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Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies

PloS one, 2014-07, Vol.9 (7), p.e102149-e102149 [Peer Reviewed Journal]

2014 Violan et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. ;2014 Violan et al 2014 Violan et al ;ISSN: 1932-6203 ;EISSN: 1932-6203 ;DOI: 10.1371/journal.pone.0102149 ;PMID: 25048354

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  • Title:
    Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies
  • Author: Violan, Concepció ; Foguet-Boreu, Quintí ; Flores-Mateo, Gemma ; Salisbury, Chris ; Blom, Jeanet ; Freitag, Michael ; Glynn, Liam ; Muth, Christiane ; Valderas, Jose M
  • Scuteri, Angelo
  • Subjects: Age Factors ; Biocompatibility ; Biomedical materials ; Chronic illnesses ; Comorbidity ; Diabetes ; Female ; Health care ; Humans ; Identification ; Literature reviews ; Male ; Medicine ; Medicine and Health Sciences ; Mental disorders ; Methods ; Osteoarthritis ; Patients ; Prevalence ; Primary care ; Primary Health Care - methods ; Public health ; Quality of Life ; Researchers ; Sex Factors ; Socioeconomic Factors ; Socioeconomics ; Standardization ; Studies ; Systematic review
  • Is Part Of: PloS one, 2014-07, Vol.9 (7), p.e102149-e102149
  • Description: Multimorbidity is a major concern in primary care. Nevertheless, evidence of prevalence and patterns of multimorbidity, and their determinants, are scarce. The aim of this study is to systematically review studies of the prevalence, patterns and determinants of multimorbidity in primary care. Systematic review of literature published between 1961 and 2013 and indexed in Ovid (CINAHL, PsychINFO, Medline and Embase) and Web of Knowledge. Studies were selected according to eligibility criteria of addressing prevalence, determinants, and patterns of multimorbidity and using a pretested proforma in primary care. The quality and risk of bias were assessed using STROBE criteria. Two researchers assessed the eligibility of studies for inclusion (Kappa= 0.86). We identified 39 eligible publications describing studies that included a total of 70,057,611 patients in 12 countries. The number of health conditions analysed per study ranged from 5 to 335, with multimorbidity prevalence ranging from 12.9% to 95.1%. All studies observed a significant positive association between multimorbidity and age (odds ratio [OR], 1.26 to 227.46), and lower socioeconomic status (OR, 1.20 to 1.91). Positive associations with female gender and mental disorders were also observed. The most frequent patterns of multimorbidity included osteoarthritis together with cardiovascular and/or metabolic conditions. Well-established determinants of multimorbidity include age, lower socioeconomic status and gender. The most prevalent conditions shape the patterns of multimorbidity. However, the limitations of the current evidence base means that further and better designed studies are needed to inform policy, research and clinical practice, with the goal of improving health-related quality of life for patients with multimorbidity. Standardization of the definition and assessment of multimorbidity is essential in order to better understand this phenomenon, and is a necessary immediate step.
  • Publisher: United States: Public Library of Science
  • Language: English
  • Identifier: ISSN: 1932-6203
    EISSN: 1932-6203
    DOI: 10.1371/journal.pone.0102149
    PMID: 25048354
  • Source: Public Library of Science (PLoS) Journals Open Access
    Geneva Foundation Free Medical Journals at publisher websites
    MEDLINE
    PubMed Central
    ProQuest Central
    DOAJ Directory of Open Access Journals
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