Family practitioners' top medical priorities when managing patients with multimorbidity: a cross-sectional study

BackgroundManaging multiple chronic and acute conditions in patients with multimorbidity requires setting medical priorities. How family practitioners (FPs) rank medical priorities between highly, moderately, or rarely prevalent chronic conditions (CCs) has never been described. The authors hypothesised that there was no relationship between the prevalence of CCs and their medical priority ranking in individual patients with multimorbidity.AimTo describe FPs’ medical priority ranking of conditions relative to their prevalence in patients with multimorbidity.Design & settingThis cross-sectional study of 100 FPs in Switzerland included patients with ≥3 CCs on a predefined list of 75 items from the International Classification of Primary Care 2 (ICPC-2); other conditions could be added. FPs ranked all conditions by their medical priority.MethodPriority ranking and distribution were calculated for each condition separately and for the top three priorities together.ResultsThe sample contained 888 patients aged 28–98 years (mean 73), of which 48.2% were male. Included patients had 3–19 conditions (median 7; interquantile range [IQR] 6–9). FPs used 74/75 CCs from the predefined list, of which 27 were highly prevalent (>5%). In total, 336 different conditions were recorded. Highly prevalent CCs were only the top medical priority in 66%, and the first three priorities in 33%, of cases. No correlation was found between prevalence and the ranking of medical priorities.ConclusionFPs faced a great diversity of different conditions in their patients with multimorbidity, with nearly every condition being found at nearly every rank of medical priority, depending on the patient. Medical priority ranking was independent of the prevalence of CCs.

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Identifying Adverse Events Using International Classification of Diseases, Tenth Revision Y Codes in Korea: A Cross-sectional Study

Journal of Preventive Medicine and Public Health ◽

10.3961/jpmph.17.118 ◽

2018 ◽

Vol 51 (1) ◽

pp. 15-22 ◽

Cited By ~ 3

Author(s):

Minsu Ock ◽

Hwa Jung Kim ◽

Bomin Jeon ◽

Ye-Jee Kim ◽

Hyun Mi Ryu ◽

...

Keyword(s):

Adverse Events ◽

International Classification Of Diseases ◽

Cross Sectional Study ◽

International Classification ◽

Sectional Study ◽

Cross Sectional ◽

Classification Of Diseases

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Adherence to treatment and related factors among patients with chronic conditions in primary care: a cross-sectional study

BMC Family Practice ◽

10.1186/s12875-019-1019-3 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 8

Author(s):

Cesar I. Fernandez-Lazaro ◽

Juan M. García-González ◽

David P. Adams ◽

Diego Fernandez-Lazaro ◽

Juan Mielgo-Ayuso ◽

...

Keyword(s):

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

World Health ◽

Healthcare Team ◽

Sectional Study ◽

Adherence To Treatment ◽

Related Factors ◽

Cross Sectional ◽

Factors Associated

Abstract Background Adherence to treatment, a public health issue, is of particular importance in chronic disease therapies. Primary care practices offer ideal venues for the effective care and management of these conditions. The aim of this study is to assess adherence to treatment and related-factors among patients with chronic conditions in primary care settings. Methods A cross-sectional study was conducted among 299 adult patients with ≥1 chronic condition(s) and prescribed medication in primary healthcare centers of Spain. The Morisky-Green-Levine questionnaire was used to assess medication adherence via face-to-face interviews. Crude and adjusted multivariable logistic regression models were used to analyze factors associated with adherence using the Multidimensional Model proposed by the World Health Organization — social and economic, healthcare team and system-related, condition-related, therapy-related, and patient-related factors. Results The proportion of adherent patients to treatment was 55.5%. Older age (adjusted odds ratio 1.31 per 10-year increment, 95% CI 1.01–1.70), lower number of pharmacies used for medication refills (0.65, 95% CI 0.47–0.90), having received complete treatment information (3.89, 95% CI 2.09–7.21), having adequate knowledge about medication regimen (4.17, 95% CI 2.23–7.80), and self-perception of a good quality of life (2.17, 95% CI 1.18–4.02) were independent factors associated with adherence. Conclusions Adherence to treatment for chronic conditions remained low in primary care. Optimal achievement of appropriate levels of adherence through tailored multifaceted interventions will require attention to the multidimensional factors found in this study, particularly those related to patients’ education and their information needs.

