Managing Multiple Chronic Conditions

Many individuals, especially those in later life, are simultaneously managing multiple chronic conditions.  For example, in the Medicare population, 65% of patients have two or more chronic illnesses.1  These patients face notable challenges and complexity in managing their health.   Some of the difficulties experienced by patients include: poor coordination of medical care, managing multiple medications, and aggravation of one condition by symptoms or treatment of another.2   Research directed at improving the health of individuals with multiple chronic conditions has been recognized as a high priority by the U.S. Department of Health and Human Services in a recent Strategic Framework for MCCs3, and by the Institute of Medicine in their report “Living Well With Chronic Illness: A Call for Public Health Action.”4

Recent or current projects at the CMCD with a focus on multiple chronic conditions include: 

Recent publications:

Clark NM. The multiple challenges of multiple morbidities. Health Education & Behavior. 2011;38:219-21..

Janevic, M.R., Janz, N.K., Connell, C.M., Kaciroti, N., Clark, N.M. (2011). Progression of symptoms and functioning among female cardiac patients with and without diabetes.  Journal of Women’s Health, 20, 107-115.

Janevic, M.R., Rosland, A.M., Wiitala, W., Connell, C.M., Piette, J.D. (in press) Providing support to relatives and friends managing both chronic physical illness and depression: The views of a national sample of U.S. adults. Patient Education and Counseling.

Recent conference presentations:

Sanders, G., Janevic, M.R., Thomas, L.J., Johnson, T.R., Clark, N.M. Depressive Symptoms in African American and Caucasian Women Participating in Telephone-Based Asthma Management Programs.  Oral presentation American Academy of Allergy, Asthma, and Immunology Annual Meeting, Orlando, FL, March 2012.

Janevic, M.R. Valerio, M., Sanders, G., Clark, N.M.. A greater number of non-lung comorbidities is associated with decreased asthma quality of life and increased odds of ED use among adult women with asthma. Poster presentation at American Thoracic Society conference, scheduled May 2012.

Ongoing research:

A qualitative study of asthma-management challenges in the context of multimorbidity among African-American women.  (substudy to Women of Color and Asthma Control, R18HL094272-01, Noreen Clark, PI)


1. Wolff JL, Starfield B, Anderson G.  Prevalence, expenditures, and complications of multiple chronic conditions in the elderly.  Arch Intern Med. 2002 Nov 11;162(20):2269-76.
2. Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS.  Descriptions of barriers to self-care by persons with comorbid chronic diseases.  Ann Fam Med. 2003 May-Jun;1(1):15-21.
3. U.S. Department of Health and Human Services. Multiple Chronic Conditions—A Strategic Framework: Optimum Health and Quality of Life for Individuals with Multiple Chronic Conditions. Washington D.C.:December 2010.
4. Committee on Living Well with Chronic Disease: Public Action to Reduce Disability and Improve Functioning and Quality of Life, Institute of Medicine. Living Well with Chronic Illness: A Call for Public Health Action. Washington. D.C.: The National Academies Press; 2012.