Research Group Psychosomatic Rehabilitation, Charité University Medicine Berlin, CBF, Hs.II, E01, Hindenburgdamm 30, 12200, Berlin, Germany.
Psychological Methods and Assessment, Ludwig-Maximilians-University Munich, Munich, Germany.
Sci Rep. 2022 Jan 7;12(1):272. doi: 10.1038/s41598-021-04256-x.
Multimorbidity is more than just the addition of individual illnesses, and its diagnosis and treatment poses special problems. General practitioners play an important role in looking after multimorbid patients. The aim of this study is to assess the prevalence and pattern of acute and chronic multimorbidity in primary care patients, regardless of body system and age group. A convenience sample of 2099 patients treated by 40 general practitioners was assessed using the Burvill scale. This measure of multimorbidity differentiates according to organ system and covers both acute and chronic illnesses. It also allows severity ratings to be assessed for both acute and chronic conditions, and thus patients' actual need for general practice care. Patients reported an average of 3.5 (SD = 2.0) acute and/or chronically affected body systems. Overall, 12.7% of patients reported only one health problem, 83.0% at least two, 65.8% at least three, 46.1% at least four, and 29.7% five or more. The most frequent problems were musculoskeletal (62.5%) and psychological (56.6%). Some morbidities were interrelated, while others co-occurred despite being medically independent. In primary care, multimorbidity is the rule rather than the exception. Acute and chronic morbidity both contribute to the burden of illness. Body systems reflect treatment needs. Instead of specialist treatment for individual illnesses, an integrative treatment approach is needed. This is the specialty of general practitioners.
多发病不仅仅是个体疾病的叠加，其诊断和治疗带来了特殊的问题。全科医生在照顾多发病患者方面发挥着重要作用。本研究旨在评估初级保健患者中无论身体系统和年龄组的急性和慢性多发病的患病率和模式。采用 Burvill 量表对 40 名全科医生治疗的 2099 名患者进行了方便抽样评估。这种多发病的衡量标准根据器官系统进行区分，涵盖了急性和慢性疾病。它还允许对急性和慢性疾病进行严重程度评估，从而评估患者对全科医疗的实际需求。患者报告平均有 3.5（SD=2.0）个急性和/或慢性受影响的身体系统。总体而言，12.7%的患者报告只有一个健康问题，83.0%至少有两个，65.8%至少有三个，46.1%至少有四个，29.7%有五个或更多。最常见的问题是肌肉骨骼（62.5%）和心理（56.6%）。一些病态相互关联，而另一些则尽管在医学上是独立的，但仍同时发生。在初级保健中，多发病是常态而非例外。急性和慢性发病都导致了疾病负担。身体系统反映了治疗需求。需要的不是针对个别疾病的专科治疗，而是需要综合治疗方法。这是全科医生的专长。
