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Jeeva Kanesarajah, Michael Waller, Jennifer A Whitty, Gita D Mishra
There is substantial multimorbidity at mid-life but little is known about the strength of evidence on multimorbidity and health-related quality of life (HrQoL) at mid-life. This review addresses this gap, focusing on studies of the general population. PubMed, Web of Science, Embase and APA PsycNET databases were screened on 6 March 2017 for original research on multimorbidity and HrQoL in adults aged 40-65 years from the general population. Studies focused on index conditions, using single-item HrQoL measures, unlikely to represent the general population (e...
March 2018: Maturitas
René Florian Oswald, H Christof Müller-Busch
A young, still multimorbid woman aquires infectious endocarditis. Anamnestically severe non-adherence concerning medical advice is reported. Complete cure may only be achieved by performing surgical heart valve replacement, which implies lifelong scrupulous oral anticoagulation postoperatively. Discussion evolves within medical staff, whether surgery should be indicated or not.
February 15, 2018: Wiener Medizinische Wochenschrift
Namsoo Kim, Hyun-Jun Nam, Juhwan Noh, Eun-Cheol Park
Most of the behavior change models regard perceived health status as a motivation for healthy behaviors or chronic disease self-management. The aim of this study was to examine the association between the number of chronic diseases and the difference between global and age-comparative self-rated health scores (GSRH and ASRH). We used national representative survey data pertaining to the elderly in 2011 from the Korea Institute for Health and Social Affairs. In total, 10,003 participants (≥60 years old) were selected from those who had completed the survey in 2008...
January 3, 2018: Archives of Gerontology and Geriatrics
Nélio Drumond, Sven Stegemann
Solid oral dosage forms (SODF) are drug vehicles commonly prescribed by physicists in primary and secondary cares, as they are the most convenient for the patient and facilitate therapy management. Concerns regarding unintended adhesion of SODF during oro-esophageal transit remain, especially in multimorbid patients, bedridden patients and patients suffering from dysphagia. Hence, this factor should be considered during the development of SODF, and more attention should be given on the design of appropriate surface conditions considering patients with swallowing problems...
February 9, 2018: Colloids and Surfaces. B, Biointerfaces
Thanya I Pathirana, Caroline A Jackson
OBJECTIVES: We performed a systematic review to identify, critically appraise and synthesise the existing literature on the association between SEP and multimorbidity occurrence. METHODS: We searched Medline and Embase from inception to December 2014. Where possible we performed meta-analysis to obtain summary odds ratios (ORs), exploring heterogeneity between studies through sub-group analysis. RESULTS: We identified 24 cross-sectional studies that largely reported on education, deprivation or income in relation to multimorbidity occurrence...
February 14, 2018: Australian and New Zealand Journal of Public Health
Barbara Bień, Katarzyna Bień-Barkowska
INTRODUCTION Multimorbidity in older adults leads to polypharmacy with all its hazardous outcomes and drug related problems. OBJECTIVES We assess the difference in the number of drugs between admission to and discharge from a geriatric ward and identify the patient-related factors associated with changes in the drug regimen. PATIENTS AND METHODS This retrospective cross-sectional study covered 301 geriatric patients who underwent drug optimization in line with the Beers and STOPP/START criteria. The numbers of drugs per individual at hospital admission and discharge were compared using the Wilcoxon signed-rank test...
February 14, 2018: Polish Archives of Internal Medicine
Alexandra A N'Goran, Jérôme Pasquier, Anouk Deruaz-Luyet, Bernard Burnand, Dagmar M Haller, Stefan Neuner-Jehle, Andreas Zeller, Sven Streit, Lilli Herzig, Patrick Bodenmann
OBJECTIVE: To identify factors associated with health literacy in multimorbid patients. DESIGN: A nationwide cross-sectional study in Switzerland. Univariate and multivariate linear regressions were calculated to identify variables associated with health literacy. A multiple imputation approach was used to deal with missing values. PARTICIPANTS: Multimorbid patients recruited in primary care settings (n=888), above 18 years old and suffering from at least 3 of 75 chronic conditions on a predefined list based on the International Classification of Primary Care 2...
