This article discusses a number of considerations for managing multimorbidity in people with chronic respiratory conditions including: the use of care planning, addressing polypharmacy, comorbid mental health conditions, and drug reactions, factors such as gender and socio-economic status, health promotion /opportunistic screening and shared decision making.
This publication describes a survey of older adults with chronic health conditions seen in primary care regarding the daily spiritual experiences (DSE), perceptions of health, pain, energy and depression. The authors concluded that an increase in DSE may be associated with more energy and less depression.
The authors state that the current health care system relies on the assumption that older populations have well-developed skills required for self-management of chronic disease. Clinicians must acknowledge the relationship between cognition and self-management and improve their ability to identify and respond to the causes of treatment non-adherence particularly as they related to dementia.
This paper discusses the literature on single disease state self-management with an aim of identifying potentially useful approaches for supporting complex chronic disease (CCD) self-management. They discuss negotiation of the goals of care, communicating with patients, engaging patients in behaviour change, reducing information processing burden, minimizing the negative impact on health-related quality of life and suggestions for future research.
The authors undertook a population-based retrospective study set in Ontario in an attempt estimate the attributable costs of multimorbidity and assess whether the association between the level of multimorbidity and health system costs varies by socio-demographic factors in young (<65 years) and older (≥65 years) adults. They found that there was a positive association between health care costs and levels of multimorbidity that was significantly stronger for older than younger adults.
This SEDAP (Social and Economic Dimensions of an Aging Population) research paper discusses the importance of health status transitions and future disability levels for the management of an elderly society. The report presents estimates for Canada’s elderly in poor health for those aged 75 and over.
The investigators used data from the 2005 Canadian Community Health Survey to focus on individuals who reported having one or more high-prevalence or high-impact chronic health condition to report on prevalence rates for specific chronic conditions, the prevalence of co-morbidity as well as health care use. They found that more than half of seniors who have chronic conditions reported more than one long-term health problem. The investigators state there is a need for better prevention and management of chronic conditions.
This investigation sought to quantify the temporal association between population increases in seasonal influenza infections and mortality due to cardiovascular causes as well as to determine if influenza incidence indicators are predictive or cardiovascular mortality during influenza season. The researchers found that emergency department visits for adults over age 65 for influenza-like illness were associated with and predictive of cardiovascular disease mortality.