ReviewThe European General Practice Research Network Presents a Comprehensive Definition of Multimorbidity in Family Medicine and Long Term Care, Following a Systematic Review of Relevant Literature
Section snippets
Method
The method adopted was a systematic literature review with a multilingual team representing eight different nationalities (Belgian, French, German, Greek, Italian, Dutch, Polish, and Spanish). The collective linguistic ability of the team enabled the inclusion and interpretation of articles in various languages. The entire process was undertaken by groups of four different researchers, drawn from at least two different national teams. The review protocol, following the Preferred Reporting Items
Results
Identification, screening, eligibility, and inclusion processes are shown in Figure 1. Eligible articles are shown in Table 1 with their study type.
One article was not found, despite the help of three different university libraries. Of the 13 other excluded articles, four were editorials with no exclusion/inclusion criteria, seven were using multimorbidity without a clear description, and two were excluded on the basis of poor quality (ie, the average score awarded by the four researchers was
Discussion
This study was undertaken to provide a comprehensive definition of multimorbidity that would be understandable and usable for further collaborative research. The research team selected a systematic review methodology. Data extraction and analysis were based on a phenomenological perspective, using a grounded theory framework. The multilingual team successfully classified the extracted criteria and arrived at a definition using a thematic classification.
There are several important issues to note
Conclusion
This definition is intended to help researchers who are studying the inclusion/exclusion process in the detection of multimorbid patients. This definition is also intended to help FPs to identify multimorbid patients. The effect modifiers direct FPs, or other long term care physicians, toward the tools to help these patients. It provides new opportunities, where medical management is optimal, to lower the burden of multimorbidity. This definition brings into focus the possible outcomes of
Acknowledgments
With special thanks to Christophe Berkhout from France for his clear and specific advice throughout the research process, and to Claire Collins (and her team from the Irish College of General Practice) from Ireland and Jan Karl Soler from Malta for their checking of the English phrasing of the definition.
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The authors have declared no conflicts of interest.