The German MultiCare-study : patterns of multimorbidity in primary health care - protocol of a prospective cohort study

Background Multimorbidity is a highly frequent condition in older people, but well designed longitudinal studies on the impact of multimorbidity on patients and the health care system have been remarkably scarce in numbe
Background Multimorbidity is a highly frequent condition in older people, but well designed longitudinal studies on the impact of multimorbidity on patients and the health care system have been remarkably scarce in numbers until today. Little is known about the long term impact of multimorbidity on the patients' life expectancy, functional status and quality of life as well as health care utilization over time. As a consequence, there is little help for GPs in adjusting care for these patients, even though studies suggest that adhering to present clinical practice guidelines in the care of patients with multimorbidity may have adverse effects. Methods The study is designed as a multicentre prospective, observational cohort study of 3.050 patients aged 65 to 85 at baseline with at least three different diagnoses out of a list of 29 illnesses and syndromes. The patients will be recruited in approx. 120 to 150 GP surgeries in 8 study centres distributed across Germany. Information about the patients' morbidity will be collected mainly in GP interviews and from chart reviews. Functional status, resources/risk factors, health care utilization and additional morbidity data will be assessed in patient interviews, in which a multitude of well established standardized questionnaires and tests will be performed. Discussion The main aim of the cohort study is to monitor the course of the illness process and to analyse for which reasons medical conditions are stable, deteriorating or only temporarily present. First, clusters of combinations of diseases/disorders (multimorbidity patterns) with a comparable impact (e.g. on quality of life and/or functional status) will be identified. Then the development of these clusters over time will be analysed, especially with regard to prognostic variables and the somatic, psychological and social consequences as well as the utilization of health care resources. The results will allow the development of an instrument for prediction of the deterioration of the illness process and point at possibilities of prevention. The practical consequences of the study results for primary care will be analysed in expert focus groups in order to develop strategies for the inclusion of the aspects of multimorbidity in primary care guidelines.
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Author:Ingmar Schäfer, Heike Hansen, Gerhard Schön, Wolfgang Maier, Susanne Höfels, Attila Altiner, Angela Fuchs, Ferdinand M. Gerlach, Juliana Petersen, Jochen Gensichen, Sven Schulz, Steffi Gerlinde Riedel-Heller, Melanie Luppa, Siegfried Weyerer, Jochen Werle, Horst Bickel, Kerstin Barth, Hans-Helmut König, Anja Rudolph, Birgitt Wiese, Jana Prokein, Monika Bullinger, Olaf von dem Knesebeck, Marion Eisele, Hanna Kaduszkiewicz, Karl Wegscheider, Hendrik van den Bussche
URN:urn:nbn:de:hebis:30-64387
Document Type:Article
Language:English
Date of Publication (online):2009/09/07
Year of first Publication:2009
Publishing Institution:Univ.-Bibliothek Frankfurt am Main
Release Date:2009/09/07
Note:
© 2009 Schafer et al. , licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License  (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Source:BMC Health Services Research 2009, 9:145 , doi:10.1186/1472-6963-9-145 ; http://www.biomedcentral.com/1472-6963/9/145/
HeBIS PPN:215594967
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 2.0

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