Department of Public Health and Primary Care, Trinity College Dublin, Ireland.
Respir Med. 2011 Feb;105(2):236-42. doi: 10.1016/j.rmed.2010.07.019. Epub 2010 Aug 15.
Multimorbidity is defined as two or more co-existing chronic conditions in an individual and is common in general practice. It is associated with poorer outcomes for patients. This study aimed to establish the prevalence of multimorbidity in patients with chronic respiratory disease in general practice and to describe its impact on health service use.
Cross-sectional study based in general practice in Dublin. Drug and disease code searches were performed to identify adult patients with a diagnosis of chronic respiratory disease. Medical records were reviewed for chronic respiratory diagnosis, other chronic conditions, demographic characteristics, General Practitioner (GP) and practice nurse utilisation rates, and numbers of medications.
In a general practice population of 16,946 patients 3.9% had chronic respiratory disease and 60% of these had one or more co-existing chronic condition(s). GP and practice nurse utilisation rates, and number of medications were significantly higher among those with multimorbidity compared with those with respiratory disease alone. Multivariate analysis showed that increasing age and low socio-economic status were significantly associated with multimorbidity.
The majority of patients with chronic respiratory disease have multimorbidity. Clinical guidelines based on single disease entities and outcomes are not as easy to implement and may not be as effective in this group.
共病是指个体中同时存在两种或多种慢性疾病，在普通科中较为常见。它与患者的预后较差有关。本研究旨在确定普通科慢性呼吸系统疾病患者共病的患病率，并描述其对卫生服务利用的影响。
基于都柏林普通科的横断面研究。通过药物和疾病代码搜索，确定患有慢性呼吸系统疾病的成年患者。对医疗记录进行审查，以确定慢性呼吸系统诊断、其他慢性疾病、人口统计学特征、全科医生（GP）和执业护士的利用率以及药物数量。
在普通科的 16946 名患者中，有 3.9%患有慢性呼吸系统疾病，其中 60%的患者存在一种或多种共病。与仅有呼吸系统疾病的患者相比，共病患者的 GP 和执业护士利用率以及药物数量明显更高。多变量分析表明，年龄增长和社会经济地位低下与共病显著相关。
大多数患有慢性呼吸系统疾病的患者都患有共病。基于单一疾病实体和结果的临床指南在实施上并不那么容易，并且在这组患者中可能效果不佳。
