Primary & Interdisciplinary Care, Antwerp, Belgium
[13] Univ Bretagne Occidentale, Dept Publ Hlth, F-29238 Brest 3, France
关键词
Family medicine; multimorbidity; epidemiology; research; QUALITY-OF-LIFE; MANAGING MULTIMORBIDITY; GLOBAL HEALTH; OLDER PERSONS; PREVALENCE; MORBIDITY; COMORBIDITY; POPULATION; PATTERNS; IMPACT;
D O I
10.1016/j.jamda.2013.01.001
中图分类号
R592 [老年病学]; C [社会科学总论];
学科分类号
03 ; 0303 ; 100203 ;
摘要
Background: Multimorbidity is a new concept encompassing all the medical conditions of an individual patient. The concept links into the European definition of family medicine and its core competencies. However, the definition of multimorbidity and its subsequent operationalization are still unclear. The European General Practice Research Network wanted to produce a comprehensive definition of multimorbidity. Method: Systematic review of literature involving eight European General Practice Research Network national teams. The databases searched were PubMed, Embase, and Cochrane (1990-2010). Only articles containing descriptions of multimorbidity criteria were selected for inclusion. The multinational team undertook a methodic data extraction, according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses guidelines. Results: The team identified 416 documents, selected 68 abstracts, included 54 articles, and found 132 definitions with 1631 different criteria. These criteria were aggregated into 11 themes that led to the following definition: Multimorbidity is defined as any combination of chronic disease with at least one other disease (acute or chronic) or biopsychosocial factor (associated or not) or somatic risk factor. Any biopsychosocial factor, any risk factor, the social network, the burden of diseases, the health care consumption, and the patient's coping strategies may function as modifiers (of the effects of multimorbidity). Multimorbidity may modify the health outcomes and lead to an increased disability or a decreased quality of life or frailty. Conclusion: This study has produced a comprehensive definition of multimorbidity. The resulting improvements in the management of multimorbidity, and its usefulness in long term care and in family medicine, will have to be assessed in future studies. Copyright (C) 2013 - American Medical Directors Association, Inc.
引用
收藏
页码:319 / 325
页数:7
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