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Category Archives: Others

Publications on multimorbidity January-April 2021

By Martin Fortin

Our search for papers on multimorbidity that were published during the period January-April 2021 has been completed. As in previous searches, we have prepared a PDF file that can be accessed following this link.

Probably, there are some publications that were not detected by our search strategy using the terms “multimorbidity”, “multi-morbidity” and the expression “multiple chronic diseases” in PubMed (https://www.ncbi.nlm.nih.gov/pubmed), but we are sure that most publications on the subject are included in the list.

All references are also included in our library. Feel free to share with anyone interested in multimorbidity.

Multimorbidity in the context of Neurodegenerative Disorders

By Rafael Linden

Dear colleagues,

The Frontiers Platform has launched a Research Topic, aimed at basic research, epidemiology, clinical, neuropathological and modelling studies in the field of Multimorbidity in the context of Neurodegenerative Disorders. We encourage authors to submit either Original Articles or Reviews on this subject.

I would appreciate should IRCMo help inform scientists interested in this subject, and we encourage submission of articles related with the field.

More information:
https://www.frontiersin.org/research-topics/17133/multimorbidity-in-the-context-of-neurodegenerative-disorders

Best regards,

Rafael Linden, M.D., Ph.D.
Associate Editor
Frontiers in Neuroscience

Professor of Neuroscience
Instituto de Biofísica Carlos Chagas Filho
Universidade Federal do Rio de Janeiro
Brasil

Publications on multimorbidity September-December 2020

By Martin Fortin

Our search for papers on multimorbidity that were published during the period September-December 2020 has been completed. As in previous searches, we have prepared a PDF file that can be accessed following this link.

Probably, there are some publications that were not detected by our search strategy using the terms “multimorbidity”, “multi-morbidity” and the expression “multiple chronic diseases” in PubMed (https://www.ncbi.nlm.nih.gov/pubmed), but we are sure that most publications on the subject are included in the list.

All references are also included in our library. Feel free to share with anyone interested in multimorbidity.

The “Journal of Comorbidity” changed to the “Journal of Multimorbidity and Comorbidity.”

By Martin Fortin

Formerly, we could find in the description of the Journal of Comorbidity that it published “original clinical and experimental research articles on the pathophysiology, diagnosis, prevention and management of patients with comorbidity/multimorbidity.” Now, in the description of the Journal of Multimorbidity and Comorbidity, one reads that it publishes the same type of articles on “comorbidity and multimorbidity.”

The change in the name of the journal and the change in the description from “comorbidity/multimorbidity” to “comorbidity and multimorbidity” may seem natural for those working on multimorbidity or those who are familiar with its meaning. However, for many who still consider both words as interchangeable, writing “comorbidity/multimorbidity” could have been seen as normal and the separation in “comorbidity and multimorbidity” could be seen as redundant.

In 1996, van den Akker and colleagues [1] pointed out the prevailing ambiguity around the use of both terms at that time, and suggested distinct definitions for them. Since then, there has been an increasing awareness about the difference between both terms and the importance of using them correctly. A benefit in using both terms adequately is that publications are then correctly classified, leading to an improvement in the quality of search queries and ultimately to better research.

However, although the first alert on the ambiguity in the use of the terms was published 25 years ago, it has taken a long time for the recognition of the difference between both terms and its effect in slowing down the advance of our knowledge on the subject. For example, in the National Library of Medicine of the National Institutes of Health (NIH), the term “multimorbidity” was a subheading under the Medical Subject Heading (MeSH) “comorbidity” until 2017. It was only in 2018 that the term “multimorbidity” appeared with the hierarchy of a MeSH.

In the editorial of the Journal of Multimorbidity and Comorbidity explaining the change in the name of the journal [2], it is well explained that multimorbidity and comorbidity are distinct concepts in research design, intervention development and healthcare delivery. However, there is not a universal recognition of this distinction yet.

We welcome the change in the name of the journal as another step in clarifying the use of the terms, hoping that it will contribute to our main goal which is to improve the health outcomes of our patients.

  1. van den Akker M, Buntinx F and Knottnerus JA. Comorbidity or multimorbidity: what’s in a name? A review of literature. Eur J Gen Pract 1996; 2: 65-70.
  2. Harrison C, Fortin M, van den Akker M, et al. Comorbidity versus multimorbidity: Why it matters. Journal of Multimorbidity and Comorbidity 2021; 11. Article first published online: March 2, 2021. DOI: https://doi.org/10.1177/2633556521993993.

