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Care of the Older Adult/ Elderly > Multimorbidity (lecture) > Flashcards

Multimorbidity (lecture) Flashcards

(43 cards)

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1
Q

What is multimorbidity?

A

The presence of two or more long-term health conditions.

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2
Q

What is another term for multimorbidity preferred by patient groups?

A

Multiple long-term conditions.

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3
Q

List examples of physical long-term conditions.

A
  • Diabetes
  • Cardiovascular disease
  • Cancer
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4
Q

List examples of mental health conditions.

A
  • Depression
  • Schizophrenia
  • Dementia
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5
Q

What are chronic infectious diseases that can be included in multimorbidity?

A
  • HIV
  • Hepatitis C
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6
Q

What are some other contributors to multimorbidity?

A
  • Learning disabilities
  • Symptom complexes (e.g., frailty, chronic pain)
  • Sensory impairments (e.g., hearing or sight loss)
  • Substance misuse
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7
Q

What is comorbidity?

A

A secondary condition linked to a primary disease.

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8
Q

How does multimorbidity affect healthcare appointments?

A

Accounts for 50% of all GP appointments.

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9
Q

What is the risk associated with polypharmacy?

A

Risks frailty with more than 5 medications.

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10
Q

What challenges does multimorbidity present in medical practice?

A

Challenges the practice of medicine as it tends to work in specialities.

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11
Q

What are the potential outcomes for patients with multimorbidity?

A

Poor outcomes and high use of unplanned healthcare.

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12
Q

What is a recommended approach to managing multimorbidity?

A

More generalism and not specialism in medicine.

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13
Q

Why may guidelines on a single condition not be appropriate for multimorbidity?

A

Often conflicting treatment guidelines.

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14
Q

What should be considered when treating patients with multimorbidity?

A

All conditions should be treated simultaneously.

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15
Q

What are some difficulties faced in managing multimorbidity?

A
  • Differentiating polypharmacy side effects from disease processes
  • Fragmented care
  • Duplication
  • Cost
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16
Q

What is a holistic approach to managing multimorbidity?

A

Thinking holistically and ensuring continuity of care.

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17
Q

Who should be assessed for multimorbidity?

A

People opportunistically during routine care and yearly reviews.

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18
Q

What are high-risk indicators for adverse drug events?

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A

People on ≥15 regular medicines.

19
Q

What tools can help identify high-risk patients?

Study These Flashcards
A
  • eFI (electronic Frailty Index)
  • PEONY (predicts emergency admissions)
  • QAdmissions (for use in GP records)
20
Q

What should be assessed regarding disease burden in multimorbidity?

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A
  • Impact on daily life and wellbeing
  • Mental health
  • Interactions between conditions
  • Effects on quality of life
21
Q

What aspects should be considered regarding treatment burden?

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A
  • Number and types of appointments
  • Medicines
  • Non-drug treatments
  • Harms from treatment
  • Impact on mental wellbeing
22
Q

What are important considerations in patient perspectives?

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A
  • Attitudes, beliefs, and understanding of treatments
  • Involve patients in decisions
  • Follow NICE guidance on medicines adherence
23
Q

What is the role of a named GP in managing multimorbidity?

Study These Flashcards
A

An expert generalist is best for holistic care.

24
Q

What should be discussed with patients to optimize care?

Study These Flashcards
A
  • Effective treatments
  • Treatments to stop
  • Overburdensome follow-ups
  • Possible alternatives
25
What is the purpose of reviewing treatments regularly?
To assess medications and non-drug therapies and discuss benefits and harms.
26
What is a specific tool used to identify risky medications?
STOPP/START.
27
When should treatment with limited benefit be discussed?
When considering continuing or stopping based on likely benefit and patient preferences.
28
What should an individualised management plan include?
* What’s recorded and actions planned * Future care planning * Medicines and treatments to start, stop, or change * Prioritisation of appointments
29
What is the goal of a multimorbidity approach?
* Understand how conditions + treatments interact * Tailor care to the person’s needs, goals, values, and lifestyle * Improve quality of life
30
What types of conditions count towards multimorbidity?
Physical (e.g. diabetes, cancer) Mental (e.g. depression, dementia) Chronic infections (e.g. HIV) Other: learning disabilities, frailty, chronic pain, sensory impairment, substance misuse
31
How is multimorbidity different from comorbidity?
Multimorbidity = multiple unrelated long-term conditions Comorbidity = one condition exists as a consequence of another (primary disease)
32
What is a key medication-related risk in multimorbidity?
Polypharmacy (5+ meds) increases the risk of frailty and adverse effects.
33
What are the key difficulties in managing multimorbidity?
Conflicting guidelines Side effects vs disease symptoms Fragmented care Duplication of effort Cost and coordination
34
What are some solutions to managing multimorbidity?
Holistic thinking Continuity of care Integrated services Tackling polypharmacy
35
When should you assess someone for multimorbidity?
Opportunistically (e.g. during reviews) Proactively (via records and polypharmacy review)
36
What are red flags for a multimorbidity approach?
On ≥15 regular meds On 10–14 meds or high-risk profile Multiple care services Physical + mental conditions Frailty, falls, or emergency care use
37
What tools can help identify at-risk patients?
eFI (electronic Frailty Index) PEONY (emergency risk) QAdmissions
38
What are the 4 core aspects to assess in multimorbidity?
Disease burden Treatment burden Patient perspectives Social context & coping
39
What do you ask when assessing disease burden?
Daily impact Wellbeing and mental health Condition interaction Quality of life
40
What is the ideal approach to managing multimorbidity?
Expert generalist (named GP) Shared decision-making Focus on individual needs and priorities Routine reviews for high medication burden Comprehensive Geriatric Assessment in hospital
41
What are the main goals of a multimorbidity approach?
Understand condition/treatment interactions Personalise care Improve quality of life Reduce treatment burden Minimise adverse events Coordinate care
42
How should treatments be reviewed?
Regular reviews of meds and therapies Use STOPP/START tool Discuss harms/benefits Plan follow-ups and changes as needed
43

Care of the Older Adult/ Elderly (5 decks)

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