Defining and measuring multimorbidity: a systematic review of systematic reviews

Johnston, M. C., Crilly, M., Black, C., Prescott, G. J. and Mercer, S. (2019) Defining and measuring multimorbidity: a systematic review of systematic reviews. European Journal of Public Health, 29(1), pp. 182-189. (doi: 10.1093/eurpub/cky098) (PMID:29878097)

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Background: Multimorbidity, the coexistence of multiple health conditions, is a growing public health challenge. Research and intervention development are hampered by the lack of consensus regarding defining and measuring multimorbidity. The aim of this systematic review was to pool the findings of systematic reviews examining definitions and measures of multimorbidity. Methods: Medline, Embase, PubMed and Cochrane were searched from database inception to February 2017. Two authors independently screened titles, abstracts and full texts and extracted data from the included papers. Disagreements were resolved with a third author. Reviews were quality assessed. Results: Of six reviews, two focussed on definitions and four on measures. Multimorbidity was commonly defined as the presence of multiple diseases or conditions, often with a cut-off of two or more. One review developed a holistic definition including biopsychosocial and somatic factors as well as disease. Reviews recommended using measures validated for the outcome of interest. Disease counts are an alternative if no validated measure exists. Conclusions: To enable comparison between studies and settings, researchers and practitioners should be explicit about their choice of definition and measure. Using a cut-off of two or more conditions as part of the definition is widely adopted. Measure selection should be based on tools validated for the outcome being considered. Where there is no validated measure, or where multiple outcomes or populations are being considered, disease counts are appropriate.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Mercer, Professor Stewart
Authors: Johnston, M. C., Crilly, M., Black, C., Prescott, G. J., and Mercer, S.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:European Journal of Public Health
Publisher:Oxford University Press
ISSN (Online):1464-360X
Published Online:05 June 2018
Copyright Holders:Copyright © 2018 The Authors
First Published:First published in European Journal of Public Health 29(1): 182-189
Publisher Policy:Reproduced in accordance with the publisher copyright policy

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
650021Multimorbidity - prevalence, risk factors and resilience in a large Scottish birth cohortStewart MercerChief Scientist office (CSO)CAF/13/03IHW - GENERAL PRACTICE & PRIMARY CARE