Multiple morbidities

Multiple morbidities or Multimorbidities means co-occurring diseases.[1] For example, a person could have diabetes and heart disease and high blood pressure. In the Medicare population, 65% of patients have two or more chronic illnesses.[2] Some of the difficulties experienced by patients include: poor coordination of medical care, managing multiple medications, increases in their time spent managing illness,[3] difficulty managing multiple illness management regimes,[4]> and aggravation of one condition by symptoms or treatment of another.[5] Concerning the qualitative experience of people with multimorbid chronic illness, Jowsey et al (2009) write: "Co-morbidity increased the amount of time participants spent managing their health and increased patients' dependency on others. Patients with co-morbid conditions encountered problems with the coordination between services and with polypharmacy. Patients prioritised the management of one condition over another; consequently, some health issues could be neglected or compromised. The three most common challenges to patients and carers in managing chronic illness (either caused or made worse by co-morbidity), relate to acting on risk factors, recognising signs and symptoms of illness and managing medications."[6] These kinds of challenges for people living with multiple chronic conditions have direct implications for health services and the way they support patient self-management.[4]

Multimorbidity is common in people who are elderly,[7] malnourished, or poor. Multi-morbidity is common in people with dementia, with the average person with dementia living with five other chronic conditions. The Medication Appropriateness Tool for Comorbid Health in Dementia (MATCH-D) was developed for this reason to support clinicians to manage medications for these people.[8]