A research paper in the latest issue of Medical Journal of Australia
provided the first insight into the prevalence and patterns of multimorbidity in
Australia. About three in 10 people who saw a GP in 2005, and one in four
Australians have multimorbidity (two or more types of chronic conditions).
Professor Helena Britt, Director of the Family Medicine Research Centre
at the University of Sydney, and her co-authors studied the multimorbidities of
more than 9,000 patients who attended GPs between July and November 2005.
Prof Britt said knowing the common combinations of multimorbidity may
help in planning the health services needed for our ageing population.
"The current health care system in Australia focuses on single diseases
- creating challenges for GPs, who care for the 'whole' person, rather than on
only one body system. "Calls are growing for a more holistic consideration of
the patient, because multimorbidity has a negative impact on quality of life and
increases health service use" she said.
Prevalence of multimorbidity was
estimated at 37.1 per cent of surveyed patients, which translates to 29 per cent
of people who attended a GP in 2005 and 25.5 per cent of the Australian
population. Among the elderly, 83% of the surveyed patients had multimorbidity.
The most common morbidity combinations were: arthritis/chronic back pain
and vascular disease (15 per cent); a psychological problem and vascular disease
(10.6 per cent); and arthritis/chronic back pain plus a psychological problem
(10.6 per cent)
The most common combination among patients with four or
more types of morbidity was arthritis/back pain, vascular disease,
gastro-oesophageal reflux and a psychological problem.
Prof Britt said
some multimorbidity combinations were particularly problematic for both
clinician and patient, particularly where the drug therapy for one problem may
have negative effects on the other.
"These issues are often not
considered in management guidelines for individual conditions," she said.
In a separate research paper in the latest issue of Medical Journal
, Prof Britt and her co-authors estimated the prevalence of
selected diagnosed chronic diseases and compared their findings to those of the
National Health Survey (NHS).
"Reliable estimates provide a marker of
the health of a community and assist planning of health services and health
promotion," Prof Britt said.
Some results aligned with the National
Health Survey: one in five Australian have a cardiovascular problem, one in 10
had asthma, and 15% arthritis. However this study suggests that one in five
Australians have a diagnosed psychological problem, and one in nine have high
cholesterol problems, about double the prevalence estimates from the NHS.
"Our method has the benefit of the input of a medical practitioner,
which probably leads to greater accuracy than self-report alone. This study
could be repeated annually to augment other data sources and better define
existing health needs in the population," she said.
The Medical Journal of
is a publication of the Australian Medical Association.