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 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 SchäferGND, Heike Hansen, Gerhard SchönORCiDGND, Wolfgang Maier, Susanne Höfels, Attila Altiner, Angela FuchsGND, Ferdinand M. GerlachORCiDGND, Juliana PetersenORCiDGND, Jochen GensichenORCiDGND, Sven Schulz, Steffi Gerlinde Riedel-HellerORCiDGND, Melanie Luppa, Siegfried Weyerer, Jochen Werle, Horst BickelGND, Kerstin Barth, Hans-Helmut König, Anja Rudolph, Birgitt WieseORCiDGND, Jana Prokein, Monika Bullinger, Olaf von dem Knesebeck, Marion Eisele, Hanna Kaduszkiewicz, Karl Wegscheider, Hendrik van den BusscheORCiDGND
Pubmed Id:
Parent Title (English):BMC health services research
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Date of Publication (online):2009/09/07
Date of first Publication:2009/08/11
Publishing Institution:Universitätsbibliothek Johann Christian Senckenberg
Release Date:2009/09/07
Issue:Art. 145
Page Number:9
First Page:1
Last Page:9
© Schäfer et al; licensee BioMed Central Ltd. 2009. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (, 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 ;
Institutes:Medizin / Medizin
Dewey Decimal Classification:6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit
Licence (German):License LogoCreative Commons - Namensnennung 2.0