Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study.

Déruaz-Luyet, Anouk; N'Goran, A Alexandra; Senn, Nicolas; Bodenmann, Patrick; Pasquier, Jérôme; Widmer, Daniel; Tandjung, Ryan; Rosemann, Thomas; Frey, Peter; Streit, Sven; Zeller, Andreas; Haller, Dagmar M; Excoffier, Sophie; Burnand, Bernard; Herzig, Lilli (2017). Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study. BMJ open, 7(6), e013664. BMJ Publishing Group 10.1136/bmjopen-2016-013664

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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.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Frey, Peter and Streit, Sven

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

2044-6055

Publisher:

BMJ Publishing Group

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

06 Jul 2017 09:05

Last Modified:

03 Aug 2017 09:39

Publisher DOI:

10.1136/bmjopen-2016-013664

PubMed ID:

28674127

Uncontrolled Keywords:

Switzerland epidemiology family medicine multimorbidity

BORIS DOI:

10.7892/boris.101755

URI:

https://boris.unibe.ch/id/eprint/101755

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