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Multimorbidity and rheumatic conditions—enhancing the concept of comorbidity

Abstract

The concept of multimorbidity is still poorly understood and not well integrated into medical care and research. For clinicians involved in rheumatology care for an ageing patient population who have multiple diseases, multimorbidity is the rule not the exception. The interaction of different diseases and the impact they have on important clinical outcomes, such as physical function, quality of life and mortality, should all be considered by the rheumatologist. Treatment decisions must be adapted for the patient with multimorbidity to best serve the individual and society. This Perspectives article describes the concept of multimorbidity, how it differs from comorbidity, and outlines why an increased understanding of multimorbiditiy will enhance our overall clinical practice and research focus.

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Figure 1: Comorbidity and multimorbidity in a patient with RA.
Figure 2: The effect of comorbidities and multimorbidity on outcomes.
Figure 3: The impact of multimorbidity on physical function in a cohort of 282 patients with RA who reached the target clinical disease activity index <10.

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H. Radner researched data for the article. H. Radner, K. Yoshida, J. S. Smolen and D. H. Solomon wrote the article. All authors made substantial contribution to discussion of the content, and reviewed and edited the manuscript before submission.

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Correspondence to Helga Radner.

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The authors declare no competing financial interests.

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Radner, H., Yoshida, K., Smolen, J. et al. Multimorbidity and rheumatic conditions—enhancing the concept of comorbidity. Nat Rev Rheumatol 10, 252–256 (2014). https://doi.org/10.1038/nrrheum.2013.212

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