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Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies

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dc.contributor.author Violan, Concepció
dc.contributor.author Foguet-Boreu, Quintı
dc.contributor.author Flores-Mateo, Gemma
dc.contributor.author Salisbury, Chris
dc.contributor.author Blom, Jeanet
dc.contributor.author Freitag, Michael
dc.contributor.author Glynn, Liam G.
dc.contributor.author Muth, Christiane
dc.contributor.author Valdera, Jose M.
dc.date.accessioned 2020-09-03T08:40:57Z
dc.date.available 2020-09-03T08:40:57Z
dc.date.issued 2014
dc.identifier.uri http://hdl.handle.net/10344/9178
dc.description peer-reviewed en_US
dc.description.abstract Introduction: Multimorbidity is a major concern in primary care. Nevertheless, evidence of prevalence and patterns of multimorbidity, and their determinants, are scarce. The aim of this study is to systematically review studies of the prevalence, patterns and determinants of multimorbidity in primary care. Methods: Systematic review of literature published between 1961 and 2013 and indexed in Ovid (CINAHL, PsychINFO, Medline and Embase) and Web of Knowledge. Studies were selected according to eligibility criteria of addressing prevalence, determinants, and patterns of multimorbidity and using a pretested proforma in primary care. The quality and risk of bias were assessed using STROBE criteria. Two researchers assessed the eligibility of studies for inclusion (Kappa =0.86). Results: We identified 39 eligible publications describing studies that included a total of 70,057,611 patients in 12 countries. The number of health conditions analysed per study ranged from 5 to 335, with multimorbidity prevalence ranging from 12.9% to 95.1%. All studies observed a significant positive association between multimorbidity and age (odds ratio [OR], 1.26 to 227.46), and lower socioeconomic status (OR, 1.20 to 1.91). Positive associations with female gender and mental disorders were also observed. The most frequent patterns of multimorbidity included osteoarthritis together with cardiovascular and/or metabolic conditions. Conclusions: Well-established determinants of multimorbidity include age, lower socioeconomic status and gender. The most prevalent conditions shape the patterns of multimorbidity. However, the limitations of the current evidence base means that further and better designed studies are needed to inform policy, research and clinical practice, with the goal of improving health-related quality of life for patients with multimorbidity. Standardization of the definition and assessment of multimorbidity is essential in order to better understand this phenomenon, and is a necessary immediate step. en_US
dc.language.iso eng en_US
dc.publisher Public Library of Science en_US
dc.relation.ispartofseries PLoS ONE;9 (7) e102149
dc.relation.uri http://dx.doi.org/10.1371/journal.pone.0102149
dc.subject multimorbidity en_US
dc.title Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1371/journal.pone.0102149
dc.contributor.sponsor National Institute for Health Research, Department of Health, United Kingdom en_US
dc.contributor.sponsor Ministry of Science and Innovation through the Instituto Carlos III (ISCiii) en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US


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