Entete 3

Author Archives: Christiane Muth

Multimorbidity: a hidden epidemic that challenges European health services

By Christiane Muth, Amaia Calderón-Larrañaga, Marjan van den Akker, Beatriz Poblador-Plou and Alexandra Prados-Torres (from left to right)

A workshop on multimorbidity was held in Malta the 9th November in the context of the 20th Annual European Public Health Conference (EUPHA).

This workshop was organized by researchers of the Aragon Institute of Health Sciences (IACS) in Spain and the CAPHRI School for Public Health and Primary Care in the Netherlands, and supported by the EUPHA Section on Chronic Diseases. The aim was to shed light on future research and action strategies for patients with multiple chronic conditions.

The analysis was performed from three complementary perspectives. During the first part of the workshop, coordinated by Alexandra Prados and Amaia Calderón from the EpiChron Research Group on Chronic Diseases of the IACS, results from epidemiological research were presented regarding the systematic association between diseases or medications into so-called multimorbidity and polypharmacy patterns. The role of adverse drug events on increased morbidity burden was discussed.

The second part, led by Marjan van den Akker from CAPHRI School at Maastricht University, focused on the role to be played by health services in face of this reality, and the need to reorient them to give a global response to patient’s health problems. Specific interventions involving the patient (e.g. shared decision making, patient centred care), but also at the level of the organization of care (e.g. case managers, reorganizing chains of care) were reviewed.

Finally, Christiane Muth from the Institute of General Practice at Frankfurt’s Goethe University suggested a methodological framework to systematically address multimorbidity in clinical practice guidelines. Taking chronic heart failure (CHF) as an example, the importance of identifying relevant interactions between CHF and its common comorbidities, as well as potential drug-disease and drug-drug interactions was highlighted, as a necessary precondition and a first step to optimize health care in patients with multiple conditions.

For further detail on the program and speakers, see:


International Workshop on Collaborative Strategies in Multimorbidity

By Dr. Med. Christiane Muth

Seventeen experts from five countries (Canada, Ireland, the UK, the Netherlands and Germany) participated in an interdisciplinary workshop that took place at the Institute for General Practice on February 4/5, 2011. Those that took part included research scientists from the fields of general practice, clinical pharmacology and gerontology, as well as a number of methodologists.

The focus of the meeting was on multimorbidity and particularly on the increasing use of multimedication resulting from the demographic ageing of the population. Intensive discussions took place on model creation, concept development, epidemiology, the development of interventions, and improving healthcare for multimorbid patients. Two trials currently being conducted in Maastricht (PIL: Polypharmacy Intervention Limburg [link]) and Frankfurt (PRIMUM: PRIorization of MUltimedication in Multimorbidity [link]) were of central importance for the optimization of multimedication therapies. Special attention was also paid to specific methodological aspects characterizing the development, evaluation and implementation of complex interventions. Ways in which the participants can continue to cooperate in the future were also discussed.

The workshop was supported by the Association of Patrons and Friends of the Johann Wolfgang Goethe University Frankfurt am Main e.V.