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How Ready Are We to Win the Multimorbidity Battle - from Croatian General Practitioner’s Point of View


Sunčana Vlah

Health Center Zagreb - East, HR
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Definition of multimorbidity is given by World Health Organization (WHO) and European general practitioner research network (EGPRN) and it states that multimorbidity refers to the presence of two or more long-term health conditions. Moreover, patient’s biopsychosocial risk factors, social network, burden of disease, health care consumption and coping strategies can function as modifiers on the effect of multimorbidity which can be seen through patient’s quality of life and health outcomes. Since progressive aging of the whole population, multimorbidity is becoming a great challenge for general practitioners (GPs) and societies in this century. Care for multimorbid patients is very complex and challenging because they usually have a larger number of medication in the chronic therapy, could be affected with drug interactions and side effects, are older with physical and sometimes psychological impairments which leads to frailty and social alienation. An individual biopsychosocial approach including doctor - patient relationship dynamic over years and expertise of GP in multimorbidity is the essence of the patient’s care. Since the computerization and construction of the Central Health Information System in Croatia (CEZIH) there are a lot of available information and applications which have arisen from it that can be very useful for GPs to treat the patient with multimorbidity by using e - consultation with hospital specialist without the patient, e - prescribing chronic medication therapy, having e - communication with a district nurse or mobile palliative care team, writing an e - referral letter or booking an e - appointment with many hospital specialists and some diagnostics procedures, and talking to the patient through software solution “Zdravlje.Net”. There are also panels for some chronic diseases like diabetes or hypertension, implemented in current software used by GPs, containing the data from lab analysis, and patient’s measures or habits that can give a coarse image of disease management. Unfortunately, this immense amount of data isn’t easily usable during a short period of consultation. It is well known that the best possible outcomes in such complex health problems in patients with multimorbidity couldn’t be achieved only by providing an excellent medical care. Understanding the problem on all levels of society, making action plan in which the government, and all parts of social and health care will participate and communicate effectively could represent a solution. So although multimorbidity is becoming an important topic there are no national guidelines or action plan how to cope with the rising demand in Croatia. Strategic plan of Ministry of Health from 2018 to 2020 has a vision for health care and health care improvement but gave leverage to the prevention and early detection of chronic non-communicable diseases and treatment of each one separately, having a healthy lifestyle and insisting on cooperation and availability of health sectors. Finally, multimorbidity is our reality and proper management depends on the visionary health care plan which will be receptive towards health care needs of the rising number of multimorbid patients and serve to all professionals participated in the network of health and social care givers.

How to Cite: Vlah S. How Ready Are We to Win the Multimorbidity Battle - from Croatian General Practitioner’s Point of View. International Journal of Integrated Care. 2021;21(S1):216. DOI:
Published on 01 Sep 2021.


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