Chronic conditions and multimorbidity in the Swiss primary care population

Abstract
 
To provide valid and representative epidemiologic estimates of prevalent chronic condition and multimorbidity in the Swiss primary care population, prospective planned cross-sectional study was utilized. Swiss primary care, Swiss Sentinel Surveillance Network, calendar weeks 11 and 12, 2015. 175 general practitioners (GP) or pediatricians (PED) with 26’853 patient contact. Thurgau Morbidity Index (TMI) (scores from 0=healthy to 6=multiple severe chronic conditions). Patients were 55.8±21.6 or 6.1±5.7 years old (mean±SD, in GPs vs. PEDs) and 47% were males. In GP patients, median TMI was 2 (IQR: 1-3). The median numbers of chronic conditions and permanently-used prescribed drugs were 2 (0-5) and 2 (1-4), respectively, whereas in the PEDs medians were 0. 16.7% of the GP and 7.0% of the PED patients had been hospitalized at least once during the previous year; patients cared by family/proxies or community nurses had been hospitalized significantly more often than patients living in homes (50.1 vs. 35.4%, OR 1.41, p<0.001). 51.5% of the patients over 80 years of age were care-dependent, and 45.5% of the patients over 90 were living in homes for the elderly. In a representative sample of Swiss primary care patients, a substantial part showed multimorbidity with a high burden for disease, treatment and care-dependency. Trial registration: www.clinicaltrials.gov NCT0229537, national study registrywww.kofam.ch SNCTP000001207.
 
Keywords: Multimorbidity, comorbidity, morbidity, drug treatment, drug utilization, polymedication, polypharmacy, care-dependency, hospitalization, primary health care, patient care management, delivery of health care, adult, child, Switzerland.