Toename multimorbiditeit bij patiënten in de huisartsenpraktijk in de periode 2003-2009^*

Objective

To determine the prevalence of chronic multimorbidity and its increase in primary care.

Design

Descriptive longitudinal study.

Method

We selected patients suffering from chronic pulmonary disease, chronic cardiovascular disease, or diabetes from a national representative general practice research database (LINH). For each year in the period 2003-2009, we calculated the prevalence of these separate conditions. We subsequently assessed the prevalence of multimorbidity and its increase for 4 different age groups (0-14, 15-44, 45-64, ≥ 65 years).

Results

The percentage of all patients suffering from at least 1 of these chronic conditions increased from 12.6% in 2003 to 15.0% in 2009, an increase of almost 20%. The multimorbidity among these patients rose from 15.9% in 2003 to 18.3% in 2009. This increase in multimorbidity was found in all 3 chronic conditions under study and in all adult age groups. To what extent this increase was caused by improvements in morbidity registration could not be identified.

Conclusion

There appears to be a considerable increase in recent years in the prevalence of chronic diseases; multimorbidity appears also to have increased. If this trend continues, in 2015 the multimorbidity among patients over 65 years of age with diabetes, chronic pulmonary and/or cardiovascular disease will be more than 30%.

Conflict of interest: Dr I.J.M. Smeele received remuneration from Astra Zeneca, Glaxo and Boerhinger Ingelheim for providing training courses. Financial support: Dr M.A.J.B. Tacken, Mrs I. Vossen, Dr H. Calsbeek, Dr J.E. Jacobs and Dr J.C.C. Braspenning received a grant through their institute from the Dutch National Institute for Public Health and the Environment’s Centre for Population Screening (RIVM-CvB) and from the primary care Regional Support Organisation Ros-Robuust.