Publications on multimorbidity May-August 2020

By Martin Fortin


Our search for papers on multimorbidity that were published during the period May-August 2020 has been completed. As in previous searches, we have prepared a PDF file that can be accessed following this link.
Probably, there are some publications that were not detected by our search strategy using the terms “multimorbidity”, “multi-morbidity” and the expression “multiple chronic diseases” in PubMed (https://www.ncbi.nlm.nih.gov/pubmed), but we are sure that most publications on the subject are included in the list.
All references are also included in our library. Feel free to share with anyone interested in multimorbidity.

Exploring professional and lay experts’ views on the definition and measurement of multimorbidity

By Iris Ho and Bruce Guthrie
Centre for Population and Health Sciences, Usher Institute, University of Edinburgh, United Kingdom

Many people, nowadays, are living with multiple chronic conditions. However, there remains no agreed method to measure this common phenomenon.

In research, there are varying conditions included in a multimorbidity measure. The number of conditions included in a measure can range from 2 to 285. As for selection of conditions, some included disease category (e.g. gastrointestinal disease), whereas others included relatively smaller disease category (e.g. chronic liver disease) or individual conditions (e.g. hepatitis, or liver cirrhosis).

In addition, methods used to count conditions differ across studies. There are two main types of counting methods. One is using a simple count of conditions to estimate how common multimorbidity is. The other type of measures is applying weights for each chronic condition based on disease severity and its impact on an outcome, and the total weighting score is used to predict the impact of multimorbidity on the outcome, such as mortality, physical disability, hospitalisation, or quality of life. Within each type of measures, researchers have used different reference definitions and weighting schemes while counting.

Due to the inconsistent definitions of multimorbidity and measurement methods, estimates of multimorbidity prevalence and burden cannot be directly compared across studies. Therefore, we want to gather your opinions and experience relevant to multimorbidity. Your opinions can help to shape future research, clinical and policy decisions on management of multimorbidity.

We are looking for:

1) Members of the public who are interested in multiple chronic conditions or have chronic illness experiences

2) Academics, clinicians, service providers, policy makers who are interested in multimorbidity or have undertaken multimorbidity-relevant work.

This study consists of two to four rounds of survey (most likely 2-3 rounds depending on when consensus is reached). The round-one survey is currently published online and the other rounds will be distributed subsequently later.

If you are interested in the topic and want to know more about this study, please get in touch with the researcher, Iris Ho (iris.s.ho@ed.ac.uk), or the principal investigator, Bruce Guthrie (bruce.guthrie@ed.ac.uk).

Thank you!

A bibliometric analysis of multimorbidity from 2005 to 2019

By Mohamed Ali Ag Ahmed, José Almirall, Patrice Ngangue, Marie-Eve Poitras, Martin Fortin

A bibliometric study published by our team in 2005 demonstrated that there was a large discrepancy between the prevalence of multimorbidity in the population and the number of research studies devoted to it at that time [1]. However, the interest in the topic has increased substantially and, thanks to the contributions of many researchers, our knowledge about multimorbidity is much better today than it was only a decade ago.

This time, we conducted a bibliometric analysis of publications on multimorbidity from 2005 to 2019 aiming to identify and analyze publications on the subject, including those that most influenced this field [2]. We searched for publications containing “multimorbidity” or “multi-morbidity” using the PubMed database, and identified them with the tool iCite (https://icite.od.nih.gov/). We analyzed the number of publications, total citations, the article-level metric Relative Citation Ratio (RCR), type of study, the country of the institutional affiliation of the authors, and journals with the most cited articles.

The number of publications using “multimorbidity” has continuously increased since 2005 (2005-2009: 138; 2010-2014: 823; 2015-2019: 3068). Articles with RCR at or above the 97th percentile (RCR = 7.43) were analyzed in detail (n = 104). In 34 publications of this subgroup (33%), the word multimorbidity was used but was not the subject of study. The remaining top 70 publications included 32 observational studies, 22 reviews, five guideline statements, three analysis papers, two randomized trials, three qualitative studies, two measurement development reports, and one conceptual framework development report. The publications were produced by authors from 32 countries. They were published in 37 different journals, ranging from one to four articles in the same journal.

This study showed the important progress made in accumulating knowledge on multimorbidity, with a continuous increase that included 76% of all publications only in the last quinquennium. Nonetheless, more high impact randomized trials and qualitative studies are needed in this field of research. Our study also suggests that these numbers should be taken with caution and considered a general trend because the analysis of a subgroup of publications showed that multimorbidity was not the subject of research in one third of the publications.

