Prevalence of Multiple Chronic Conditions Among US Adults: Estimates From the National Health Interview Survey, 2010

Ward, Brian; Schiller, Jeannine S.

doi:10.5888/pcd10.120203

Cited by 482 publications

(441 citation statements)

References 17 publications

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“…Ageing does not affect people's health in the same way, but about 80% of older people ( 65 years old) have at least one underlying chronic disease ('usual ageing'), and 25% have more than three underlying chronic diseases [1]. While some seniors 'age successfully' and have no underlying chronic diseases, others become frail and can need long-term care in specialised facilities.…”

Section: Higher Risk Of Infectious Diseases In the Elderlymentioning

confidence: 99%

The role of vaccination in successful independent ageing

McElhaney¹,

Gavazzi

Flamaing

et al. 2016

European Geriatric Medicine

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Section: Higher Risk Of Infectious Diseases In the Elderlymentioning

confidence: 99%

The role of vaccination in successful independent ageing

McElhaney¹,

Gavazzi

Flamaing

et al. 2016

European Geriatric Medicine

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“…Thus optimising the care of multimorbidity is of concern for healthcare research, policy, and education. 6 Multimorbid patients are also more likely to experience polypharmacy and potentially inappropriate prescribing than patients with single diseases. 7,8 However, prescribing 'appropriately' in multimorbidity is not always straightforward.…”

Section: Introductionmentioning

confidence: 99%

What to give the patient who has everything? A qualitative study of prescribing for multimorbidity in primary care

et al. 2015

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BackgroundUsing clinical guidelines in the management of patients with multimorbidity can lead to the prescription of multiple and sometimes conflicting medications. AimTo explore how GPs make decisions when prescribing for multimorbid patients, with a view to informing intervention design. Design and settingIn-depth qualitative interviews incorporating chart-stimulated recall with purposively sampled GPs in the Republic of Ireland. MethodGrounded theory analysis with iterative theory development. ResultsTwenty GPs were interviewed about 51 multimorbid cases. In these cases, GPs integrated information from multiple sources including the patient, specialists, and evidencebased medicine. Difficulties arose when recommendations or preferences conflicted, to which GPs responded by 'satisficing': accepting care that they deemed satisfactory and sufficient for a particular patient. Satisficing was manifest as relaxing targets for disease control, negotiating compromise with the patient, or making 'best guesses' about the most appropriate course of action to take. In multimorbid patients perceived as stable, GPs preferred to 'maintain the status quo' rather than rationalise medications, even in cases with significant polypharmacy. Proactive changes in medications were facilitated by continuity of care, sufficient consultation time, and open lines of communication with the patient, other healthcare professionals, and other GPs. ConclusionGPs respond to conflicts in the management of multimorbid patients by making compromises between patient-centred and evidence-based care. These findings will be used to inform interventions that aim to care in multimorbidity.

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“…2 As the population ages, the number of people living with MCC is growing dramatically, 3 and their medical costs account for 75 % of health care spending in the United States. Among the Medicare older adult population, over 90 % of health care spending is devoted to people with MCC.…”

Section: T He Article By Donna Zulman and Colleagues In This Issuementioning

confidence: 99%

The Use of Technology to Enhance Health

Nilsen

2015

J GEN INTERN MED

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T he article by Donna Zulman and colleagues in this issueof the Journal of General Internal Medicine 1 provides important information in support of our understanding of the utility and value of eHealth-more broadly known as health information technology-for people with multiple chronic conditions (MCC).More than one in four Americans lives with the burden of two or more ongoing health conditions. 2 As the population ages, the number of people living with MCC is growing dramatically, 3 and their medical costs account for 75 % of health care spending in the United States. Among the Medicare older adult population, over 90 % of health care spending is devoted to people with MCC. 4 However, research shows that this heavy expenditure has not resulted in the desired improvements in the quality of life of the people with MCC. 4 In this environment, eHealth-including computers, Internet, mobile technologies and sensors-may have some potential to improve health and enhance the quality of life, while also reducing costs. eHealth technology allows for smart distillation and distribution of information in a personalized format that should support patients and providers alike, especially with the complex issues of managing multiple chronic conditions.Zulman and colleagues' work explores how a group of 53 people with MCC at either a Veterans Affairs or an academic medical center used technology. Their survey and focus groups studied the technology usage and needs of people with MCC. Not surprisingly, the group found that participants' eHealth usage and requirements targeted three specific areas: managing, coordinating, and generating information to support their health. Management of information focused on collecting and organizing schedules, exploring treatment effects and medication interactions, and collating these data for the patient, caregiver and health care team. Coordinating information stressed the need for communication between the many systems and providers involved with people with MCC. Finally, generating information described people's collection of health information from disparate sources so that they could develop specialized knowledge about their diseases and treatments, both for their own needs and to share with providers.The focus of Zulman and colleagues' article is especially important given multiple recent articles in the popular press noting that eHealth and mobile health have not been fulfilling their potential. The overriding message is that health information technology, regardless of format, has to move away from being just exciting technology for a select group of tech-savvy individuals and become a product that fits the needs of the population and merges an understanding of clinical science and consumer behavior to create useful tools. This emerging literature also emphasizes the need to conceptualize and design health information technology around the needs of actual end-users. Instead of developing tools that are based on the idea of passive patients waiting for health technology to affect thei...

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Prevalence of Multiple Chronic Conditions Among US Adults: Estimates From the National Health Interview Survey, 2010

Cited by 482 publications

References 17 publications

The role of vaccination in successful independent ageing

The role of vaccination in successful independent ageing

What to give the patient who has everything? A qualitative study of prescribing for multimorbidity in primary care

The Use of Technology to Enhance Health

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