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Research

Family practitioners' top medical priorities when managing patients with multimorbidity: a cross-sectional study

Lilli Herzig, Yolanda Mueller, Dagmar M Haller, Andreas Zeller, Stefan Neuner-Jehle, Anouk Déruaz-Luyet, Christine Cohidon, Sven Streit, Bernard Burnand and Jean-Christophe Zuchuat
BJGP Open 2019; 3 (1): bjgpopen18X101622. DOI: https://doi.org/10.3399/bjgpopen18X101622
Lilli Herzig
1Chief of Research Department, Department of Family Medicine, General Medicine and Public Health Centre, University of Lausanne, , Switzerland
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  • For correspondence: lilli.herzig@hin.ch
Yolanda Mueller
2Chief of Research Department, Department of Family Medicine, General Medicine and Public Health Care Centre, University of Lausanne, , Switzerland
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Dagmar M Haller
3Chief of Research Department, Primary Care Unit, Faculty of Medicine, University of Geneva, , Switzerland
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Andreas Zeller
4Chief of Institution, Centre of Primary Health Care, University of Basel, , Switzerland
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Stefan Neuner-Jehle
5Research Collaborator, Institute of Primary Care, University of Zürich, , Switzerland
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Anouk Déruaz-Luyet
6Projects Chief, Department of Family Medicine, General Medicine and Public Health Centre, University of Lausanne, , Switzerland
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Christine Cohidon
7Research Collaborator, Institute of Primary Care, Department of Family Medicine, General Medicine and Public Health Centre, University of Lausanne, , Switzerland
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Sven Streit
8Research Collaborator, Institute of Primary Health Care (BIHAM), University of Bern, , Switzerland
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Bernard Burnand
9Head of Department, Institute of Social and Preventive Medicine, Lausanne University Hospital, , Switzerland
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Jean-Christophe Zuchuat
10Statistician, Department of Family Medicine, General Medicine and Public Health Centre, University of Lausanne, , Switzerland
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Article Figures & Data

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    Figure 1 Boxplot of medical priority rank given by family practitioners to 74 chronic conditions (categories 1 and 2), sorted by mean rank (diamond)
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    Figure 2 Scatterplot of correlation between prevalence and medical priority ranking
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    Figure 3 Relationship between medical priority ranking and category of conditions
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    Figure 4 Distribution of the three categories of conditions among the top three ranking medical priorities

