Letters
Volume 47, Issue 9, September 2018

September correspondence


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The opinions expressed by correspondents in this column are not endorsed by the editors or The Royal Australian College of General Practitioners. 
 

Are you using up-to-date data on multimorbidity?

I read with interest the good viewpoint article by Sathanapally et al on the importance and challenges of shared decision making in people with multimorbidity (AJGP June 2018).1 I would like to point out that there are more recent data on the reported prevalence of complex multimorbidity in Australia. The authors cited the 2016 study by Harrison et al.2 The same research group published a further sub-study of the nationally representative Bettering the Evaluation and Care of Health (BEACH) program in March 2017. In this more recent analysis, with 1449 general practitioners (GPs) and a total of 43,501 patients, it was found that the proportion of patients with complex multimorbidity was 30.4%. After adjustment, Harrison et al estimated that 12.1% of the Australian population had complex multimorbidity.3

Also in 2017, data on multimorbidity in Australia from ‘The 45 and Up Study’ were evaluated. Of 90,352 participants, 52% were identified with multimorbidity. In this analysis on the prevalence of multimorbidity, Lujic et al from the University of New South Wales compared self-report data, medication data and hospital data.4 This study, available at http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0183817, is certainly interesting for regular AJGP readers. Furthermore, the authors cite an older English study,5 which found that 78% of primary care consultations in the UK were with patients with multimorbidity. A recent retrospective cohort study in England involving 403,985 adult patients came to the conclusion that 52.9% of general practice consultations in the study sample were patients with multimorbidity.6
 

Dr Martin Hofmeister
Consumer Centre of the German
Federal State of Bavaria, Department of
Food and Nutrition, Munich, Germany

 
References
1. Sathanapally H, Khunti K, Kadam U, Seidu S. Shared decision making in multimorbidity. Aust J Gen Pract 2018;47(6):397–98. doi: 10.31128/AJGP-01-18-4469.
2. Harrison C, Henderson J, Miller G, Britt H. The prevalence of complex multimorbidity in Australia. Aust N Z J Public Health 2016;40(3):239–44. doi: 10.1111/1753-6405.12509.
3. Harrison C, Henderson J, Miller G, Britt H. The prevalence of diagnosed chronic conditions and multimorbidity in Australia: A method for estimating population prevalence from general practice patient encounter data. PLoS One 2017;12(3):e0172935. doi: 10.1371/journal.pone.0172935.
4. Lujic S, Simpson JM, Zwar N, Hosseinzadeh H, Jorm L. Multimorbidity in Australia: Comparing estimates derived using administrative data sources and survey data. PLoS One 2017;12(8):e0183817. doi: 10.1371/journal.pone.0183817.
5. Salisbury C, Johnson L, Purdy S, Valderas JM, Montgomery AA. Epidemiology and impact of multimorbidity in primary care: A retrospective cohort study. Br J Gen Pract 2011;61(582):e12–21. doi: 10.3399/bjgp11X548929.
6. Cassell A, Edwards D, Harshfield A, et al. The epidemiology of multimorbidity in primary care: A retrospective cohort study. Br J Gen Pract 2018;68(669):e245–51. doi: 10.3399/bjgp18X695465.


Reply

Thank you for highlighting some further, more recent data with similar results to the literature cited in our viewpoint article, highlighting the spread of complex multimorbidity in the Australian population.1,2 We would also like to add that the article published in the British Journal of General Practice in March 2018 regarding the ‘epidemiology of multimorbidity in primary care’ in the UK3 was not cited in this viewpoint article, as we had written and submitted our article for publication prior to the publication of the aforementioned article.
 

Harini Sathanapally 
Academic Clinical Fellow,
Leicester Diabetes Centre,
University of Leicester, UK

Kamlesh Khunti 
Professor of Primary Care,
Diabetes and Vascular Medicine,
Leicester Diabetes Centre,
University of Leicester, UK

Umesh Kadam 
Professor of Primary Care and Public Health Research,
Leicester Diabetes Centre,
University of Leicester, UK

Sam Seidu 
Primary Care Fellow,
Leicester Diabetes Centre,
University of Leicester, UK

 

 
References

1. Harrison C, Henderson J, Miller G, Britt H. The prevalence of diagnosed chronic conditions and multimorbidity in Australia: A method for estimating population prevalence from general practice patient encounter data. PLoS One 2017;12(3):e0172935. doi: 10.1371/journal.pone.0172935.
2. Lujic S, Simpson JM, Zwar N, Hosseinzadeh H, Jorm L. Multimorbidity in Australia: Comparing estimates derived using administrative data sources and survey data. PLoS One 2017;12(8):e0183817. doi: 10.1371/journal.pone.0183817.
3. Cassell A, Edwards D, Harshfield A, et al. The epidemiology of multimorbidity in primary care: A retrospective cohort study. Br J Gen Pract 2018;68(669):e245–51. doi: 10.3399/bjgp18X695465.

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