Taylor Clare J, Harrison Christopher, Britt Helena, Miller Graeme, Hobbs Fd Richard
Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, UK.
Sydney School of Public Health, University of Sydney, Sydney, NSW, Australia.
J Comorb. 2017 Apr 28;7(1):44-49. doi: 10.15256/joc.2017.7.106. eCollection 2017.
Heart failure (HF) is a serious condition that mostly affects older people. Despite the ageing population experiencing an increased prevalence of many chronic conditions, current guidelines focus on isolated management of HF.
To describe the burden of multimorbidity in patients with HF being managed in general practice in Australia.
Data from the Bettering the Evaluation And Care of Health (BEACH) programme were used to determine (i) the prevalence of HF, (ii) the number of co-existing long-term conditions, and (iii) the most common disease combinations in patients with HF. The study was undertaken over fifteen, 5-week recording periods between November 2012 and March 2016.
The dataset included a total of 25,790 general practitioner (GP) encounters with patients aged ≥45 years, collected by 1,445 GPs. HF had been diagnosed in 1,119 of these patients, a prevalence of 4.34% (95% confidence interval [CI] 3.99-4.68) among patients at GP encounters, and 2.08% (95% CI 1.87-2.29) when applied to the general Australian population overall. HF rarely occurred in isolation, with 99.1% of patients having at least one and 53.4% having six or more other chronic illnesses. The most common pair of comorbidities among active patients with HF was hypertension and osteoarthritis (43.4%).
Overall, one in every 20-25 GP encounters with patients aged ≥45 years in Australia is with a patient with HF. Multimorbidity is a typical presentation among this patient group and guidelines for general practice must take this into account.
心力衰竭（HF）是一种主要影响老年人的严重疾病。尽管老年人口中许多慢性病的患病率有所上升，但目前的指南侧重于对HF进行单独管理。
描述在澳大利亚普通医疗中接受管理的HF患者的多重疾病负担。
利用改善健康评估与护理（BEACH）项目的数据来确定：（i）HF的患病率；（ii）并存的长期疾病数量；（iii）HF患者中最常见的疾病组合。该研究在2012年11月至2016年3月期间的15个为期5周的记录期内进行。
数据集包括1445名全科医生收集的总共25790次与年龄≥45岁患者的全科医生诊疗记录。其中1119名患者被诊断为HF，在全科医生诊疗的患者中患病率为4.34%（95%置信区间[CI]3.99 - 4.68），应用于澳大利亚总体人口时为2.08%（95%CI 1.87 - 2.29）。HF很少单独发生，99.1%的患者至少有一种其他慢性病，53.4%的患者有六种或更多其他慢性病。活跃的HF患者中最常见的合并症组合是高血压和骨关节炎（43.4%）。
总体而言，在澳大利亚，每20 - 25次与年龄≥45岁患者的全科医生诊疗中，就有一次是与HF患者的诊疗。多重疾病是该患者群体的典型表现，普通医疗指南必须考虑到这一点。
