Managing Multiple Chronic Conditions

Many individuals, especially those in later life, are simultaneously managing more than one chronic health condition, a situation often referred to as “multimorbidity.”  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  In spite of the high prevalence of multimorbidity in the population, there has been little research on the specific needs of patients with multiple chronic illnesses, both generally and for specific combinations of illnesses.  A better understanding of how to best support self-management among multimorbid patients is an important priority.

Recent or current projects at the CMCD with a focus on multimorbidity include:  

• Comparing symptoms and functioning over time among older female heart disease patients with and without diabetes.
  • Janevic, M.R., Janz, N.K., Connell, C. M., Kaciroti, N., & Clark, N.M.   Progression of symptoms and functioning among female cardiac patients with and without diabetes.  Journal of Women's Health. 2010 Nov 22. [Epub ahead of print]

References:
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.