Abstract:
:Research on multimorbidity has rapidly increased in the last decade, but evidence on the effectiveness of interventions to improve outcomes in patients with multimorbidity is limited. The European Commission is co-funding a large collaborative project named Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS) in the context of the 2nd EU Health Programme 2008-2013. The present manuscript summarizes first results of the JA-CHRODIS, focuses on the identification of a population with multimorbidity who has a high or very high care demand. Identification of characteristics of multimorbid patients associated with a high rate of resource consumption and negative health outcomes is necessary to define a target population who can benefit from interventions. Indeed, multimorbidity alone cannot explain the complexity of care needs and further, stratification of the general population based on care needs is necessary for allocating resources and developing personalized, cost-efficient, and patient-centered care plans. Based on analyses of large databases from European countries a profile of the most care-demanding patients with multimorbidity is defined. Several factors associated with adverse health outcomes and resource consumption among patients with multimorbidity were identified in these analyses, including disease patterns, physical function, mental health, and socioeconomic status. These results underline that a global assessment is needed to identify patients with multimorbidity who are at risk of negative health outcomes and that a comprehensive approach, targeting not only diseases, but also social, cognitive, and functional problems should be adopted for these patients.
journal_name
Eur J Intern Medjournal_title
European journal of internal medicineauthors
Onder G,Palmer K,Navickas R,Jurevičienė E,Mammarella F,Strandzheva M,Mannucci P,Pecorelli S,Marengoni A,Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS).doi
10.1016/j.ejim.2015.02.020subject
Has Abstractpub_date
2015-04-01 00:00:00pages
157-9issue
3eissn
0953-6205issn
1879-0828pii
S0953-6205(15)00071-0journal_volume
26pub_type
杂志文章,评审abstract:BACKGROUND:We tested our hypothesis that serum BNP levels rise in sepsis and septic shock patients as a result of an inflammatory state and not only because of left ventricular dysfunction. METHODS:Twenty-one patients with sepsis or septic shock were enrolled in the study. Echocardiography was performed in every patie...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2006.07.013
更新日期:2006-12-01 00:00:00
abstract::Approximately 30% of patients with chronic HCV infection show persistently normal ALT levels. Although formerly referred to as 'healthy' or 'asymptomatic' HCV carriers, and thus historically excluded from antiviral treatment, it has now become clear that the majority of these patients have some degree of histological ...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2009.12.006
更新日期:2010-04-01 00:00:00
abstract::Background: We recently observed that a short course of trimethoprim 300 mg b.i.d. in healthy volunteers can cause a substantial increase in fasting plasma homocysteine levels, up to concentrations reportedly associated with atherothrombotic complications. The purpose of this study was to determine whether primary Pne...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/s0953-6205(01)00134-0
更新日期:2001-07-01 00:00:00
abstract:BACKGROUND:Tachycardia is a reliable predictor of adverse outcomes in normotensive patients with acute pulmonary embolism (PE). However, different prognostic relevant heart rate thresholds have been proposed. The aim of the study was to investigate the prognostic performance of different thresholds used for defining ta...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2020.08.009
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Hepatitis B virus infection has decreased in Italy. The aims of this study were to identify changes, if any, in the epidemiological pattern of HBV infection in a southern Italian town first surveyed in 1996 and to assess the effectiveness of vaccination campaign against hepatitis B. METHODS:In 2010, subject...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2012.08.009
更新日期:2012-12-01 00:00:00
abstract:BACKGROUND:Patients with chronic diseases often receive multiple medications and are associated with increased vulnerability to medication errors. Identifying high-alert medications for them would help to prioritize the interventions with greatest impact for improving medication safety. The aim of this study was to dev...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2014.10.021
更新日期:2014-12-01 00:00:00
