Multimorbidity in Primary Care: Current Situation and Research Gap / 日本プライマリ・ケア連合学会誌

ABSTRACT

In the 1980s, some researchers started using the word "multimorbidity", which is defined as "the co-existence of two or more long-term conditions in an individual". Multimorbidity has become one of the most important topics in recent primary care because of its clinical significance. Multimorbidity is more common among the elderly, and was suggested to be associated with female sex, lower socio-economic status and mental disease. Multimorbidity is associated with a higher mortality, lower quality of life and reduced functional status. It is also associated with the treatment burden such as consultation frequency, fragmented healthcare provision and inadequate polypharmacy. Multimorbidity has negative impact on health care resource use such as hospital visits, unexpected admission and total health care costs. However, the total picture and health care effects of multimorbidity have only been reported in observational studies, and there is little evidence of which interventions are effective for multimorbidity patients. In this review paper, we carried out a literature review of high-quality reports from Japan and overseas. We provide an overview of the current situation of multimorbidity research and highlight the research gaps. Based on these results, we would like to propose approaches for multimorbidity patients in clinical settings.