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Costs associated with multimorbidity among VA patients.

BACKGROUND: Multimorbidity (the presence of multiple chronic conditions) is associated with high levels of healthcare utilization and associated costs. We investigated the association between number of chronic conditions and costs of care for nonelderly and elderly Veterans Affairs (VA) patients, and estimated mean VA healthcare costs for the most prevalent and most costly combinations of 3 conditions (triads). METHODS: We identified a cohort of 5,233,994 patients who received care within the VA system in fiscal year 2010. We estimated the costs of VA care for each patient using established m…

Cognitive Behavioral Therapy and Biofeedback.

PURPOSE OF REVIEW: This review aims to understand the foundations of cognitive behavioral therapy (CBT) and biofeedback, their indications for therapy, and evidence-based support. RECENT FINDINGS: Both CBT and biofeedback are noninvasive therapy options for patients who are suffering from a variety of chronic pain conditions, including chronic low back pain, headache, fibromyalgia, and temporomandibular disorder (TMD). CBT has been shown to be effective in treating multiple chronic pain conditions.

Association between sleep duration and co-existing chronic conditions in adults: insights from the 2017-2018 Canadian Community Health Survey.

BACKGROUND: Sleep duration plays a crucial role in overall health, with far-reaching implications for individuals globally. Although research has extensively explored the association between sleep and chronic conditions, few studies have investigated the association between multiple co-existing chronic conditions on sleep duration. This study examines the association between sleep duration and the prevalence of chronic conditions in the Canadian adults from four provinces and two territories. METHODOLOGY: Canadian Community Health Survey (CCHS) 2017-2018, a population-based cross-sectional su

Economic Burden of Chronic Conditions Among Survivors of Cancer in the United States.

Purpose The prevalence of cancer survivorship and chronic health conditions is increasing. Limited information exists on the economic burden of chronic conditions among survivors of cancer. This study examines the prevalence and economic effect of chronic conditions among survivors of cancer. Methods Using the 2008 to 2013 Medical Expenditure Panel Survey, we present nationally representative estimates of the prevalence of chronic conditions (heart disease, high blood pressure, stroke, emphysema, high cholesterol, diabetes, arthritis, and asthma) and multiple chronic conditions (MCCs) and the …

Self-Management and Clinical Decision Support for Patients With Complex Chronic Conditions Through the Use of Smartphone-Based Telemonitoring: Randomized Controlled Trial Protocol.

BACKGROUND: The rising prevalence of chronic illnesses hinders the sustainability of the health care system because of the high cost of frequent hospitalizations of patients with complex chronic conditions. Clinical trials have demonstrated that telemonitoring can improve health outcomes, but they have generally been limited to single conditions such as diabetes, hypertension, or heart failure. Few studies have examined the impact of telemonitoring on complex patients with multiple chronic conditions, although these patients may benefit the most from this technology. OBJECTIVE: The aim of thi…

The impact of multimorbidity patterns on health-related quality of life in the general population: results of the Belgian Health Interview Survey.

BACKGROUND: Chronic diseases and multimorbidity are a major cause of disease burden-for patients, caregivers, and society. Little is known however about potential interaction effects between specific disease combinations. Besides an additive effect, the presence of multiple conditions could also act synergistically or antagonistically regarding the impact on patients' health-related quality of life (HRQoL). The aim was to estimate the impact of coexisting chronic diseases on HRQoL of the adult general Belgian population. METHODS: The Belgian Health Interview Survey 2018 provided data on self-

Систематический обзор: цифровые биомаркеры усталости от хронических заболеваний.

В рамках этого систематического обзора изучается взаимосвязь между цифровыми биомаркерами, измеряемыми с использованием изношенных устройств, и усталостью у пациентов с хроническими заболеваниями. Исследования, включенные в этот обзор, были посвящены лицам с заболеваниями или заболеваниями 13 широких категорий: множественный склероз (MS); ревматоидный артрит (RA); хроническая обструктивная легочная болезнь (COPD); длинный COVID; рак; синдром хронической усталости (CFS); саркоидоз легких; болезнь Паркинсона; хронический инсульт; хроническое воспалительное ревматическое заболевание (CIRD); болез

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… These associations were observed across multiple chronic conditions, such as multiple sclerosis (MS), rheumatoid arthritis (RA), COPD, long COVID, and cancer, and were supported by several high-quality studies, resulting in high certainty of evidence (see Supplementary Table 3 for details). …

Managing multimorbidity in primary care in patients with chronic respiratory conditions.

The term multimorbidity is usually defined as the coexistence of two or more chronic conditions within an individual, whereas the term comor … are utilisation and specifically with an increased number of prescription drugs in individuals with multiple chronic conditions such as chronic obstructive pulmonary disease. This npj Primary Care Respiratory Medicine Education Section case study involves a patient in a primary care consultation presenting several common diseases prevalent in people of this age. The patient …

Comorbid clinical conditions in chronic fatigue: a co-twin control study.

OBJECTIVES: Chronically fatiguing illness, defined as fatigue for at least 6 months, has been associated with various physical health conditions. Our objective was to determine whether there is a significant relationship between chronically fatiguing illness and 10 clinical conditions that frequently appear to be associated with fatigue, adjusting for the potentially confounding effects of psychiatric illness. DESIGN: A co-twin control study controlling for genetic and many environmental factors by comparing chronically fatigued twins with their nonfatigued co-twins. SETTING: A nationally di

The Utility of a Syndemic Framework in Understanding Chronic Disease Management Among HIV-Infected and Type 2 Diabetic Men Who Have Sex with Men.

