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
Open accessAbstract
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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“Additionally polymorbidity is associated with increased health service utilization and poorer health outcomes [6,7], demonstrating the relevance of proper treatment for polymorbid patients.”
From ESPEN guideline on nutritional support for polymorbid medical inpatients (2023) · cites this paper as [7]
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Pereira, C. C., Magalhães, L. S., Batista, S. R. R., Pagotto, V., & Guimarães, R. A. (2026) · PLoS ONE · doi:10.1371/journal.pone.0343166
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Azevedo, D. C., Valle, E. A., & Calderaro, D. C. (2026) · Revista da Associação Médica Brasileira · doi:10.1590/1806-9282.20250884
Palakshappa, D., Stone, R. J., Torres, J. B., Berkowitz, S. A., Rhodes, S. D., Kirkendall, E. S., Dressler, E. V. M., Acosta, L. P., Williamson, J. D., Ard, J. D., et al. (2026) · Contemporary Clinical Trials · doi:10.1016/j.cct.2026.108331
Evaluating Health System Performance Through the Analysis of Multimorbidity Population Networks
Moreno, C. S., Hurtado, R., & Velasco, N. (2026) · Lecture notes in production engineering · doi:10.1007/978-3-032-19656-9_53
Chen, L. H., Xiao, S., Su, Y., Li, H., Lin, J., & Xing, D. (2026) · Journal of Clinical Medicine · doi:10.3390/jcm15124542
Hašek, D. (2026) · healthbook TIMES Oncology Hematology · doi:10.36000/hbt.oh.2026.28.207
COVID stress, anxiety and depressive symptoms, and multimorbidity: a longitudinal examination
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Multimorbidität, Komorbidität und verwandte Begriffe: Synonyme oder unterschiedliche Konzepte?
Calderón‐Larrañaga, A., & van den Akker, M. (2022) · Elsevier eBooks · doi:10.1016/b978-3-437-23685-3.00002-3
Obesity as a risk factor for multimorbidity: a 23-years population-based prospective study
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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)
- 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
- 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
- diamond
- doi.org
- 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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