February 13, 2018: BMJ Open
Xiao-Xiao Wang, Zhao-Bin Chen, Xu-Jia Chen, Ling-Ling Huang, Xiao-Yue Song, Xiao Wu, Li-Ying Fu, Pei-Xi Wang
BACKGROUND: Hospitalization over the last one year, an indicator of health service utilization, is an important and costly resource in older adult care. However, data on the relationship between functional status and annual hospitalization among older Chinese people are sparse, particularly for those with and without multimorbidity. In this study,we aimed to examine the association between functional status and annual hospitalization among community-dwelling older adults in Southern China, and to explore the independent contributions of socio-demographic variables, lifestyle and health-related factors and functional status to hospitalization in multimorbid and non-multimorbid groups...
February 13, 2018: Health and Quality of Life Outcomes
Julia Riebandt, Dominik Wiedemann, Guenther Laufer, Daniel Zimpfer
A novel sternotomy sparing implantation technique for the Thoratec HeartMate 3 is described. Cannulation of the left ventricular apex is performed via a minithoracotomy in the left fourth or fifth intercostal space. The outflow graft is advanced through the pericardium to a second minithoracotomy in the right second intercostal space and then anastomosed to the ascending aorta. This approach was performed in three patients so far with no need for conversion. We did not observe any perioperative adverse events, such as bleeding or thromboembolic complications, as well as no short-term mortality...
February 9, 2018: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
Deborah Kinnear, Jill Morrison, Linda Allan, Angela Henderson, Elita Smiley, Sally-Ann Cooper
OBJECTIVES: To investigate the prevalence of multimorbidity in adults with intellectual disabilities with and without Down syndrome. DESIGN: Large, population-based cross-sectional study. SETTING: The geographical area of one Health Board, Scotland. PARTICIPANTS: All adults (aged 16+ years) known to general practitioners to have intellectual disabilities and adults receiving services provided or paid by intellectual disabilities health or social work services...
February 5, 2018: BMJ Open
Hsiu-Yu Ho, Mei-Hui Chen, Meei-Fang Lou
Background: Many people with diabetes have comorbidities, even multimorbidities, which have a far-reaching impact on the older adults, their family, and society. However, little is known of the experience of older adults living with comorbidities that include diabetes. Aim: The aim of this study was to explore the experience of older adults living with comorbidities including diabetes. Methods: A qualitative approach was employed. Data were collected from a selected field of 12 patients with diabetes mellitus in a medical center in northern Taiwan...
2018: Patient Preference and Adherence
Christopher Harrison, A Niroshan Siriwardena
No abstract text is available yet for this article.
January 2018: Aust J Gen Pract
Julie Gordon, Graeme C Miller, Helena Britt
BACKGROUND: There is currently no accepted standard definition for chronic conditions. OBJECTIVE: The objective of this article is to provide an overview of the characteristics that define health conditions as chronic. DISCUSSION: A list of health conditions classified as chronic should be made available to all general practitioners and policymakers in Australia. This will assist in the claims process for chronic disease management and aid the selection of patients for healthcare home enrolment...
January 2018: Aust J Gen Pract
Stephen R Leeder, Tanisha Jowsey, Justin W McNab
BACKGROUND: Non-communicable diseases (NCDs) are increasing in prevalence and straining health systems globally. This creates a so-called 'burden of disease', which can be traced in terms of fiscal health system matters and in terms of quality of life and lived experiences of people with NCDs. The United Nations has called for a global agenda to manage NCDs and reduce their burden. OBJECTIVE: The purpose of this article is to summarise key findings from the Serious and Continuing Illness Policy and Practice Study concerning patients’ and carers’ experiences of multimorbid NCDs in Australia...