The article can be accessed at the following link:
https://journals.sagepub.com/doi/full/10.1177/2235042X20965283

  1. Fortin M, Lapointe L, Hudon C , Vanasse A. Multimorbidity is common to family practice. Is it commonly researched? Can Fam Physician 2005;51:244-5.
  2. Ag Ahmed MA, Almirall J, Ngangue P, Poitras M-E , Fortin M. A bibliometric analysis of multimorbidity from 2005 to 2019. Journal of Comorbidity 2020;10:1-7.

Publications on multimorbidity January-April 2020

By Martin Fortin

Our search for papers on multimorbidity that were published during the period January-April 2020 has been completed. As in previous searches, we have prepared a PDF file that can be accessed following this link.
Probably, there are some publications that were not detected by our search strategy using the terms “multimorbidity”, “multi-morbidity” and the expression “multiple chronic diseases” in PubMed (https://www.ncbi.nlm.nih.gov/pubmed), but we are sure that most publications on the subject are included in the list.
All references are also included in our library. Feel free to share with anyone interested in multimorbidity.

Publications on multimorbidity September-December 2019

By Martin Fortin


Our search for papers on multimorbidity that were published during the period September-December 2019 has been completed. As in previous searches, we have prepared a PDF file that can be accessed following this link.


Probably, there are some publications that were not detected by our search strategy using the terms “multimorbidity”, “multi-morbidity” and the expression “multiple chronic diseases” in PubMed (https://www.ncbi.nlm.nih.gov/pubmed), but we are sure that most publications on the subject are included in the list.


All references are also included in our library. Feel free to share with anyone interested in multimorbidity.

OUR WELCOME POST: US Deprescribing Research Network


By Cynthia Boyd and Mike Steinman

Though medications offer the capacity to extend lives, relieve symptoms, and reduce the feared consequences of disease, they can also cause bothersome and dangerous side effects, burden older adults and their caregivers, and deplete savings. The use of multiple prescription drugs among U.S. adults age 65 and older has increased from 24% in 2000 to 39% in 2012. This significant growth is attributable to a growing older population, onset of chronic disease, and increasing availability of drugs for treatment and prevention. So, how do we handle the double-edged sword that is medication-treatment? By understanding and identifying the medications that are suitable for each patient, and deprescribing those for which these harms outweigh the benefit.

What is deprescribing? Deprescribing refers to the thoughtful and systematic process of identifying problematic medications and either reducing the dose or stopping the medication in a manner that is safe, effective, and helps people maximize their health and wellness goals.

However, this process is not easy. Little is known about how to best identify which medications are prime for deprescribing, how to safely and effectively stop them, and how to engage older adults, their loved ones, clinicians, and the health system in this process in a seamless and person-centered manner.

The National Institute on Aging recognizes the need for deprescribing medications among older adults and has awarded a five-year, $6.2 million grant to the University of California, San Francisco (UCSF) and Johns Hopkins University to establish the U.S. Deprescribing Research Network (USDeN).

Who we are and what we do – The USDeN is led by Co-Principal Investigators Michael Steinman, MD, at UCSF and the San Francisco VA Medical Center, and Cynthia Boyd, MD, MPH, at Johns Hopkins University School of Medicine. The network is comprised of a community of individuals who share the common goal of developing and disseminating high-quality evidence about deprescribing for older adults, and in doing so, helping improve medication use among older adults and the outcomes that are important to them.

The network’s key activities are designed to provide resources and create a central place for mutual learning, collaboration, building research capacity, and catalyzing work among a large and multidisciplinary group of investigators. Network activities are oriented around 4 cores and a series of working groups:

Investigator Development Core – Organizes activities to provide education and collaboration about deprescribing research, with a special focus on the needs of early-stage investigators.

Pilot and Exploratory Studies Core – Funds and supports pilot and grant planning studies related to deprescribing for older adults.

Stakeholder Engagement Core – Supports engagement of patients, caregivers, clinicians, and health system stakeholders with various activities of the network, so that the resulting research is maximally responsive to their priorities and needs.

Data and Resources Core – Provides information about prior and ongoing research on deprescribing, research resources relevant to deprescribing, and will build capacity for the use of existing electronic health record data for deprescribing research

Working Groups – Supports 4 working groups that will synthesize existing research and develop new tools for deprescribing research, including identifying high-priority targets for deprescribing, optimizing measurement tools and using electronic health data in deprescribing research, and optimizing communication around deprescribing.

We invite you to join our community of innovators by visiting us at https://deprescribingresearch.org, and following us on Twitter @DeprescribeUS. For more information contact admin@deprescribingresearch.org.

Cross-posted at https://deprescribingresearch.org/our-welcome-post-us-deprescribing-research-network/