Article
Multimorbidity in patients enrolled in a community-based methadone maintenance treatment programme delivered through primary care
Journal of Comorbidity
(2014)
Abstract
Background: Multimorbidity, the co-existence of two or more (2+) long-term conditions in an individual, is
common among problem drug abusers. Objective: To delineate the patterns, multimorbidity prevalence, and
disease severity in patients enrolled in a community-based primary care methadone maintenance treatment
(MMT) programme. Design: This was a retrospective cohort study (n=274). The comparator group consisted
of mainstream primary care patients. Electronic medical record assessment was performed using the Cumulative
Illness Rating Scale. Results: Prevalence of multimorbidity across 2+ domains was significantly higher
within the MMT sample at 88.7% (243/274) than the comparator sample at 51.8% (142/274), p<0.001. MMT
patients were seven times more likely to have multimorbidity across 2+ domains compared with mainstream
patients (OR 7.29, 95% confidence interval 4.68–11.34; p<0.001). Prevalence of multimorbidity was consistently
high across all age groups in the MMT cohort (range 87.8–100%), while there was a positive correlation
with age in the comparator cohort (r=0.29, p<0.001). Respiratory, psychiatric, and hepatic–pancreatic domains
were the three most common domains with multimorbidity. Overall, MMT patients (mean±SD, 1.97±0.43)
demonstrated significantly higher disease severity than mainstream patients (mean±SD, 1.18±0.78), p<0.001.
Prevalence of moderate disease severity observed in the <45-year MMT age group was 50% higher than the
≥45-year comparator age group. Conclusions: Prevalence of multimorbidity and disease severity in MMT
patients was greater than in the age- and sex-matched comparators. Patients with a history of drug abuse require
co-ordinated care for treatment of their addiction, and to manage and prevent chronic illnesses. Communitybased
programmes delivered through primary care help fulfil this need.
Disciplines
Publication Date
2014
DOI
10.15256/joc.2014.4.42
Citation Information
Arnold-Reed, D., Brett, T., Troeung, L., O'Neill, J., Backhouse, R., and Bulsara, M. (2014). Multimorbidity in patients enrolled in a community-based methadone maintenance treatment programme delivered through primary care. Journal of Comorbidity, 2014(4), 46-54. DOI: 10.15256/joc.2014.4.42