Syndemic theory posits that epidemics of multiple physical and psychosocial problems co-occur among disadvantaged groups due to adverse social conditions. Although sexual minority populations are often stigmatized and vulnerable to multiple health problems, the syndemic perspective has been underutilized in understanding chronic disease. To assess the potential utility of this perspective in understanding the management of co-occurring HIV and Type 2 diabetes, we used linear regression to examine glycemic control (A1c) among men who have sex with men (MSM) with both HIV and Type 2 diabetes (n 

Multimorbidity is associated with better quality of care among vulnerable elders.

BACKGROUND: Older patients with multiple chronic conditions may be at higher risk of receiving poorer overall quality of care compared with those with single or no chronic conditions. Possible reasons include competing guidelines for individual conditions, burden of numerous recommendations, and difficulty implementing treatments for multiple conditions. OBJECTIVES: We sought to determine whether coexisting combinations of 8 common chronic conditions (hypertension, coronary artery disease, chronic obstructive pulmonary disease, osteoarthritis, diabetes mellitus, depression, osteoporosis, and …

Multimorbidity Patterns in US Adults with Subjective Cognitive Decline and Their Relationship with Functional Difficulties.

ObjectivesThis study identified different multimorbidity patterns among adults with subjective cognitive decline (SCD) and examined their as … y help in development and implementation of interventions to prevent serious consequences of having multiple chronic conditions.

"We do what needs to be done": caregivers' experiences of healthcare and support for people with multiple long-term conditions in the last year of life.

BACKGROUND: Towards the end of life, people with multiple long-term conditions face an array of challenges associated with their growing healthcare needs including unclear illness trajectories and multifaceted uncertainty. Caregivers, most often family or friends, play a key role in providing and coordinating care at the end of life. This study aimed to explore, through the perspective of bereaved caregivers, the experiences of healthcare and support in the last year of life for people with multiple long-term health conditions. METHODS: Interpretative Phenomenological Analysis was used to ana

Chronic physical health consequences of being injured during the terrorist attacks on World Trade Center on September 11, 2001.

Few studies have focused on injuries from the World Trade Center disaster on September 11, 2001. Severe injury has health consequences, including an increased mortality risk 10 years after injury and the risk of mental health problems, such as posttraumatic stress disorder (PTSD). The World Trade Center Health Registry identified 14,087 persons with none of a selected group of preexisting chronic conditions before 2002 who were present during and soon after the World Trade Center attacks, 1,980 of whom reported sustaining 1 or more types of injury (e.g., a broken bone or burn). Survey data obt

Acceptance of disability and its correlates.

In a sample of 1,266 U.S. adults with disabilities, relationships were examined between acceptance of disability and (a) demographic characteristics (age, gender, race, education, marital status, and income); (b) disability conditions (disability onset, multiple disabilities, and chronic pain); and (c) other psychosocial factors (self-esteem, emotional support, perceived discrimination, and hostility). Self-esteem and emotional support from family and friends played important roles in the participants' adjustment to disability. Furthermore, perceived social discrimination against people with d

Relationship between vulvodynia and chronic comorbid pain conditions.

OBJECTIVE: To estimate the relationship among the presence of vulvodynia, fibromyalgia, interstitial cystitis, and irritable bowel syndrome. METHODS: Validated questionnaire-based screening tests for the four pain conditions were completed by women with and without vulvodynia who were participating in the Michigan Woman to Woman Health Study, a longitudinal population-based survey in southeastern Michigan. Weighted population-based estimates of the prevalence and characteristics of participants with these chronic comorbid pain conditions were calculated using regression analyses. RESULTS: Of

Implementation of a comprehensive template to support personalised care for people with multiple long-term conditions: a mixed-methods evaluation in primary care.

BACKGROUND: Healthcare services are mainly organised around single health conditions and need reconfiguration to meet the needs of people with multiple long-term conditions (multimorbidity). Typically, people are offered annual reviews for each of their long-term conditions separately. In a randomised controlled trial, a comprehensive computerised template based on a personalised care model increased the person-centredness of multimorbidity reviews in primary care, but there were implementation challenges. We sought to understand and address the challenges of implementing a template to support

Experiences of Social Relationships for Adults Living With Multiple Long-Term Conditions: A Qualitative Interview Study.

BACKGROUND: Social relationships are important for self-management and outcomes of multiple long-term conditions (MLTC). Previous research indicates MLTC negatively impacts social relationships and people living with MLTC do not feel adequately supported to manage their health. However, there is limited understanding of the processes and contextual factors that influence social relationships in the context of MLTC. This study explored experiences of social relationships for adults living with MLTC to improve understanding of their social relationship needs. METHODS: Semi-structured telephone

Association between chronic diseases and falls among a sample of older people in Finland.

BACKGROUND: Falls are a major problem for older people and recurrent fallers are especially prone to severe consequences due to falls. This study investigated the association between chronic conditions and falls. METHODS: Responses from 872 older persons (age 65-98) to a health questionnaire were used in the analyses. Characteristics and disease prevalence between recurrent fallers, one-time fallers and non-fallers were compared. A hierarchical clustering method was applied to find combinations of chronic conditions that were associated with recent recurrent falling. RESULTS: The results sho

Catalog of 199 register-based definitions of chronic conditions.

IntroductionThe aim of the current study was to present and discuss a broad range of register-based definitions of chronic conditions for use in register research, as well as the challenges and pitfalls when defining chronic conditions by the use of registers.Materials and methodsThe definitions were defined based on information from nationwide Danish public healthcare registers. Medical and epidemiological specialists identified and grouped relevant diagnosis codes that covered chronic conditions, using the International Classification System version 10 (ICD-10). Where relevant, prescription