Research ArticleOriginal Research

Prevalence of Multimorbidity Among Adults Seen in Family Practice

Martin Fortin, Gina Bravo, Catherine Hudon, Alain Vanasse and Lise Lapointe
The Annals of Family Medicine May 2005, 3 (3) 223-228; DOI: https://doi.org/10.1370/afm.272

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Tables

  • Table 1.

    Published Data on Multimorbidity

    AuthorCountry Data Collection YearContextPrevalence* of Multimorbidity by Age-GroupChronic Health Problems per Person Average No.
    * Multimorbidity defined as 2 or more chronic health problems.
    † Male, female.
    ‡ Prevalence calculated here among patients reporting at least 1 chronic health problem.
    Guralnik et al8United States before 1989General population (survey)60–69 y: 35
    70–79 y: 47—
    80+ y: 53
    Metsemakers et al5Netherlands, 1990Family medicine registry25–44 y: 2.4, 2.9†
    45–64 y: 3.8, 4.3†
    -—65–74 y: 5.0, 5.2†
    75+ y: 5.7, 6.2†
    Hoffman et al9United States, 1987General population (survey)18–44 y: 28.4‡
    45–64 y: 51.0‡—
    65+ y: 69.2‡
    Van den Akker et al4Netherlands, 1994Family medicine registry0–19 y: 10.0
    20–39 y: 17.4
    40–59 y: 34.740–59 y: 1.3
    60–79 y: 63.160–79 y: 2.5
    80+ y: 78.280+ y: 3.5
    Daveluy10Canada (Quebec), 1998General population (survey)25–44 y: 27.7
    45–64 y: 40.2—
    65+ y: 63.4
    Fuchs6Israel, 1989–1992General population (survey)75+ y: 64.02.2
    Wolff7United States, 1999Medicare65–69 y: 53.92.3
    70–74 y: 63.1
    75–79 y: 68.8
    80–84 y: 72.5
    85+ y: 72.8
    This studyCanada, 2003Family medicine18–44 y: 69.318–14 y: 2.8
    45–64 y: 92.845–64 y: 4.6
    65+ y: 98.765+ y: 6.5
  • Table 2.

    Characteristics of Physicians

    CharacteristicsParticipants n = 21Nonparticipants n = 98PValue
    * Fisher’s exact test.
    † Student t test.
    Male, %57.150.0.63*
    Private practice, %76.284.7.35*
    Urban area, %90.581.6.52*
    Years in practice, No.17.416.6.30†
  • Table 3.

    Prevalence of Multimorbidity by Age and Sex

    Percentage* of Patients With Multimorbidity (95% CI)
    18–44 Years45–64 Years65+ Years
    IndexMale n = 58Female n = 173Male n = 141Female n = 288Male n = 121Female n = 199
    CI = confidence interval; CIRS = Cumulative Illness Rating Scale.
    * Decimals omitted for clarity.
    Chronic health problems
        2 or more72 (59–83)68 (61–75)89 (82–93)95 (92–97)98 (93–99)99 (97–100)
        3 or more48 (35–62)46 (38–53)65 (57–73)82 (77–87)91 (84–95)98 (94–99)
        4 or more38 (26–52)30 (23–37)52 (43–60)66 (60–71)83 (75–89)91 (86–94)
        5 or more19 (10–31)18 (13–25)42 (34–50)51 (46–57)74 (65–81)77 (71–83)
    CIRS score
        5 or more55 (42–68)48 (40–56)80 (73–86)85 (80–89)93 (87–97)98 (94–99)
        10 or more17 (9–29)13 (9–19)33 (25–41)39 (34–45)69 (60–78)70 (64–77)
  • Table 4.

    Number of Chronic Health Problems and CIRS Score by Age and Sex

    Mean Multimorbidity Score (95% CI) [Median]
    18–44 Years45–64 Years65+ Years
    IndexMale n = 58Female n = 173Male n = 141Female n = 288Male n = 121Female n = 199
    CI = confidence interval; CIRS = Cumulative Illness Rating Scale.
    Number of chronic health problems2.9 (2.4–3.4) [2.0]2.7 (2.4–3.0) [2.0]4.1 (3.66–4.45) [4.0]4.8 (4.5–5.1) [5.0]6.3 (5.8–6.8) [6.0]6.6 (6.21–6.92) [6.0]
    CIRS score6.3 (5.1–7.5) [5.0]5.1 (4.6–5.6) [4.0]8.7 (7.8–9.6) [7.0]8.8 (8.3–9.3) [8.0]13.1 (11.9–14.2) [12.0]12.9 (12.2–13.7) [12.0]

Additional Files

  • The Article in Brief

    Background: When patients have multiple medical conditions at the same time, it is referred to as multimorbidity or comorbidity. There has been little research examining whether multimorbidity is common in patients. The purpose of this study was to determine the rate of multimorbidity in patients in the Saguenay region of Canada and to measure the severity of their medical conditions.
    What This Study Found: Nine of 10 patients seeing family physicians have more than 1 chronic medical condition. Almost one half of patients had 5 or more chronic conditions. On average, older patients have more chronic conditions than younger patients.
    Implications:
    * Among patients seeing family physicians, having more than 1 medical condition is the rule, rather than the exception.
    * Guidelines for medical practice that are designed for patients with a single medical condition might not be suitable for patients with multiple conditions.
    * Treatment plans need to consider the unique needs of patients with multiple conditions.
    * Clinicians, educators, researchers, policy makers, and others should pay special attention to the impact of multimorbidity as they make decisions about medical care and the delivery of health care services.

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