Thiem U, Theile G, Junius-Walker U, Holt S, Thürmann P, Hinrichs T, Platen P, Diederichs C, Berger K, Hodek J-M, Greiner W, Berkemeyer S, Pientka L, Trampisch H J
Department of Geriatrics, Marienhospital Herne, University of Bochum, Widumer Str. 8, 44627, Bochum, Deutschland.
Z Gerontol Geriatr. 2011 Apr;44(2):115-20. doi: 10.1007/s00391-010-0156-z. Epub 2010 Dec 16.
Multimorbidity, the concurrent manifestation or presence of multiple chronic conditions, poses huge challenges to affected patients, their relatives, physicians, and practitioners alike. The growing number of affected persons and the complexity of their needs places just as much of a burden on the health care system as does the plethora of often poorly coordinated interventions. The Chronic Care Model developed for different chronic diseases is suited for improving medical care. The PRISCUS research consortium was established to create the prerequisites for a new care model for multimorbid, elderly patients oriented along those lines.
The research consortium utilizes data gathered in a large-scale epidemiological study on peripheral arterial disease (getABI study) and from the Dortmund and Münster stroke registries, by extracting epidemiologic and health economic data, quality-of-life parameters, and data on the extent and quality of medication. Additional projects evaluate the implementation of a multidimensional geriatric assessment in primary care, the functional consequences of multimorbidity in stroke patients along with options for prevention and therapy afforded by physical activity. Systematic reviews of the literature are used to describe quality of life and patient preferences. Experts will work on an initial draft treatment standard for patients with multimorbidity and a list of potentially inappropriate medication for the elderly in Germany.
The results of the PRISCUS research consortium will enable an epidemiologic characterization and description of consequences of multimorbidity, while illustrating new approaches towards prevention, diagnosis, and management of multimorbid patients. With this, some prerequisites for a new health care model for patients with multimorbidity comparable to the Chronic Care Model will be fulfilled.
多重疾病，即多种慢性病的同时表现或存在，给患者及其亲属、医生和从业者都带来了巨大挑战。受影响人数的增加及其需求的复杂性给医疗保健系统带来的负担，与大量往往协调不佳的干预措施所带来的负担一样大。为不同慢性病开发的慢性病照护模式适用于改善医疗服务。PRISCUS研究联盟的成立是为了创造条件，建立一种基于这些理念的针对患有多种疾病的老年患者的新型照护模式。
该研究联盟利用在一项关于外周动脉疾病的大规模流行病学研究（getABI研究）以及多特蒙德和明斯特中风登记处收集的数据，提取流行病学和卫生经济数据、生活质量参数以及用药范围和质量的数据。其他项目评估在初级保健中实施多维老年评估、中风患者多重疾病的功能后果以及体育活动提供的预防和治疗选择。通过对文献的系统综述来描述生活质量和患者偏好。专家们将制定一份针对患有多种疾病患者的初始治疗标准草案以及一份德国老年人潜在不适当用药清单。
PRISCUS研究联盟的结果将能够对多重疾病的后果进行流行病学特征描述，同时阐明针对患有多种疾病患者的预防、诊断和管理的新方法。由此，将满足为患有多种疾病患者建立一种类似于慢性病照护模式的新型医疗保健模式的一些先决条件。