January 2018: Aust J Gen Pract
Nadeeka K Chandraratne, Kgrv Pathirathna, Christopher Harrison, A Niroshan Siriwardena
Important differences exist in how national policies seek to address multimorbidity. Policy implementation, how this affects quality of care and outcomes, and the role of primary care should be examined.
January 2018: Aust J Gen Pract
Kylie J McKenzie, David Pierce, Jane M Gunn
BACKGROUND: Multimorbidity is an increasing and complex issue in Australian general practice. General practitioners (GPs) face the challenge of navigating multiple potential intervention pathways. Emerging guidelines for multimorbidity recommend patient-centred care and addressing the lifestyle factors of the patient. Motivational interviewing is a patient-centred approach that is focused on behavioural change and effective across a range of lifestyle factors. OBJECTIVE: The aim of this article is to provide a practical introduction to motivational interviewing skills that may be helpful in working with patients who have multimorbidity...
January 2018: Aust J Gen Pract
Ai Koyanagi, Elvira Lara, Brendon Stubbs, Andre F Carvalho, Hans Oh, Andrew Stickley, Nicola Veronese, Davy Vancampfort
OBJECTIVES: To assess the association between chronic physical conditions and multimorbidity and mild cognitive impairment (MCI) in low- and middle-income countries (LMICs). DESIGN: Nationally representative, cross-sectional, community-based study. SETTING: Six countries that participated in the World Health Organization Study on Global Ageing and Adult Health. PARTICIPANTS: Individuals aged 50 and older (N=32,715; mean age 62...
February 10, 2018: Journal of the American Geriatrics Society
Karin Ranstad, Patrik Midlöv, Anders Halling
BACKGROUND: Healthcare systems are complex networks where relationships affect outcomes. The importance of primary care increases while health care acknowledges multimorbidity, the impact of combinations of different diseases in one person. Active listing and consultations in primary care could be used as proxies of the relationships between patients and primary care. Our objective was to study hospitalisation as an outcome of primary care, exploring the associations with active listing, number of consultations in primary care and two groups of practices, while taking socioeconomic status and morbidity burden into account...
February 9, 2018: BMC Health Services Research
Kalpana Singh, Shivani A Patel, Suddhendu Biswas, Roopa Shivashankar, Dimple Kondal, Vamadevan S Ajay, Ranjit Mohan Anjana, Zafar Fatmi, Mohammed K Ali, M Masood Kadir, Viswanathan Mohan, Nikhil Tandon, K M Venkat Narayan, Dorairaj Prabhakaran
Background: We report the prevalence, risk factors and mortality associated with multimorbidity in urban South Asian adults. Methods: Hypertension, diabetes, heart disease, stroke and chronic kidney disease were measured at baseline in a sample of 16 287 adults ages ≥20 years in Delhi, Chennai and Karachi in 2010-11 followed for an average of 38 months. Multimorbidity was defined as having ≥2 chronic conditions at baseline. We identified correlates of multimorbidity at baseline using multinomial logistic models, and we assessed the prospective association between multimorbidity and mortality using Cox proportional hazards models...
February 7, 2018: Journal of Public Health
Daniela Simões, Fábio Azevedo Araújo, Teresa Monjardino, Milton Severo, Ivo Cruz, Loreto Carmona, Raquel Lucas
The aim of this study was to quantify the population impact of rheumatic and musculoskeletal diseases (RMDs) with other non-communicable diseases (NCDs), using two complementary strategies: standard multivariate models based on global burden of disease (GBD)-defined groups vs. empirical mutually exclusive patterns of NCDs. We used cross-sectional data from the Portuguese Fourth National Health Survey (n = 23,752). Six GBD-defined groups were included: RMDs, chronic obstructive pulmonary disease or asthma, cancer, depression, diabetes or renal failure, and stroke or myocardial infarction...
February 8, 2018: Rheumatology International
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