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The prevalence of disease clusters in older adults with multiple chronic diseases--a systematic literature review.

Sinnige J, Braspenning J, Schellevis F, Stirbu-Wagner I, Westert G, Korevaar J - PLoS ONE (2013)

Bottom Line: Depression was found to be the disease that was most commonly clustered, and was paired with 8 different diseases, in the available studies.Hypertension and diabetes mellitus were found to be the second most clustered diseases, both with 6 different diseases.Prevalence rates for each disease combination varied considerably per study, but were highest for the pairs that included hypertension, coronary artery disease, and diabetes mellitus.

View Article: PubMed Central - PubMed

Affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands ; IQ Healthcare, Scientific Institute for Quality of Healthcare, Radboud University medical centre, Nijmegen, The Netherlands.

ABSTRACT

Background: Since most clinical guidelines address single diseases, treatment of patients with multimorbidity, the co-occurrence of multiple (chronic) diseases within one person, can become complicated. Information on highly prevalent combinations of diseases can set the agenda for guideline development on multimorbidity. With this systematic review we aim to describe the prevalence of disease combinations (i.e. disease clusters) in older patients with multimorbidity, as assessed in available studies. In addition, we intend to acquire information that can be supportive in the process of multimorbidity guideline development.

Methods: We searched MEDLINE, Embase and the Cochrane Library for all types of studies published between January 2000 and September 2012. We included empirical studies focused on multimorbidity or comorbidity that reported prevalence rates of combinations of two or more diseases.

Results: Our search yielded 3070 potentially eligible articles, of which 19 articles, representing 23 observational studies, turned out to meet all our quality and inclusion criteria after full text review. These studies provided prevalence rates of 165 combinations of two diseases (i.e. disease pairs). Twenty disease pairs, concerning 12 different diseases, were described in at least 3 studies. Depression was found to be the disease that was most commonly clustered, and was paired with 8 different diseases, in the available studies. Hypertension and diabetes mellitus were found to be the second most clustered diseases, both with 6 different diseases. Prevalence rates for each disease combination varied considerably per study, but were highest for the pairs that included hypertension, coronary artery disease, and diabetes mellitus.

Conclusions: Twenty disease pairs were assessed most frequently in patients with multimorbidity. These disease combinations could serve as a first priority setting towards the development of multimorbidity guidelines, starting with the diseases with the highest observed prevalence rates and those with potential interacting treatment plans.

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Related in: MedlinePlus

Type of diseases examined in the included studies (top 20).
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pone-0079641-g002: Type of diseases examined in the included studies (top 20).

Mentions: Sixty-three different diseases were found, of which some were defined rather broadly (e.g. heart disease, gastrointestinal disease), while others were described in more detail (e.g. cataract, atrial fibrillation). Diabetes mellitus was the most frequently measured disease (described in 19 out of 23 studies). Other commonly assessed diseases were hypertension, cancer, stroke, and depression (Figure 2). Besides the 63 diseases, 165 combinations of two diseases (i.e. disease pairs) and 50 combinations of three diseases (i.e. disease triplets) were reported in the studies. Of the disease pairs, 20 were described rather frequently (≥ 3 studies), see Table 3. The disease triplets could not be replicated in any of the other studies and were therefore not further analyzed.


The prevalence of disease clusters in older adults with multiple chronic diseases--a systematic literature review.

Sinnige J, Braspenning J, Schellevis F, Stirbu-Wagner I, Westert G, Korevaar J - PLoS ONE (2013)

Type of diseases examined in the included studies (top 20).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3823581&req=5

pone-0079641-g002: Type of diseases examined in the included studies (top 20).
Mentions: Sixty-three different diseases were found, of which some were defined rather broadly (e.g. heart disease, gastrointestinal disease), while others were described in more detail (e.g. cataract, atrial fibrillation). Diabetes mellitus was the most frequently measured disease (described in 19 out of 23 studies). Other commonly assessed diseases were hypertension, cancer, stroke, and depression (Figure 2). Besides the 63 diseases, 165 combinations of two diseases (i.e. disease pairs) and 50 combinations of three diseases (i.e. disease triplets) were reported in the studies. Of the disease pairs, 20 were described rather frequently (≥ 3 studies), see Table 3. The disease triplets could not be replicated in any of the other studies and were therefore not further analyzed.

Bottom Line: Depression was found to be the disease that was most commonly clustered, and was paired with 8 different diseases, in the available studies.Hypertension and diabetes mellitus were found to be the second most clustered diseases, both with 6 different diseases.Prevalence rates for each disease combination varied considerably per study, but were highest for the pairs that included hypertension, coronary artery disease, and diabetes mellitus.

View Article: PubMed Central - PubMed

Affiliation: NIVEL, Netherlands Institute for Health Services Research, Utrecht, the Netherlands ; IQ Healthcare, Scientific Institute for Quality of Healthcare, Radboud University medical centre, Nijmegen, The Netherlands.

ABSTRACT

Background: Since most clinical guidelines address single diseases, treatment of patients with multimorbidity, the co-occurrence of multiple (chronic) diseases within one person, can become complicated. Information on highly prevalent combinations of diseases can set the agenda for guideline development on multimorbidity. With this systematic review we aim to describe the prevalence of disease combinations (i.e. disease clusters) in older patients with multimorbidity, as assessed in available studies. In addition, we intend to acquire information that can be supportive in the process of multimorbidity guideline development.

Methods: We searched MEDLINE, Embase and the Cochrane Library for all types of studies published between January 2000 and September 2012. We included empirical studies focused on multimorbidity or comorbidity that reported prevalence rates of combinations of two or more diseases.

Results: Our search yielded 3070 potentially eligible articles, of which 19 articles, representing 23 observational studies, turned out to meet all our quality and inclusion criteria after full text review. These studies provided prevalence rates of 165 combinations of two diseases (i.e. disease pairs). Twenty disease pairs, concerning 12 different diseases, were described in at least 3 studies. Depression was found to be the disease that was most commonly clustered, and was paired with 8 different diseases, in the available studies. Hypertension and diabetes mellitus were found to be the second most clustered diseases, both with 6 different diseases. Prevalence rates for each disease combination varied considerably per study, but were highest for the pairs that included hypertension, coronary artery disease, and diabetes mellitus.

Conclusions: Twenty disease pairs were assessed most frequently in patients with multimorbidity. These disease combinations could serve as a first priority setting towards the development of multimorbidity guidelines, starting with the diseases with the highest observed prevalence rates and those with potential interacting treatment plans.

Show MeSH
Related in: MedlinePlus