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Co-morbidity in general practice

¹ Discipline of General Practice, University of Sydney, Australia
² Product Strategy and Research, Health Communication Network, Australia
³ Clinical Pharmacologist, Australia

Correspondence to:
Correspondence to:
Professor D C Saltman
Discipline of General Practice, University of Sydney, 37A Booth Street, Balmain 2041, NSW, Australia; deborah{at}gp.med.usyd.edu.au

Background: Co-morbidity, or the presence of more than one clinical condition, is gaining increased attention in epidemiological and health services research. However, the clinical relevance of co-morbidity has yet to be defined. In general practice, few studies have been conducted into co-morbidity, either at a single health care encounter, an episode of care, or for a defined time period.

Aims: To describe the major co-morbidity cluster profiles recorded by general practitioners. Another aim of this study is to describe the common clusters of co-prescribing.

Methods and results: Twelve month data from patients attending 156 GPs from 95 practices around a six month period of January to June 2003 were analysed. This represented 840 961 encounters from about 200 000 individual patients at these participating practices. Co-morbidity and co-prescribing cluster profiles are represented by problems managed and reasons for prescribing for the top 10 presentations and top 10 prescribed drugs in the study period.

Conclusions: By analysing the 10 most prevalent problems and 10 most prevalent drugs prescribed in consultations in a community sample, other co-morbidities that are particular to general practice, for example hypertension and lipid disorders, can be uncovered. Whether these clusters are causally related or occur by chance requires further analysis.

Keywords: comorbidity; general practice; prescribing; multimorbidity

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