abstract::Portopulmonary hypertension is a form of pulmonary arterial hypertension that has gained interest in recent years with the development of liver transplantation techniques and new pulmonary vasodilator therapies. Portopulmonary hypertension is defined as pulmonary artery hypertension associated with portal hypertension...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2011.02.018
更新日期:2011-10-01 00:00:00
abstract::Over the last 15 years, diagnostic strategies to diagnose deep vein thrombosis (DVT) and pulmonary embolism (PE) have changed significantly. The gold standard for detecting DVT is still venography, but invasivity, radiation, contrast media, and the painful injection in pedal veins are limiting factors for initial and ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2005.04.001
更新日期:2005-08-01 00:00:00
abstract::Background: Parkinson's disease is a common neurodegenerative disorder that affects an increasing number of older people every year. Dysphagia is not only a common feature, but one that results in poor nutrition and an increased risk of bronchopneumonia. Previous work has suggested that the oral flora is altered in pa...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2003.09.009
更新日期:2003-12-01 00:00:00
abstract:BACKGROUND:After an acute pulmonary embolism (PE), the complete resolution of thromboemboli may not be routinely achieved. The rate of persistence may depend on the time and the diagnostic technique used for evaluation. PATIENTS AND METHODS:Patients were diagnosed with acute PE by means of computed tomography angiogra...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2011.08.018
更新日期:2012-06-01 00:00:00
abstract:BACKGROUND:Prealbumin is a maker of nutritional status and inflammation of potential prognostic value in acute heart failure (HF). The aim of this study is to evaluate if low prealbumin levels on admission predict mortality and readmissions in patients with acute HF. METHOD:We conducted a prospective observational coh...
journal_title:European journal of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ejim.2017.05.009
更新日期:2017-09-01 00:00:00
abstract:BACKGROUND:In bromocriptine-treated hyperprolactinemic patients with impaired glucose tolerance, metformin was found to reduce plasma levels of prolactin. No previous study has investigated its impact on plasma prolactin in patients with drug-induced hyperprolactinemia. METHODS:The study included 20 women with antipsy...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2016.01.015
更新日期:2016-05-01 00:00:00
abstract:BACKGROUND:The role of estrogen receptor α (ERα) polymorphism in coronary artery disease (CAD) was investigated previously in several populations. There are few data on relation between ERa polymorphism and CAD in Chinese population. Our study was to investigate the possible association between ERα polymorphism and CAD...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2011.05.006
更新日期:2012-03-01 00:00:00
abstract:BACKGROUND:Antiphospholipid antibodies, the hallmark of the antiphospholipid syndrome, are associated with both venous and arterial thrombosis. Despite some reports stating that this association may be present in patients with low titres of anticardiolipin antibodies, a clear association has only been established in th...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2009.12.010
更新日期:2010-04-01 00:00:00
abstract::We report a case of hypocomplementemic urticarial vasculitis heralding a relapsing polychondritis in a 63-year-old woman. The patient, who had suffered in the past from polymyalgia rheumatica, suddenly experienced a generalized urticarial eruption with a dramatic decrease in C4 complement fraction and the presence of ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2004.10.022
更新日期:2005-06-01 00:00:00
abstract::In all industrialized countries, life expectancy has risen in the past 100 years. The incidence of elderly patients reaching end-stage renal disease (ESRD) and requiring renal replacement therapy has also increased. During the past few decades, the pattern of ESRD has changed significantly with the emerging predominan...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/s0953-6205(01)00121-2
更新日期:2001-04-01 00:00:00
abstract::The evolution of strategies for the use of spironolactone and its analogue, eplerenone, has, over the years, encompassed favourable modification of the natural history of symptomatic heart failure in subjects with subnormal left ventricular ejection fraction (LVEF), and mitigation of the risk of new-onset atrial fibri...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2012.11.007
更新日期:2013-06-01 00:00:00
abstract:OBJECTIVE:18F-FDG PET/CT can detect large-vessel involvement in giant-cell arteritis (GCA) with a good sensitivity. In patients with clinically and biologically controlled disease, we aimed to assess how vascular uptakes evolve on repetitive FDG-PET/CT. PATIENTS AND METHODS:All included patients had to satisfy the 4 f...
