multiple medical problems; multimorbidity (MMP)
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Introduction
Epidemiology
- > 50% of elderly
- adults < 65 years of age in the poorest socioeconomic decile have rates of multimorbidity equivalent to those of people 10-15 years older in the most affluent decile
Complications
- increased risk* of
- death
- disability
- adverse effects
- institutionalization
- use of healthcare resources
- decreased quality of life
* elderly with multimorbidity are heterogenous in terms of
- illness severity
- functional status
- prognosis[2]
Management
- consider patient preferences
- consider the evidence base for treatment
- consider the patient's prognosis
- assess the clinical feasibility of proposed plan
- optimize care plan[2][5]
Notes
- most clinical practice guidelines focus on a single disease
- elderly with multiple medical problems are excluded from clinical trials
More general terms
Additional terms
References
- ↑ Barnett K et al. Epidemiology of multimorbidity and implications for health care, research, and medical education: A cross-sectional study. Lancet 2012 May 10 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22579043 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60240-2/fulltext
Salisbury C. Multimorbidity: Redesigning health care for people who use it. Lancet 2012 May 10 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/22579042 <Internet> http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(12)60482-6/fulltext - ↑ 2.0 2.1 2.2 Geriatric Review Syllabus, 8th edition (GRS8) Durso SC and Sullivan GN (eds) American Geriatrics Society, 2013
Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016 - ↑ Guiding principles for the care of older adults with multimorbidity: an approach for clinicians: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. Guiding principles for the care of older adults with multimorbidity: an approach for clinicians. J Am Geriatr Soc. 2012 Oct;60(10):E1-E25. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22994865 (corresponding NGC guideline withdrawn Dec 2017)
Patient-centered care for older adults with multiple chronic conditions: a stepwise approach from the American Geriatrics Society: American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. American Geriatrics Society Expert Panel on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2012 Oct;60(10):1957-68. PMID: https://www.ncbi.nlm.nih.gov/pubmed/22994844 - ↑ Varadhan R, Weiss CO, Segal JB et al Evaluating health outcomes in the presence of competing risks: a review of statistical methods and clinical applications. Med Care. 2010 Jun;48(6 Suppl):S96-105. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/20473207
- ↑ 5.0 5.1 Talebraza S et al Geriatrics Evaluation & Management Tools American Geriatrics Society. 2021 https://geriatricscareonline.org/ProductAbstract/geriatrics-evaluation-management-tools/B007/