Entete 3

A request to the International Research Community on Multimorbidity

By Helene Rosenbrandt

In Denmark the health sector is split in three: regions (responsible for hospitals), general practitioners and communities. I am planning process and content in a series of meetings in a political committee regarding multimorbidity. The political committee is interested in performing a study trip to other countries (if possible in Europe) who are working with handling challenges regarding multimorbidity in a yet more specialised health service. Our interest is in projects/activities that “can be seen” for example including interventions for patients (more than research on databases etc). I contact you with hope that you have ideas regarding interesting projects and solutions on this topic?

 We work with two different meanings of the area:
–      Multimorbidity where the perspective is the “whole” patient – all diseases are seen as equal.
–      Comorbidity where one disease is the primary and other diseases are seen as comorbidity to the primary disease – the perspective is a specialist one where a specialist in one primary disease tries to take other diseases (comorbidity) into consideration.

 Our focus is multimorbidity.

Some of the problems we see are:
–      That the hospital sector gets more and more specialized and if one follows the clinical guidelines for the individual diagnoses it leads to overwhelming treatment plans for the patient with 2, 3 or more simultaneous diseases – including polypharmacy.
–      In the actual process of diagnosing the patient a more general or cooperating view on the patient may lead to quicker diagnosis and start of relevant treatment.
–      The general practitioner have a role in this broad look on the patient but does not possess the specialist competences needed with more severe diseases.
–      One or more chronic diseases often lead to even more diseases – partly through negative feedback on lifestyle factors (arthritis may lead to inactivity which may then increase the risk of getting diabetes etc..).

We are interested in a broad range of projects and activities which deal with multimorbidity:
–      Handling multimorbidity in a specialised hospital sector.
–      The general practitioners role as an anchor/coordinator.
–      Cooperation between primary and secondary health sector.
–      Polypharmacy issues.
–      Patients own role in handling multimorbidity (self efficacy, social inequalities in health).

Best wishes,

Helene Rosenbrandt
(Administrator in the Regional part of the Danish Health sector)

One comment

  • 1
    August 10, 2011 - 6:55 am | Permalink

    Dear Helene,
    Your description of the issues regarding coping with multimorbidity issues in the Danish health care system is very comparable to the issues we are trying to deal with in the Netherlands. Of course you are welcome to pay a visit to the Netherlands. We will not be able to provide you with the definite solutions (….), but we could give you an overview on current projects and activities.

    Francois Schellevis

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