journal_title:European journal of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ejim.2017.08.013
更新日期:2017-12-01 00:00:00
abstract::Endothelins are powerful vasoconstrictor peptides that also play numerous other roles. The endothelin (ET) family consists of three peptides produced by a variety of tissues. Endothelin-1 (ET-1) is the principal isoform produced by the endothelium in the human cardiovascular system, and it exerts its actions through b...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2007.04.002
更新日期:2007-07-01 00:00:00
abstract::Obesity, one of the most prevalent health problems in the Western world, is a chronic and progressive condition. Therefore, as with other chronic diseases, patients with obesity require lifelong treatment. Long-term efficacy and effectiveness of obesity treatments is notoriously poor. This may in part be attributable ...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2007.09.011
更新日期:2008-05-01 00:00:00
abstract:BACKGROUND:Low serum levels of alkaline phosphatase (ALP) are a hallmark of hypophosphatasia. However, the clinical significance and the underlying genetics of low ALP in unselected populations are unclear. METHODS:In order to clarify this issue, we performed a clinical, biochemical and genetic study of 42 individuals...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2015.12.019
更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Knowing what substances cause death in intoxicated patients is of medical, legal, and political relevance. Harmonized data documentation like TESS (Toxic Exposure Surveillance System) in the United States does not exist yet in Germany. However, the GIZ-Nord Poison Center in Göttingen issues an annual report ...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2006.04.009
更新日期:2006-11-01 00:00:00
abstract:SUMMARY:The aims of this study were to determine the incidence of fungal infections in hospital intensive care units and to evaluate a molecular method to detect these infections. MATERIAL AND METHODS:The participants in this study were patients admitted to any of the 10 intensive care units at Nemazi Hospital (Shiraz...
journal_title:European journal of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ejim.2011.08.025
更新日期:2011-12-01 00:00:00
abstract:BACKGROUNDS/AIMS:Nephrotic dyslipidemia is a risk factor for development of systemic atherosclerosis; also it may aggravate glomerulosclerosis and enhance progression of glomerular disease. We aimed to assess the efficacy and safety of Monascus purpureus Went rice vs. fluvastatin therapy in the management of nephrotic ...
journal_title:European journal of internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.ejim.2008.08.012
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Porphyrias are a group of metabolic diseases, individually rare but with an important combined prevalence. Because of their pathological complexity and clinical heterogeneity, they present a challenging diagnosis. The present review aims to provide a clinically based approach to the recognition and treatment...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2019.06.014
更新日期:2019-09-01 00:00:00
abstract::The morbidity and mortality related to many communicable infectious diseases have significantly decreased in Western countries largely because of the use of antibiotics, and the implementation of well-planned vaccination strategies and national immunisation schedules specifically aimed at infants and children. However...
journal_title:European journal of internal medicine
pub_type: 杂志文章,评审
doi:10.1016/j.ejim.2013.12.004
更新日期:2014-03-01 00:00:00
abstract:BACKGROUND:The role of thrombophilic and cardiovascular risk factors in different manifestations of retinal vein occlusion (RVO), i.e., central or branch RVO, and at different ages is still debated. AIMS:To evaluate the association between thrombophilic and cardiovascular risk factors and the risk of RVO (overall, sep...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2017.06.022
更新日期:2017-10-01 00:00:00
abstract:INTRODUCTION:Patients with chronic hepatitis C (CHC) and end-stage renal disease (ESRD) on dialysis are difficult to treat and show higher dropout rates during treatment. The aim of this study was to analyze the treatment outcomes in patients with CHC and underlying end-stage renal disease on dialysis in Korea. METHOD...
journal_title:European journal of internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1016/j.ejim.2015.03.011
更新日期:2015-05-01 00:00:00
abstract:INTRODUCTION:Acute admissions to hospital are rising. As a part of a service evaluation we examined pathways of patients following hospital discharge depending on data available on admission to hospital. METHODS:We merged data available on admission to the Wrexham Maelor hospital from an existing data-base in the Acut...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2017.09.029
更新日期:2017-11-01 00:00:00
abstract::Clostridium difficile-associated disease seems to be increasing worldwide. A wide spectrum of clinical manifestations, ranging from asymptomatic to life-threatening disease, has been described. A case of pseudomembranous colitis with massive ascites as the main presenting manifestation is described in order to illustr...
journal_title:European journal of internal medicine
pub_type: 杂志文章
doi:10.1016/j.ejim.2006.09.034
更新日期:2007-07-01 00:00:00