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Differences in the classification of hypertensive controlled patient in primary care: Cross sectional study

JRSM Short Reports ◽

10.1258/shorts.2012.012008 ◽

2012 ◽

Vol 3 (10) ◽

pp. 1-8 ◽

Cited By ~ 1

Author(s):

Lena Barrera ◽

Christopher Millett ◽

Marta Blangiardo ◽

Utz J. Pape ◽

Azeem Majeed

Keyword(s):

Primary Care ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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Multimorbidity and patterns of chronic conditions in a primary care population in Switzerland: a cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2016-013664 ◽

2017 ◽

Vol 7 (6) ◽

pp. e013664 ◽

Cited By ~ 17

Author(s):

Anouk Déruaz-Luyet ◽

A Alexandra N'Goran ◽

Nicolas Senn ◽

Patrick Bodenmann ◽

Jérôme Pasquier ◽

...

Keyword(s):

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional ◽

Primary Care Population

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Prevalence and coprevalence of chronic comorbid conditions in patients with type 2 diabetes in Catalonia: a population-based cross-sectional study

BMJ Open ◽

10.1136/bmjopen-2019-031281 ◽

2019 ◽

Vol 9 (10) ◽

pp. e031281 ◽

Cited By ~ 5

Author(s):

Manel Mata-Cases ◽

Josep Franch-Nadal ◽

Jordi Real ◽

Marta Cedenilla ◽

Didac Mauricio

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Cardiovascular Disease ◽

Primary Care ◽

Chronic Conditions ◽

Cross Sectional Study ◽

Secondary Outcome ◽

Sectional Study ◽

Cross Sectional

ObjectivesTo evaluate the prevalence and coprevalence of several chronic conditions in patients with type 2 diabetes in a Mediterranean region.DesignA cross-sectional study.SettingTwo hundred and eighty-six primary care teams of the Catalonian Health Institute (Catalonia, Spain).ParticipantsWe included patients aged ≥18 years with a diagnosis of type 2 diabetes by 31 December, 2016, who were registered in the Information System for the Development of Research in primary care (SIDIAP) database. We excluded patients with a diagnosis of type 1 diabetes, gestational diabetes mellitus and any other type of diabetes.Primary and secondary outcome measuresWe collected data on diabetes-related comorbidities (ie, chronic complications, associated cardiovascular risk factors and treatment complications). Diagnoses were based on the International Classification of Diseases, 10thRevision codes recorded in the database or, for some entities, on the cut-off points for a particular test result or a specific treatment indicated for that entity. The presence and stage of chronic kidney disease (CKD) were based on the glomerular filtration rate, the CKD Epidemiology Collaboration creatinine equation and the urine albumin-to-creatinine ratio.ResultsA total of 373 185 patients were analysed. 82% of patients exhibited ≥2 comorbidities and 31% exhibited ≥4 comorbidities. The most frequent comorbidities were hypertension (72%), hyperlipidaemia (60%), obesity (45%), CKD (33%), chronic renal failure (CRF)(28%) and cardiovascular disease (23%). The most frequently coprevalent pairs of chronic conditions were the combination of hypertension with hyperlipidaemia (45%), obesity (35%), CKD (28%), CRF (25%) or cardiovascular disease (19%), as well as the combination of hyperlipidaemia with obesity (28%), CKD (21%), CRF (18%) or cardiovascular disease (15%); other common pairs of comorbidities were obesity/CKD, obesity/CRF, hypertension/retinopathy, hypertension/albuminuria, hypertension/urinary tract infection, CVD/CRF and CVD/CKD, which were each present in more than 10% of patients.ConclusionPatients with type 2 diabetes have a high frequency of coprevalence of metabolic risk factors, cardiovascular disease and CKD and thus require an integrated management approach.

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