Multimorbidity

Question 1

Define multimorbidity

Answer 1

Multimorbidity refers to the co-existence of two or more long-term health conditions
which can include:
A physical non-communicable disease of long duration, such as diabetes, cardiovascular disease, or cancer.
A mental health condition of long duration, such as a mood disorder, schizophrenia, or dementia.
An infectious disease of long duration, such as HIV or hepatitis C.

Question 2

Polypharmacy

Answer 2

• > 5 medications

Question 3

Multimorbidity goals

Answer 3

• Adults with multimorbidity are identified by their GP practice.
• Adults with an individualised management plan for multimorbidity are given opportunities to discuss their values, priorities and goals.
• Adults with an individualised management plan for multimorbidity know who is responsible for coordinating their care.
• Adults having a review of their medicines and other treatments for multimorbidity discuss whether any can be stopped or changed.

Question 4

Assessing multimorbidity

Answer 4

• Establish the extent of the disease burden
• Establish the treatment burden
• Explore the person’s attitudes to their treatments and the potential benefits and harms of those treatments
• Also ask about and consider:
  Social circumstances, financial constraints, living conditions, and social support.
  Health literacy.
  Functional autonomy.
  Coping strategies.
• ? Deprssion / ? Chronic pain
• ## Assess frailty

Question 5

Assessment for frailty

Answer 5

PRISMA-7 questionnaire

Question 6

Multimorbidity Mx

Answer 6

• Be proactive with patients with Multimorbidity
• Discuss the purpose of a multimorbidity approach with the person
• Review medicines and other treatments
• Develop and agree on an individualised management plan with the person that should include
• Consider self-management where appropriate
• Share copies of the management plan
• Provide instructions for safety-netting

Question 7

Solutions to Multimorbidity

Answer 7

• Think holistically
• Continuity of care
• Integration of secondary care teams with primary care
• Tackle polypharmacy
• Patient decision aids.