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New ‘score’ developed to measure multimorbidity

The National Institute for Health Research (NIHR) has revealed a new “score” for measuring multiple long-term health conditions in patients in primary care.

Researchers from the organisation’s School for Primary Care Research have developed the Cambridge Multimorbidity Score; a transparent, simple measure of multimorbidity that can predict different outcomes in people with multiple conditions.

The institute says that the score could help people planning clinical services or allocating healthcare resources to respond to the needs of patients with multiple health conditions, as around quarter of patients in primary care have multiple conditions.

In 2018, GP leaders called for longer consultation times on the back of an analysis that showed patients with multimorbidities account for more than half of appointments.

The study, which was published in the British Journal of General Practice, looked at data from more than 400,000 GP-registered patients, of which 27.2% were found to have at least two long-term conditions, such as hypertension (18.2%) and chronic pain (10.1%).

According to the data, patients with multimorbidity accounted for 52.9% of GP consultations, 78.7% of prescriptions, and 56.1% of hospital admissions.

The study authors concluded that multimorbidity is “common, socially patterned, and associated with increased health service utilisation,” and that their findings “support the need to improve the quality and efficiency of health services providing care to patients with multimorbidity at both practice and national level.”

Further to the findings, the NIHR reminds that the number of patients with multiple long-term conditions is going up as the population ages, putting pressure on primary and secondary care.

When developing the new score index, researchers modelled how conditions such as hypertension, anxiety or depression affected three key patient outcomes: general practitioner visits, unplanned hospital admissions and death.

As a result, the new score outperforms the most commonly used current measure, the Charlson index, in predicting these three outcomes.