Impact of multimorbidity on functioning: evaluating the ICF Core Set approach in an empirical study of people with rheumatic diseases.
OBJECTIVE
Chronic conditions can lead to considerable deterioration in functioning. Several condition-specific Core Sets, selections of categories from the International Classification of Functioning, Disability and Health (ICF), have been developed to facilitate the rehabilitation process. Considering the increase in patients with more than one specific condition, we evaluated the impact of multimorbidity on functioning and the implications for the Core Set approach.


METHODS
Internet survey.


METHODS
A total of 127 people with a rheumatic disease and 707 people with rheumatic disease and multimorbidity were included.


METHODS
Self-report information on chronic conditions and perceived functioning using the IMPACT-S (ICF Measure of Participitation and Activities Screener) questionnaire, measuring the ICF component activities and participation (32 items).


RESULTS
The mean number of reported serious limitations/restrictions was 5.6 (standard deviation (SD) 5.7) for respondents with rheumatic disease and 6.7 (SD 6.8) for respondents with rheumatic disease and multimorbidity (p < 0.05). Seventeen items were relevant (more than 20% of the respondents reported serious limitations/restrictions) for individuals with rheumatic disease and multimorbidity, and 12 items were relevant for individuals with rheumatic disease only.


CONCLUSIONS
Multimorbidity seriously aggravates the already existing functioning problems of people with rheumatic disease. We recommend that in the ICF Core Set approach more emphasis is given to systematic empirical analysis of the impact of multimorbidity on functioning.
TNO, Leiden, The Netherlands.
Gert Jan
GJ
Wijlhuizen
Rom J M
RJ
Perenboom
Francisca Galindo
FG
Garre
Yvonne F
YF
Heerkens
Nico
N
van Meeteren
D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004185:Disability Evaluation; D036262:Empirical Research; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009017:Morbidity; D011788:Quality of Life; D012216:Rheumatic Diseases / Q000150:complications / Q000453:epidemiology* / Q000503:physiopathology; D012648:Self Care; D057566:Self Report; D012931:Social Environment; D055815:Young Adult