Research in multiple chronic conditions

  • - a challenge in highly specialised health care

Multimorbidity has become a major societal issue. The number of people living with several chronic conditions is on the rise due to complex disease interactions, new treatment options and complex disease and increasing life expectancy.

The highly specialised health care system constitutes a challenge to multimorbidity care, as each condition must be treated in accordance with disease-specific guidelines, whereas no clinical guidelines govern multimorbidity as a whole. This often results in fragmented care for the individual patient. 

Multiple chronic conditions are mostly treated in general practice. Therefore, it is important to include general practice in the evidence on the treatment, prognosis and development of multimorbidity. The general practitioner is also used to dealing with a multitude of physical, psychological and social issues. 

The group engages in register-based research and has conducted studies in close collaboration with a wide range of international partners. The group has developed the Danish Multimorbidity Index, which categorises 39 physical and mental disorders at population level in both primary and secondary care.


Selected publications

  • Association between mental disorders and subsequent medical conditions. Momen N, Plana-Ripoll O, Agerbo E et al. NEJM 2020 Apr 30;382(18):1721-1731. doi: 10.1056/NEJMoa1915784.
  • Chronic care services and variation between Danish general practices: a nationwide cohort study. Prior A, Vestergaard C, Ribe AR et al. Br J Gen Pract. 2021 Nov 29;BJGP.2021.0419. doi: 10.3399/BJGP.2021.0419.

  • Exploring Comorbidity Within Mental Disorders Among a Danish National Population. Plana-Ripoll O, Pedersen CB, Holtz Y et al. JAMA Psychiatry 2019 Mar 1;76(3):259-270. doi: 10.1001/jamapsychiatry.2018.3658

  • Perceived stress, multimorbidity, and risk for hospitalizations for ambulatory care-sensitive conditions: a population-based cohort study. Prior A, Vestergaard M, Davydow DS et al. Med Care 2017 Feb;55(2):131-139. doi: 10.1097/MLR.0000000000000632.
  • Potientially inappropriate medications (PIMS): frequency and extent of GP-related variation in PIMs: a register-based cohort study. Ribe AR, Christensen LD, Vestergaard CH, Prior A et al. BMJ Open. 2021 Jul 14;11(7):e046756. doi: 10.1136/bmjopen-2020-046756.

Researchers


Projects

  • GPs at the 'deep end' in Denmark
  • Multimorbidity and treatment pathways in general practice
  • Pharmacological treatment of type 2 diabetes in general practice
  • Potentielly inapppropriate medications in general practice [completed]
  • Short-term readmission and mortality in older patients discharged after a pneumonia admission [completed]