Selby Kevin, Mueller Chabloz Yolanda, Schwarz Joëlle, Senn Nicolas
Département des policliniques, Unisanté, 1011 Lausanne.
Département de formation, recherche et innovation, Unisanté, 1011 Lausanne.
Rev Med Suisse. 2019 Oct 30;15(669):1968-1971.
We have been studying multimorbidity in epidemiology and clinical practice since the 1970s. Growing experience shows that the concept of multimorbidity is helpful for epidemiologists to describe population-level changes, but of little use to patients and clinicians who 'diagnose' multimorbidity. Several large, rigorous clinical trials show that organizational changes in primary care can improve the care of these complex patients, but do not improve directly health-related quality of life. This article describes the history of multimorbidity and results of recent randomized trials to prompt a discussion of new approaches to improve the experience of people living with multiple chronic diseases.
自20世纪70年代以来,我们一直在流行病学和临床实践中研究多病共存问题。越来越多的经验表明,多病共存的概念有助于流行病学家描述人群层面的变化,但对于“诊断”多病共存的患者和临床医生却用处不大。几项大型、严谨的临床试验表明,初级保健中的组织变革可以改善对这些复杂患者的护理,但并不能直接提高与健康相关的生活质量。本文介绍了多病共存的历史以及近期随机试验的结果,以促使人们讨论改善患有多种慢性病患者体验的新方法。