Managing multimorbidity in primary care

Approximately eight in ten of all GP consultations involve a patient with multimorbidity. An average consultation covers 2.5 problems, but those involving a patient with multimorbidity will often be more complex, usually without additional time being available to address the extra problems. As the population ages the prevalence of multimorbidity and the pressures it creates will increase. Although there is little evidence to suggest the best way to deliver care for these patients, it is apparent that the use of single-disease-oriented guidelines without due regard for the individual is often inappropriate. GPs need the confidence and ability to interpret evidence-based recommendations within the context of individual patients. This article discusses the growing phenomenon of multimorbidity, its impact on patients, GPs and the health service, and outlines the skills required of GPs to provide optimal management.