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Impact of comorbidity and multimorbidity on primary care practice

Comorbidity and multimorbidity are often defined as the co-existence of two or more long-term medical conditions. Comorbidity and multimorbidity have been shown to be associated with adverse health outcomes, such as poor quality of life, disability, psychological problems and increased mortality. They also associated with increased frequency of health-service use involving emergency hospital admission, adverse drug events, poly-pharmacy, duplicate testing and poor care co-ordination.

Presently, health care workers have limited guidance or experience as to how to approach care decisions for patients with multimorbidity. Medical training and clinical care has been largely informed by evidence and guidelines for single systems or diseases. Current clinical practice is increasingly specialist, with healthcare professionals often basing treatment decisions on relatively narrow aspects of an individual's health problems. As such our medical care system is particularly ill-prepared to deal with patients with comoribidity and multimorbidity. These issues are especially relevant in certain clinical settings, such as general practice and services caring for the aging population.

In this context, BMC Family Practice presents our special collection focused on the impact of comorbidity and multimoribidty on primary care. This thematic series examines the breadth of research on comorbidity and multimorbidity and their impact on clinical practice in primary care.

Some topics included in the series:
• Comorbid anxiety in patients with long-term conditions (LTCs)
• Access to care for patients with multimorbidity
• Patient perspectives on managing numerous LTCs, including the impact of treatment burden
• Medically unexplained symptoms

For further information, please email in-house editor Tovah Aronin at 

  1. Debate

    Current and future perspectives on the management of polypharmacy

    Because of ageing populations, the growth in the number of people with multi-morbidity and greater compliance with disease-specific guidelines, polypharmacy is becoming increasingly common. Although the correc...

    Mariam Molokhia and Azeem Majeed

    BMC Family Practice 2017 18:70

    Published on: 6 June 2017

  2. Debate

    “Medically unexplained” symptoms and symptom disorders in primary care: prognosis-based recognition and classification

    Many patients consult their GP because they experience bodily symptoms. In a substantial proportion of cases, the clinical picture does not meet the existing diagnostic criteria for diseases or disorders. This...

    Marianne Rosendal, Tim C Olde Hartman, Aase Aamland, Henriette van der Horst, Peter Lucassen, Anna Budtz-Lilly and Christopher Burton

    BMC Family Practice 2017 18:18

    Published on: 7 February 2017

  3. Research article

    Musculoskeletal pain and co-morbid insomnia in adults; a population study of the prevalence and impact on restricted social participation

    Comorbidity is common in patients consulting in primary care. Musculoskeletal pain and insomnia each increase the risk of the other. Co-occurrence may pose an increased burden on well-being. However, the preva...

    Shula Baker, John McBeth, Carolyn A. Chew-Graham and Ross Wilkie

    BMC Family Practice 2017 18:17

    Published on: 7 February 2017

  4. Research article

    Patient capacity and constraints in the experience of chronic disease: a qualitative systematic review and thematic synthesis

    Life and healthcare demand work from patients, more so from patients living with multimorbidity. Patients must respond by mobilizing available abilities and resources, their so-called capacity. We sought to su...

    Kasey R. Boehmer, Michael R. Gionfriddo, Rene Rodriguez-Gutierrez, Abd Moain Abu Dabrh, Aaron L. Leppin, Ian Hargraves, Carl R. May, Nathan D. Shippee, Ana Castaneda-Guarderas, Claudia Zeballos Palacios, Pavithra Bora, Patricia Erwin and Victor M. Montori

    BMC Family Practice 2016 17:127

    Published on: 1 September 2016

  5. Research article

    Living with complexity; marshalling resources: a systematic review and qualitative meta-synthesis of lived experience of mental and physical multimorbidity

    Multimorbidity poses a major health burden worldwide yet most healthcare is still orientated towards the management of single diseases. Literature on the experience of living with multimorbidity is accumulatin...

    Peter A. Coventry, Nicola Small, Maria Panagioti, Isabel Adeyemi and Penny Bee

    BMC Family Practice 2015 16:171

    Published on: 24 November 2015

  6. Commentary

    The triple whammy anxiety depression and osteoarthritis in long-term conditions

    Improving the management of people with long-term conditions is a key priority of the UK National Health Service. Whilst the coexistence of two or more long-term conditions in one person is increasingly the no...

    Valerie Tan, Clare Jinks, Carolyn Chew-Graham, Emma L. Healey and Christian Mallen

    BMC Family Practice 2015 16:163

    Published on: 14 October 2015