● Higher incidence of more complex combinations of physical and mental illness Understanding elements of multimorbidity and lifestyle attributes is important for clinicians to gain insight into commonalities amongst people living with multiple chronic conditions. Recognizing specific features and correlates will help to unveil potential attributes of multimorbidity. This insight and shared information can be utilized to expand patient assessments that can identify areas of therapeutic goals that can be impaired by concurrent treatment (Table 1). Evidence-based practice! In addition to the six aspects of life that affect life with chronic conditions it should be noted that respondents in Bissenbaker et al.’s (2023) research also shared perceived inequities that were a direct result of their health. These inequities included perceived feelings of not being heard or seen by their providers, limited understanding of their condition and lack of insight into the extent of the disease or condition, a sense of stigmatization, and feelings of being powerless due to their health-related situation. It should be noted that these expressed perceptions and feelings were regarding their interactions with clinicians and other providers.
ability to recognize that the situation may be temporary can be distorted and potentially prolong any negative feelings and recovery time. 6. Financial management : Personal finances are often affected when illness presents and, left unattended, can spiral into a difficult situation that can increase stress levels, thus affecting disease management and quality of life. Patients who can focus on solution and disease management, including medication management, can integrate life with chronic conditions into daily living that includes work resumption. According to Georgetown University’s Health Policy Institute (2024), approximately 60 million people, equivalent to 34% of U.S. adults aged 18-65, live with a minimum of one chronic condition, while 19 million people, equivalent to 11%, live with two or more chronic conditions. These people are working while living with their respective illnesses, hopefully engaging in financial planning that will provide the support necessary should their conditions worsen. Other variables that correlate to a multimorbidity diagnosis include: ● Higher prevalence in women ● Higher incidence in groups with lower education levels ● Areas with higher rates of poverty and deprivation
Table 1: Assessing and Evaluating Multimorbitidy Patient Attributes Actual chronic conditions ● Higher morbidity ● Quality of life ● Disease burden on patient ● Disease burden on community ● Mortality ● Regional impact Social determinants of health assessment and evaluation
● Understanding individual patient responses and outcomes ● Training healthcare professionals ● Cultural competency ● Identifying community health workers ● Improving community services ● Ongoing training programs (should be culturally appropriate)
Application of multimorbidity guidelines
● Understanding concurrent condition treatment plans ● Identification of potential adverse reactions or events ● Comprehensive care assessments ● Integrate disease specific treatment plans into multimorbidity comprehensive treatment plans ● Research and intervention development ● Polypharmacy assessment ● Deprescribing assessment and implementation ● Understand social context of multimorbidity and quality of life ● Include patient education, engagement, and empowerment imperative
(Banerjee et al., 2020)
Healthcare Consideration: Addressing multimorbidity is a challenge that must be expedited as population longevity increases simultaneously with concurrent disease burdens. How would you prepare your patients for a future that may be built on the foundation of disease and chronic illness and the impact that can have on quality of life and well-being? Would you also present opportunities for life-changing interventions that may allay many of the effects of disease? Multimorbidity and medication
Verghese asserts that the significance of the identification of five medications is important due to the noted risks that arise at that point in disease management; patients may experience increased rates of adverse outcomes that can include higher rates of falls, increased frailty, increased morbidity, and mortality, most notable in older adults. The United States has the highest incidence of polypharmacy throughout the world, although it is becoming a global challenge. The global issue of polypharmacy has prompted
Patients living with multiple conditions frequently rely on condition-specific medications to manage their illnesses, prevent disease exacerbation, and minimize symptoms and side effects. The need to take multiple medications to manage one’s respective conditions is called polypharmacy. According to Canio (2022) and Varghese et al (2023) there is not one consistent definition of polypharmacy; however, the most widely referenced and accepted definition is applied to a person who uses five or more medications daily.
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Book Code: MTX1326
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