title: Time to face the challenge of multimorbidity. A European perspective from the joint action on chronic diseases and promoting healthy ageing across the life cycle (JA-CHRODIS).
abstract: Research on multimorbidity has rapidly increased in the last decade, but evidence on the effectiveness of interventions to improve outcomes in patients with multimorbidity is limited. The European Commission is co-funding a large collaborative project named Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) in the context of the 2nd EU Health Programme 2008-2013. The present manuscript summarizes first results of the JA-CHRODIS, focuses on the identification of a population with multimorbidity who has a high or very high care demand. Identification of characteristics of multimorbid patients associated with a high rate of resource consumption and negative health outcomes is necessary to define a target population who can benefit from interventions. Indeed, multimorbidity alone cannot explain the complexity of care needs and further, stratification of the general population based on care needs is necessary for allocating resources and developing personalized, cost-efficient, and patient-centered care plans. Based on analyses of large databases from European countries a profile of the most care-demanding patients with multimorbidity is defined. Several factors associated with adverse health outcomes and resource consumption among patients with multimorbidity were identified in these analyses, including disease patterns, physical function, mental health, and socioeconomic status. These results underline that a global assessment is needed to identify patients with multimorbidity who are at risk of negative health outcomes and that a comprehensive approach, targeting not only diseases, but also social, cognitive, and functional problems should be adopted for these patients.
authors: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy; Agenzia Italiana del Farmaco (AIFA), Rome, Italy. Electronic address: graziano.onder@rm.unicatt.it.
authors: Graziano
authors: G
authors: Onder
authors: Agenzia Italiana del Farmaco (AIFA), Rome, Italy.
authors: Katie
authors: K
authors: Palmer
authors: Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania; Vilnius University, Faculty of Medicine, Lithuania.
authors: Rokas
authors: R
authors: Navickas
authors: Vilnius University Hospital Santariškių Klinikos, Vilnius, Lithuania.
authors: Elena
authors: E
authors: Jurevičienė
authors: Department of Geriatrics, Centro Medicina dell'Invecchiamento, Università Cattolica del Sacro Cuore, Rome, Italy; Agenzia Italiana del Farmaco (AIFA), Rome, Italy.
authors: Federica
authors: F
authors: Mammarella
authors: Health System Performance Directorate, National Center of Public Health and Analyses, Sofia, Bulgaria.
authors: Mirela
authors: M
authors: Strandzheva
authors: Scientific Direction, IRCCS Ca' Granda Maggiore Policlinico Hospital Foundation, Milan, Italy.
authors: Piermannuccio
authors: P
authors: Mannucci
authors: Agenzia Italiana del Farmaco (AIFA), Rome, Italy.
authors: Sergio
authors: S
authors: Pecorelli
authors: Agenzia Italiana del Farmaco (AIFA), Rome, Italy; Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors: Alessandra
authors: A
authors: Marengoni
mesh_terms: D002908:Chronic Disease / Q000453:epidemiology*; D015897:Comorbidity; D004185:Disability Evaluation; D005060:Europe; D006301:Health Services Needs and Demand; D006801:Humans; D008603:Mental Health; D018802:Patient-Centered Care; D012923:Social Class
keywords: Comprehensive geriatric assessment; Joint Action CHRODIS; Multimorbidity