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Article
The Use of Comorbidities Among Adults Experiencing Care Transitions: A Systematic Review and Evolutionary Analysis of Empirical Literature
Chronic Illness
  • Harleah G. Buck, Pennsylvania State University
  • Salimah Meghani, University of Pennsylvania
  • Janet Prvu Bettger, Duke University
  • Eeeseung Byun, University of Pennsylvania
  • Michael J. Fachko, University of Pennsylvania
  • Melissa O'Connor, University of Pennsylvania
  • Christine Tocchi, Yale University
  • Mary Naylor, University of Pennsylvania
Document Type
Article
Publication Date
12-1-2012
Keywords
  • comorbidity,
  • systematic review,
  • evolutionary analysis,
  • measurement,
  • conceptual framework
Digital Object Identifier (DOI)
http://dx.doi.org/10.1177/1742395312444741
Abstract

Objective: To systematically review how comorbidities are employed in the empirical literature for adults coping with multiple chronic conditions during common episodes of acute illness that resulted in transition across health care setting.

Methods: Evolutionary concept analysis inductively identifies current consensus regarding the usage of a concept and results in exploring attributes and clarification of the concept. Sixty studies from 1965 to 2009 identified from MEDLINE, CINAHL, PsychINFO, and ISI Web of Science databases were analysed.

Results: Comorbidities were used heterogeneously among reviewed studies with most controlling for their presence (n=33) and lacking robust measurement (n=37). The designation of index or principal condition was equally heterogeneous with approximately half (n=26) representing the main disease or diagnosis of interest to the researcher. In this study comorbidities were associated with personal, disease or system level antecedents and consequences. A conceptual framework is proposed.

Discussion: The impact of comorbidities on the care and outcomes of adults coping with multiple chronic conditions is limited by heterogeneous and ambiguous usage. While analytic techniques have become more sophisticated, continued lack of meaningful conceptualization and instrument use has limited maturation of this important concept for research, practice and policy purposes.

Citation / Publisher Attribution

Chronic Illness, v. 8, no. 4, p. 278-295

Citation Information
Harleah G. Buck, Salimah Meghani, Janet Prvu Bettger, Eeeseung Byun, et al.. "The Use of Comorbidities Among Adults Experiencing Care Transitions: A Systematic Review and Evolutionary Analysis of Empirical Literature" Chronic Illness Vol. 8 Iss. 4 (2012) p. 278 - 295
Available at: http://works.bepress.com/harleah-buck/34/