Tables

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    Table 1 Medical priority ranking (absolute and relative) for each chronic condition on the list and its prevalence (categories 1 and 2). 1 was the highest medical priority ranking and 19 the lowest for the absolute ranking, whereas 100% was the highest medical priority for the relative ranking. Chronic condition labels adapted from ICPC-2.
    Chronic conditionsCases in the sample, nPrevalence, %Absolute medical priority ranking
    Relative medical priority ranking, %
    MedianQuantilesMedianQuantiles
    High0.250.75LowHigh0.250.75Low
    Highly prevalent chronic conditionsHypertension uncomplicated46051.83125156010080330
    Risk factor cardiovascular38042.86148143210056110
    Obesity28331.95137134410067220
    Depressive23826.84126155210075250
    Osteoarthritis, knee22325.15136155010071250
    Atrial fibrillation21023.621231680100100610
    Pain, general20523.0512815361008600
    Diabetes, non insulin-dependent20422.921141276100100500
    Atherosclerosis16718.85138155010071170
    Ischaemic heart without angina16418.521141383100100610
    Osteoporosis16318.45137154310071200
    Hypertension, complicated15917.94126155710080330
    Osteoarthritis, hip15317.35137135010075260
    Chronic obstructive pulmonary disease12614.231161271100100370
    Neuropathy11212.65137154310071170
    Hearing complaint11012.46148122510042130
    Cerebrovascular disease10611.94127135010088200
    Ischaemic heart with angina10411.721131188100100740
    Gout10011.25147133310050170
    Diabetes, insulin-dependent9110.221131088100100710
    Elevated blood pressure9010.14137114010067200
    Asthma869.64136145310072320
    Irritable bowel disease849.44137153910069200
    Tobacco abuse738.2513714291006990
    Rheumatoid arthritis687.621161482100100310
    Incontinence627.06147124010063170
    Chronic alcohol abuse495.64126115810088250
    Prostate neoplasm495.64126115010083130
    Slightly prevalent chronic conditionsMacular degeneration424.85146154310066210
    Involuntary movement414.75147143710057160
    Chronic bronchitis404.55136124310075220
    Migraine384.35137142510067170
    Chronic skin ulcer273.15137125010067210
    Memory disturbance263.05128166010080200
    Trauma263.04137104410075290
    Breast female, neoplasm252.84125155710088380
    Colorectal neoplasm252.82115970100100450
    Retinopathy252.86158133210041270
    Bladder neoplasm222.53126125010079340
    Parkinsonism222.521141080100100500
    Personality disorder222.52125127810089300
    Chronic enteritis212.4714915221004100
    Other blood neoplasm212.441161163100100400
    Epilepsy192.2524613438650200
    Phobia, compulsive192.24137152910085110
    Pulmonary heart disease192.25138146310076260
    Somatisation182.06137145210070140
    Dementia171.9412685710089350
    Bowel incontinence161.85139113310071230
    Medication abuse161.85136106410080160
    Multiple sclerosis131.51111710010010010029
    Affective psychosis111.24128106910093270
    Blindness111.26138123610080190
    Bronchus lung neoplasm111.2111661001001006229
    Deafness101.163471027755800
    Other malignant neoplasm101.15138131510056100
    Drug abuse80.9513811421008270
    Lymphoma80.96139113310077160
    Anorexia bulimia70.8544713407347130
    Post-traumatic stress60.7444610518063230
    Kidney neoplasm50.63114578100857264
    Pain, face50.68229936898000
    Psychosis, other50.64129122510090118
    Schizophrenia50.611136801001005955
    Thyroid neoplasm50.65126853100832513
    Poliomyelitis40.5623910578675310
    Cervix neoplasm30.332368418261200
    Organic psychosis, other30.3746911254535130
    Other digestive neoplasm30.3444794273572711
    AIDS20.2534564460523629
    Pancreas neoplasm20.22123392100968885
    Stomach neoplasm20.22123375100886350
    Trigeminal neuralgia20.2635894671593320
    Mental retardation10.111111100100100100100
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Family practitioners' top medical priorities when managing patients with multimorbidity: a cross-sectional study
Lilli Herzig, Yolanda Mueller, Dagmar M Haller, Andreas Zeller, Stefan Neuner-Jehle, Anouk Déruaz-Luyet, Christine Cohidon, Sven Streit, Bernard Burnand, Jean-Christophe Zuchuat
BJGP Open 2019; 3 (1): bjgpopen18X101622. DOI: 10.3399/bjgpopen18X101622

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Family practitioners' top medical priorities when managing patients with multimorbidity: a cross-sectional study
Lilli Herzig, Yolanda Mueller, Dagmar M Haller, Andreas Zeller, Stefan Neuner-Jehle, Anouk Déruaz-Luyet, Christine Cohidon, Sven Streit, Bernard Burnand, Jean-Christophe Zuchuat
BJGP Open 2019; 3 (1): bjgpopen18X101622. DOI: 10.3399/bjgpopen18X101622
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Keywords

  • Primary Care
  • chronic disease
  • Multimorbidity
  • epidemiology
  • prioritisation

More in this TOC Section

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  • What features are considered important for electronic safety-netting tools to UK general practice staff? An interview and Delphi consensus study
  • Ideas, Concerns, Expectations and Effects on life (ICEE) in GP consultations: an observational study using video-recorded UK consultations
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