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Measuring multimorbidity in research : Delphi consensus study
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Ho, Iris S. S., Azcoaga-Lorenzo, Amaya, Akbari, Ashley, Davies, Jim, Khunti, Kamlesh, Kadam, Umesh T., Lyons, Ronan A., McCowan, Colin, Mercer, Stewart W., Nirantharakumar, Krishnarajah, Staniszewska, Sophie and Guthrie, Bruce (2022) Measuring multimorbidity in research : Delphi consensus study. BMJ Medicine, 1 (1). e000247. doi:10.1136/bmjmed-2022-000247 ISSN 2754-0413.
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Official URL: http://dx.doi.org/10.1136/bmjmed-2022-000247
Abstract
Objective To develop international consensus on the definition and measurement of multimorbidity in research.
Design Delphi consensus study.
Setting International consensus; data collected in three online rounds from participants between 30 November 2020 and 18 May 2021.
Participants Professionals interested in multimorbidity and people with long term conditions were recruited to professional and public panels.
Results 150 professional and 25 public participants completed the first survey round. Response rates for rounds 2/3 were 83%/92% for professionals and 88%/93% in the public panel, respectively. Across both panels, the consensus was that multimorbidity should be defined as two or more long term conditions. Complex multimorbidity was perceived to be a useful concept, but the panels were unable to agree on how to define it. Both panels agreed that conditions should be included in a multimorbidity measure if they were one or more of the following: currently active; permanent in their effects; requiring current treatment, care, or therapy; requiring surveillance; or relapsing-remitting conditions requiring ongoing care. Consensus was reached for 24 conditions to always include in multimorbidity measures, and 35 conditions to usually include unless a good reason not to existed. Simple counts were preferred for estimating prevalence and examining clustering or trajectories, and weighted measures were preferred for risk adjustment and outcome prediction.
Conclusions Previous multimorbidity research is limited by inconsistent definitions and approaches to measuring multimorbidity. This Delphi study identifies professional and public panel consensus guidance to facilitate consistency of definition and measurement, and to improve study comparability and reproducibility.
Item Type: | Journal Article | |||||||||
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Subjects: | R Medicine > RA Public aspects of medicine R Medicine > RB Pathology R Medicine > RC Internal medicine |
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Divisions: | Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School |
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Library of Congress Subject Headings (LCSH): | Comorbidity , Chronic diseases , Chronically ill | |||||||||
Journal or Publication Title: | BMJ Medicine | |||||||||
Publisher: | BMJ Group | |||||||||
ISSN: | 2754-0413 | |||||||||
Official Date: | 27 July 2022 | |||||||||
Dates: |
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Volume: | 1 | |||||||||
Number: | 1 | |||||||||
Article Number: | e000247 | |||||||||
DOI: | 10.1136/bmjmed-2022-000247 | |||||||||
Status: | Peer Reviewed | |||||||||
Publication Status: | Published | |||||||||
Access rights to Published version: | Open Access (Creative Commons) | |||||||||
Date of first compliant deposit: | 17 August 2022 | |||||||||
Date of first compliant Open Access: | 17 August 2022 | |||||||||
RIOXX Funder/Project Grant: |
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