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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

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Official URL: http://dx.doi.org/10.1136/bmjmed-2022-000247

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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
Subjects: R Medicine > RA Public aspects of medicine
R Medicine > RB Pathology
R Medicine > RC Internal medicine
Divisions: Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences
Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
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:
DateEvent
27 July 2022Published
26 May 2022Accepted
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
RIOXX Funder/Project Grant:
Project/Grant IDRIOXX Funder NameFunder ID
UNSPECIFIEDHealth Data Research UKhttps://www.hdruk.ac.uk/
UNSPECIFIED[NIHR] National Institute for Health Researchhttp://dx.doi.org/10.13039/501100000272

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