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KMID : 0614720140570090743
Journal of Korean Medical Association
2014 Volume.57 No. 9 p.743 ~ p.748
Management of multimorbidity in the ederly
Kim Sun-Wook

Kim Kwang-Il
Abstract
As the population ages, more people are living with multiple medical conditions, and patients are suffering from functional decline or disabilities as part of multimorbidity. Multiple chronic diseases are the greatest challenge facing health-care systems, but we are still focused on individual disorders rather than multimorbidity. A new care model for these patients is required. First, we have to know that most clinical guidelines were developed in relation to single conditions, so following the guidelines without regard to a patient¡¯s multimorbidity should be avoided. Physicians should be encouraged to consider their patients as a whole person rather than focusing on the disease itself. Second, it is necessary to identify and listen to patients¡¯ priorities. Focusing on outcomes that come from a single-condition approach is the most important barrier to goal-oriented care. Third, comprehensive geriatric assessment and care can improve the functional outcome of older patients with multimorbidity. It is important to order the chaos of multiple chronic conditions and share the same therapeutic plan among doctors. Lastly, doctors must review patients¡¯ medication lists systematically before adding a new medication. Clearly, we should avoid prescription of potentially inappropriate medications and polypharmacy.
KEYWORD
Aged, Comorbidity, Chronic disease, Patient-centered care, Polypharmacy
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