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Cited by 619Chronic Disease Management StrategiesPrimary Care and Health OutcomesPharmaceutical Practices and Patient Outcomes

The DOI matches its Crossref record; 69 of the 72 references it cites were found in a registry or an index.

Measures of Multimorbidity and Morbidity Burden for Use in Primary Care and Community Settings: A Systematic Review and Guide

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Huntley, A. L., Johnson, R., Purdy, S., Valderas, J. M., Salisbury, C.·2012·The Annals of Family Medicine
DOI 10.1370/afm.1363PMC PMC3315139
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Abstract

PURPOSE: Many patients consulting in primary care have multiple conditions (multimorbidity). Aims of this review were to identify measures of multimorbidity and morbidity burden suitable for use in research in primary care and community populations, and to investigate their validity in relation to anticipated associations with patient characteristics, process measures, and health outcomes. METHODS: Studies were identified using searches in MEDLINE and EMBASE from inception to December 2009 and bibliographies. RESULTS: Included were 194 articles describing 17 different measures. Commonly used measures included disease counts (n = 98), Chronic Disease Score (CDS)/RxRisk (n = 17), Adjusted Clinical Groups (ACG) System (n = 25), the Charlson index (n = 38), the Cumulative Index Illness Rating Scale (CIRS; n = 10) and the Duke Severity of Illness Checklist (DUSOI; n = 6). Studies that compared measures suggest their predictive validity for the same outcome differs only slightly. Evidence is strongest for the ACG System, Charlson index, or disease counts in relation to care utilization; for the ACG System in relation to costs; for Charlson index in relation to mortality; and for disease counts or Charlson index in relation to quality of life. Simple counts of diseases or medications perform almost as well as complex measures in predicting most outcomes. Combining measures can improve validity. CONCLUSIONS: The measures most commonly used in primary care and community settings are disease counts, Charlson index, ACG System, CIRS, CDS, and DUSOI. Different measures are most appropriate according to the outcome of interest. Choice of measure will also depend on the type of data available. More research is needed to directly compare performance of different measures.

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Metadata

Authors
Huntley, A. L., Johnson, R., Purdy, S., Valderas, J. M., & Salisbury, C.
Affiliations
  • University of Bristol (GB)
  • University of Oxford (GB)
ORCID
Venue
The Annals of Family Medicine
Publisher
Annals of Family Medicine
Published
2012-03-01
Volume
10
Issue
2
Pages
134-141
ISSN
  • 1544-1709 (ISSN-L)
  • 1544-1717
DOI
10.1370/afm.1363
PMC
PMC3315139
OpenAlex
W2131863095
Cited by
619
References
72
Citations by year
2026: 17 · 2025: 32 · 2024: 40 · 2023: 42 · 2022: 43 · 2021: 74 · 2020: 41 · 2019: 51 · 2018: 49 · 2017: 40 · 2016: 43 · 2015: 55 · 2014: 48 · 2013: 35 · 2012: 8
FWCI
5.82
Type
journal article
Language
en
Open access
Locations
  • The Annals of Family Medicine (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • BIBSYS Brage (BIBSYS (Norway)) (submittedVersion)
  • NORA - Norwegian Open Research Archives (submittedVersion, other-oa)
  • Explore Bristol Research (submittedVersion)
  • Bristol Research (University of Bristol) (submittedVersion)
Funders
National Institute for Health and Care Research (NIHR/CS/010/024, IAT/I-PF/009/011, CL-2010-25-005, SPCR-037)
Topics
  • Health Sciences › Medicine › Epidemiology › Chronic Disease Management Strategies
  • Health Sciences › Medicine › Family Practice › Primary Care and Health Outcomes
  • Health Sciences › Medicine › Geriatrics and Gerontology › Pharmaceutical Practices and Patient Outcomes
Keywords
multimorbidity, disease burden, Charlson Comorbidity Index, Chronic Disease Score, Cumulative Illness Rating Scale, predictive validity, primary care, community population, health outcomes, mortality, quality of life, health care utilization, health care costs
MeSH terms
Community Health Services, Humans, Outcome and Process Assessment, Health Care, Primary Health Care, Comorbidity

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