Multimorbidity and the primary healthcare perspective

The ageing population is marked by an increase in chronic health problems, raising concerns over the feasibility of healthcare systems and their financial capabilities [1,2]. A central point here is the growing rate of multimorbidity, i.e. the coexistence of multiple chronic conditions in a given individual [3]. The concept of multimorbidity conflicts with the ‘single-disease model’, around which healthcare, medicine and health research are traditionally organized. This model has dominated healthcare, research and education for so long that it is only recently that multimorbidity is being presented as a demographic feature. Multimorbidity requires a paradigm shift away from this single-disease model of patient management; a shift that is now increasingly recognized and adopted, albeit at a slow pace. However, the reality in primary healthcare is already somewhat different. Primary healthcare, in its comprehensive approach to all health problems in all individuals at all disease stages and phases of life, has a long experience in dealing with individuals experiencing a range of health problems [4], including chronic health problems as reported in the literature [5?7]. These reports indicate that multimorbidity is substantial, with about a third of the (primary healthcare) population affected; this prevalence is in line with those reported in more recent studies from other countries [8?12]. Journal of Comorbidity 2016;6(2):46?49