Research on patients with multiple health conditions: different constructs, different views, one voice

Valderas, J.M., Mercer, S.W. and Fortin, M. (2011) Research on patients with multiple health conditions: different constructs, different views, one voice. Journal of Comorbidity, 1(1), pp. 1-3.

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Technological advances, improvements in medical care and public health policies have resulted in a growing proportion of patients with multiple health conditions. The prevalence of multiple health conditions among individuals increases with age, is substantial among older adults, and will increase dramatically in coming years. This phenomenon has received growing interest in the most recent literature and has led to several – and often differing – conceptualizations.<p></p> The term “comorbidity” was originally defined by Feinstein as “any distinct additional clinical entity that has existed or may occur during the clinical course of a patient who has the index disease under study”. This definition places one disease in a central position and all other condition(s) as secondary, in that they may or may not affect the course and treatment of the index disease. Feinstein’s principle has been applied all too readily as if the effect of comorbidity was secondary or indeed negligible. In clinical research, individuals with a narrowly defined index condition and no major comorbidities are usually enrolled, leaving the majority of the patients seen in a typical family practice out in the cold. In clinical practice, management of the index condition invariably takes priority, with disjointed – if any – treatment plans developed for each of the comorbidities. This model of care is typical of delivery systems constructed around specialized care, where areas of expertise are defined around specific conditions and bodily systems [11]. Not surprisingly, clinical practice guidelines arising from that model of care lack pertinence for patients with multiple health conditions.

Item Type:Articles
Glasgow Author(s) Enlighten ID:Mercer, Professor Stewart
Authors: Valderas, J.M., Mercer, S.W., and Fortin, M.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
Journal Name:Journal of Comorbidity
Journal Abbr.:JOC
Published Online:01 January 2011
Copyright Holders:Copyright © 2011 The Authors
First Published:First published in Journal of Comorbidity 1(1): 1-3
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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