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Medicina
Special Issues
Providing Primary Care to Those with Multimorbidities: Current Challenges and...
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Providing Primary Care to Those with Multimorbidities: Current Challenges and Technologies

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Epidemiology & Public Health".

Deadline for manuscript submissions: closed (31 December 2024) | Viewed by 2263

Special Issue Editor

Prof. Dr. Leonas Valius

E-Mail Website
Guest Editor
Department of Family Medicine, Lithuanian University of Health Sciences, LT-50161 Kaunas, Lithuania
Interests: control of chronic health conditions at the primary healthcare level
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

Since the beginning of the COVID-19 pandemic, most patient consultations have gone to remote locations. Multimorbid patients suffer not only from chronic physical diseases, but also from the logistics of disease control, polypharmacy, and cognitive disorders. The most usual combinations of multimorbid status for the patient are two or more of them: arterial hypertension, diabetes mellitus, chronic heart insufficiency, ischemic heart disease, chronic supraventricular fibrillation, COPD, bronchial asthma, osteoporosis, oncologic conditions, obesity, anxiety, depression, cognitive disorders, and social maladaptation.

How do primary health level/family physicians care for multimorbid patient health control: evaluation of health status, regular preventive and control checks, management of logistics for the upper healthcare level/consultants, including remote consultations, home care, and telemedicine? What is the role of family physician team members?

Cutting-edge research: At least no later than preferably 2019–2023.

We invite our authors to contribute their most important testimonials regarding original articles, case reports, reviews, systemic reviews, and scientific research.

Dr. Leonas Valius
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • primary health care
  • multimorbidity
  • cognitive disorders
  • vaccination

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Published Papers (2 papers)

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Research

12 pages, 312 KiB  
Article
Assessment of Quality of Life in Lithuanian Patients with Multimorbidity Using the EQ-5D-5L Questionnaire
by Olga Vasiliauskienė, Dovydas Vasiliauskas, Aušrinė Kontrimienė, Lina Jaruševičienė and Ida Liseckienė
Medicina 2025, 61(2), 292; https://doi.org/10.3390/medicina61020292 - 8 Feb 2025
Viewed by 846
Abstract
Background and Objectives: Despite the critical importance of effective healthcare management for patients with multimorbidity, robust and reliable tools for assessing health-related quality of life in Lithuania remain scarce. We aim to identify trends in the quality of life of patients with [...] Read more.
Background and Objectives: Despite the critical importance of effective healthcare management for patients with multimorbidity, robust and reliable tools for assessing health-related quality of life in Lithuania remain scarce. We aim to identify trends in the quality of life of patients with multimorbidity and to evaluate the effectiveness of the Lithuanian version of the EuroQol EQ-5D-5L questionnaire. Materials and Methods: The study included patients between the ages of 40 and 85 (N = 498) who had at least two chronic conditions, arterial hypertension being a prerequisite. The participants completed a comprehensive set of questionnaires specifically prepared for the TELELISPA “Improved healthcare quality for patients with multimorbidity in Lithuania” project which included the translated EQ-5D-5L questionnaire. The predictive validity of the EQ-5D-5L questionnaire was assessed using correlations with the SF-36 and EQ-VAS scores, a random forest regression model. Reliability was evaluated using Cronbach’s alpha and inter-item correlations. Trends in the quality of life in different patient groups were assessed with Chi-square tests. Results: The EQ-5D-5L questionnaire demonstrated high reliability and validity with a Cronbach’s alpha value of 0.737, EQ-5D-5L random forest machine learning regression model RMSE value of 0.1396, and adequate scores from other measures. Lower quality of life was found in patients with multimorbidity who had chronic conditions such as angina pectoris, heart failure, atrial fibrillation, or joint diseases, as well as the patients who were older than 60 years of age, women, or unemployed. Different aspects of quality of life were also significantly negatively impacted by diabetes, asthma, and chronic kidney disease. Heart failure, joint diseases, and older age had the biggest negative effect on quality of life. Conclusions: It is found that the Lithuanian EQ-5D-5L questionnaire is suitable for the assessment of the quality of life in patients with multimorbidity and indicates lower quality of life among those with specific cardiovascular and joint disorder chronic conditions and, in particular, demographic groups. Full article
(This article belongs to the Special Issue Providing Primary Care to Those with Multimorbidities: Current Challenges and Technologies)
15 pages, 275 KiB  
Article
Assessment of Cognitive Functions in Multimorbid Patients in Lithuanian Primary Care Settings: A Cross-Sectional Study Using MMSE and LT-GPCOG
by Silvija Valdonė Alšauskė, Ingrida Grabauskytė, Ida Liseckienė and Jūratė Macijauskienė
Medicina 2025, 61(1), 122; https://doi.org/10.3390/medicina61010122 - 14 Jan 2025
Viewed by 1006
Abstract
Background and Objectives: The aging population has led to a rise in cognitive impairments, including dementia, often associated with multimorbidity. Early diagnosis of cognitive decline is crucial, especially in primary care, where time constraints and the limitations of diagnostic tools may hinder [...] Read more.
Background and Objectives: The aging population has led to a rise in cognitive impairments, including dementia, often associated with multimorbidity. Early diagnosis of cognitive decline is crucial, especially in primary care, where time constraints and the limitations of diagnostic tools may hinder accurate detection. This study aims to assess the cognitive functions of multimorbid patients using the Mini-Mental State Examination (MMSE) and the Lithuanian version of the General Practitioner Assessment of Cognition (LT-GPCOG). We hypothesized that the LT-GPCOG would perform similarly to the MMSE in suspecting cognitive impairments. Materials and Methods: This cross-sectional study, conducted from 2021 to 2022, included 796 patients aged 40–85, with arterial hypertension and at least one other chronic disease, recruited from seven Lithuanian primary health care centers. Cognitive function was assessed using the MMSE and LT-GPCOG, and statistical analyses were performed using SPSS to determine the association between cognitive impairment and various demographic and clinical variables. Results: Out of 796 participants, 793 completed the study. Cognitive impairment was suspected in 5.1% of participants based on MMSE and 4.2% based on the LT-GPCOG. Statistically significant associations were found between cognitive impairment and chronic obstructive pulmonary disease (COPD) (p = 0.008 and p = 0.003) in both tests and chronic kidney disease (CKD) (p = 0.005) while testing with the MMSE. Lower education and unemployment were also correlated with cognitive impairment (p = 0.008 and p < 0.001). Conclusions: The findings suggest that regular cognitive assessments should be integrated into the management of multimorbid patients, particularly those with COPD and CKD. The LT-GPCOG proved to be an efficient alternative to the MMSE in primary care settings, demonstrating comparable diagnostic accuracy. Further studies are also needed to assess the sensitivity and specificity of the LT-GPCOG test. Full article
(This article belongs to the Special Issue Providing Primary Care to Those with Multimorbidities: Current Challenges and Technologies)
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