Institute of Life Course and Medical Sciences, University of Liverpool.
Department of Rheumatology, Aintree Hospital, Liverpool University Hospitals NHS Foundation Trust, Liverpool.
Rheumatology (Oxford). 2021 Jul 1;60(7):3058-3071. doi: 10.1093/rheumatology/keab214.
This systematic literature review aimed to analyse terms describing coexisting conditions in the RA literature, informing the need for an operationalized definition of multimorbidity. Articles discussing RA with multimorbidity, published 1946 until August 2020, were identified. The primary outcome was the use and/or definition of 'multimorbidity' in RA. Information extracted included terms defining coexisting conditions, the use of a comorbidity/multimorbidity score and the use of 'index disease' to describe RA (more applicable to comorbidity than multimorbidity). Thirty-nine articles were included. Eight articles used the term 'multimorbidity', 18 used 'comorbidity' and 12 used both terms, 7 synonymously. One used no term. Fourteen articles fully defined the term. The number of co-existing conditions described in included studies was one-121. Twelve articles used a comorbidity/multimorbidity score. Four articles described RA as the 'index disease'. Our results demonstrate inconsistent use of the term multimorbidity. Improved assessment of multimorbidity is indicated in RA patients, including an operationalized use and definition.
本系统文献回顾旨在分析 RA 文献中描述共存疾病的术语，为多病共存的操作性定义提供信息。确定了 1946 年至 2020 年 8 月发表的讨论 RA 伴多病共存的文章。主要结果是 RA 中“多病共存”的使用和/或定义。提取的信息包括定义共存疾病的术语、使用合并症/多病共存评分以及使用“索引疾病”来描述 RA（更适用于合并症而非多病共存）。共纳入 39 篇文章。8 篇文章使用了“多病共存”一词，18 篇文章使用了“合并症”，12 篇文章同时使用了这两个术语，其中 7 篇同义词。一篇文章未使用任何术语。14 篇文章充分定义了术语。纳入研究中描述的共存疾病数量为 1-121。12 篇文章使用了合并症/多病共存评分。4 篇文章将 RA 描述为“索引疾病”。我们的结果表明，多病共存一词的使用不一致。RA 患者需要更好地评估多病共存，包括操作性使用和定义。
