Chronic conditions and multimorbidity in a primary care population: a study in the Swiss Sentinel Surveillance Network (Sentinella)

Abstract

Objectives: To provide estimates of the prevalence of chronic conditions in Swiss primary care.

Methods: In total, 175 general practitioners (GP) or pediatricians (PED) reporting to the Swiss Sentinel Surveillance Network collected morbidity data.

Results: In 26,853 patient contacts, mean (± SD) age was 55.8 ± 21.6 or 6.1 ± 5.7 years (in GPs vs. PEDs, respectively) and 47% were males. In GP patients, median Thurgau Morbidity Index was 2 (IQR 1-3). The median numbers of chronic conditions and permanently used prescribed drugs were 2 (0-5) and 2 (1-4), respectively; in PEDs medians were 0. Out of all patients, 16.7 and 7.0% of the PED patients were hospitalized during the previous year; patients cared by family/proxies or community nurses were hospitalized significantly more often than patients living in homes (50.1 vs. 35.4%, OR 1.41, p < 0.001). Out of patients over 80 years of age, 51.5% were care dependent and 45.5% of the patients over 90 years were living in homes for the elderly.

Conclusions: In a representative sample of Swiss primary care patients, a substantial part shows multimorbidity with a high prevalence of chronic diseases, multiple drug treatment, and care dependency. These data may serve to be compared with other patient groups or other primary care systems. Trial registration www.clinicaltrials.gov NCT0229537, national study registry www.kofam.ch SNCTP000001207.

Trial registration: ClinicalTrials.gov NCT02295371.

Keywords: Care dependency; Drug treatment; Hospitalization; Morbidity; Primary health care; Switzerland.

Conflict of interest statement

Conflict of interest

The authors declare that they have no financial conflicts of interest regarding this study.

Ethical approval

The ethical committee of the Canton of Zurich waived our study since they decided that it did not need formal approval according to the regulations of the law on human research in Switzerland (KEK-ZH 2014-0400).

Informed consent

Informed consent was not deemed since the data were fully anonymous.

Figures

Fig. 1

Thurgau Morbidity Index* (TMI) values, percent % (MIPC study, Switzerland 2015). *The index values denote: “0” healthy, “1” premorbid, “2” one or two mild-to-moderate conditions, “3” three and more mild-to-moderate conditions, “4” one severe and less than three mild-to-moderate conditions, “5” one severe and three or more mild-to-moderate conditions, “6” two or more severe conditions. Graduations denote the entire class

Fig. 2

Number of prescribed drugs* regularly taken, percent values (%) (MIPC study, Switzerland 2015). *Graduations denote the entire class

Fig. 3

Care dependency* by age groups (percent values %, adult patients only) (MIPC study, Switzerland 2015). *Graduations denote the entire class

Fig. 4

Comparison of Thurgau Morbidity Index (≥ 3) or chronic conditions (≥ 3) with literaturea (Fortin et al. , see figure 3 of that article, with permission) (MIPC study, Switzerland 2015). aThis review collected consultation-derived information in primary care settings from several studies and compared the prevalence of three or more chronic conditions by age groups. However, the Swiss FIRE data (Rizza et al. 2012) were not consultation- but registry-based