Thiem U, Hinrichs T, Müller C A, Holt-Noreiks S, Nagl A, Bucchi C, Trampisch U, Moschny A, Platen P, Penner E, Junius-Walker U, Hummers-Pradier E, Theile G, Schmiedl S, Thürmann P A, Scholz S, Greiner W, Klaassen-Mielke R, Pientka L, Trampisch H J
Klinik für Altersmedizin und Frührehabilitation, Marienhospital Herne, Klinik Börnig, Ruhr-Universität Bochum, Widumer Str. 8, 44627, Herne, Deutschland.
Z Gerontol Geriatr. 2011 Dec;44 Suppl 2:101-12. doi: 10.1007/s00391-011-0246-6.
The concurrent presence or manifestation of multiple chronic conditions, i.e. multimorbidity, poses a challenge to affected patients and their relatives, physicians, and practitioners, and to the health care system in general. Aiming to improve medical care for different chronic diseases, the Chronic Care Model also appears to be suited for multimorbidity. The established research consortium PRISCUS is trying to create some of the prerequisites for a new care model for multimorbid, elderly patients oriented along the lines of the Chronic Care Model.
Four out of seven subprojects of the research consortium provide an overview of some of their findings. Topics in a sports medicine subproject were the assessment of physical activity by means of a newly developed questionnaire and the development and feasibility testing of an exercise program for elderly people with chronic conditions and mobility impairment. Partners from family medicine implemented geriatric assessment in a primary care setting and evaluated its consequences. In a pharmacological subproject, potentially inappropriate medication as well as drug-drug interactions and dosing errors were addressed. The health economic subproject investigated quality of life impairment due to multiple chronic diseases and the effects of multimorbidity on costs.
The results of the PRISCUS research consortium allow a better description of consequences of multimorbidity and illustrate at least some new approaches towards prevention, diagnosis, and treatment of patients suffering from multimorbidity. Ongoing projects will test the efficacy of a physical activity program and a new complex intervention to reduce potentially inappropriate medication in the elderly. With this, the research consortium will create some prerequisites for a new health care model for patients with multimorbidity comparable to the Chronic Care Model.
多种慢性病的同时存在或表现，即共病，给受影响的患者及其亲属、医生和从业者以及整个医疗保健系统都带来了挑战。旨在改善针对不同慢性病的医疗护理，慢性病护理模式似乎也适用于共病情况。已成立的研究联盟PRISCUS正试图为一种以慢性病护理模式为蓝本的、针对患有多种疾病的老年患者的新护理模式创造一些先决条件。
该研究联盟七个子项目中的四个对其部分研究结果进行了概述。运动医学子项目的主题包括通过新开发的问卷评估身体活动情况，以及为患有慢性病和行动不便的老年人制定运动计划并进行可行性测试。家庭医学领域的合作伙伴在初级保健环境中实施了老年评估并评估了其后果。在一个药理学子项目中，探讨了潜在不适当用药以及药物相互作用和剂量错误问题。卫生经济学子项目研究了多种慢性病导致的生活质量受损情况以及共病对成本的影响。
PRISCUS研究联盟的结果有助于更好地描述共病的后果，并至少阐明了一些针对患有共病的患者进行预防、诊断和治疗的新方法。正在进行的项目将测试一项身体活动计划以及一项新的综合干预措施减少老年人潜在不适当用药的效果。通过这样做，该研究联盟将为一种类似于慢性病护理模式的、针对患有多种疾病的患者的新医疗保健模式创造一些先决条件。
