Posts
 |
| Image Credit: By freestocks.org freestocks (https://unsplash.com/photos/nss2eRzQwgw) [CC0], via Wikimedia Commons |
Healthcare Challenges Offered By Multi-Morbidity
Such individuals with usual involvement of more than one of the vital organs (heart, kidneys, liver, brain, pancreas, lungs, intestines, and joints) are more likely to die prematurely, and have a poor quality of life, despite high health care costs.
Such individuals depend a lot on health services, and it has been estimated that a patient with diabetes, osteoarthritis, COPD, ischemic heart disease would require 11 or more medications and need more than 40 contacts per year with the system.
Barriers to appropriate care for such patients with multiple diseases include the complexity of their illness, clinical vulnerability, logistical challenges, polypharmacy, physical limitations, and functional dependence, and exacerbation of one condition by another condition or its treatment.
The emergence of multiple diseases was found to occur 10–15 years earlier in deprived people as compared to people from more affluent groups.
Such individuals depend a lot on health services, and it has been estimated that a patient with diabetes, osteoarthritis, COPD, ischemic heart disease would require 11 or more medications and need more than 40 contacts per year with the system.
Barriers to appropriate care for such patients with multiple diseases include the complexity of their illness, clinical vulnerability, logistical challenges, polypharmacy, physical limitations, and functional dependence, and exacerbation of one condition by another condition or its treatment.
Profiling Individuals With Multi-Morbidity
A study estimated that one in four elderly individuals suffers from multiple chronic conditions, and the figure for younger adults was in the range of 11–16%.The emergence of multiple diseases was found to occur 10–15 years earlier in deprived people as compared to people from more affluent groups.
If one thinks about a person with multiple coexisting chronic conditions, the picture that comes to mind is generally of an older person, with illnesses, such as heart conditions, asthma, arthritis, and Type 2 diabetes. But, it is not always old people who suffer from multiple conditions related to lifestyle issues or to genetics or the environment. These may also be young people or people with rare conditions, for example, Thalassemia, Type 1 diabetes, and epilepsy.
A study found that among all the people with multiple conditions, the groups who have the highest risk of death include people with age ≥85 years, those without a caregiver or caregiver other than the spouse, people with cancers, dementia, severe breathlessness that confines people to bed, severe physical activity limitation, and ≥4 hospital admissions in last 12 months.
Way Forward
There have been frequent calls to healthcare systems to formulate strategies to provide personalized, and comprehensive care for such individuals but the system seems to be occupied with a single disease framework, ignoring the needs of such vulnerable groups.
American Geriatric Society gave recommendations for older adults with multiple conditions and identified five principles for such care that were:
In their concluding statement, they also highlighted the research gap for this group and noted that "Patients should be evaluated, and care plans should be designed and implemented according to the individual needs of each patient, with the recognition that few studies are currently available that have rigorously evaluated the effectiveness of approaches related to these guiding principles."
About the author: Dr. Naval Asija is a licensed MBBS Physician from India. MBBS is the equivalent of the MD degree offered by international medical schools. He is based in Delhi, India, and works as a medical writer, editor, and consultant. He supports medical researches as an author's editor, medical communication companies involved in medico-marketing activities, and medical technology companies in improving their products. He can be contacted via his LinkedIn Profile: https://www.linkedin.com/in/navalasija/
Disclaimer: The content provided here is NOT a substitute for professional medical advice. If you consider taking any action based on the above information, we recommend that it should be first confirmed with your doctor. Our detailed disclaimer statement can be read at our homepage
- Incorporating patient preferences into medical decision-making,
- Recognizing the limitations of the evidence base,
- Framing clinical management decisions within the context of risks, burdens, benefits, and prognosis,
- Considering treatment complexity and feasibility, and
- Choosing therapies that optimize benefit, minimize harm, and enhance the quality of life.
In their concluding statement, they also highlighted the research gap for this group and noted that "Patients should be evaluated, and care plans should be designed and implemented according to the individual needs of each patient, with the recognition that few studies are currently available that have rigorously evaluated the effectiveness of approaches related to these guiding principles."
About the author: Dr. Naval Asija is a licensed MBBS Physician from India. MBBS is the equivalent of the MD degree offered by international medical schools. He is based in Delhi, India, and works as a medical writer, editor, and consultant. He supports medical researches as an author's editor, medical communication companies involved in medico-marketing activities, and medical technology companies in improving their products. He can be contacted via his LinkedIn Profile: https://www.linkedin.com/in/navalasija/
Comments
Post a Comment
Thank you for your comments. The comments are moderated and it may take some time to get live.