Page 37 - KMD 2022-23 EDITION

Health News

MULTIMORBIDITY PUTTING PRESSURE ON

HEALTHCARE SYSTEMS

he number of Kenyans with three or more out-patient appointments impacting negatively on
long-term conditions continues to grow the economy.
Tand the management of patients with
multimorbidities is complex thus putting pressure Evidence has shown that exercise and education can
on the healthcare systems. improve outcomes and mitigate the progression of
many chronic diseases and is recommended in
Multimorbidity, defined as the coexistence of two guidelines for many single diseases, exercise-based
or more chronic conditions, is a critical problem in rehabilitation for people with multimorbidity may
most healthcare systems and is common in clinical have a role to play in addressing common symptoms
practice.People with such conditions often visit and risk factors for multiple chronic diseases, rather
hospitals many times than the general population than only focusing on management of one disease.
and is associated with increase mortality.

The African Journal of Hospital and Scientific
Although exact prevalence estimates depend on Medicine in a recent edition indicated that each
the type and number of conditions considered in and every detail about all other parts of the history
the definition of multimorbidity, most experts agree of the patient in front of the clinician are relevant
that more than one in four adults have at least and important.
three chronic conditions such diabetes mellitus,
hypertension, HIV/AIDS, specific organ-system In clerking a new patient with presenting symptoms,
failure, e.g heart, kidney, lung, liver or brain among the emphasis must not necessarily be on the ‘chief
others. complaints’.

Multimorbidity is a rising healthcare burden locally, The majority, if not all, multimorbidities in a given
and as a result, policy and lawmakers need to patient will require simultaneous recognition and
ensure that this complex population have access to management. At the very least, the clinician must
evidence-based and sustainable interventions. keep them in mind during the entire process of
clerking and management of a patient, including
Kenya’s healthcare systems are largely designed to physical examination, investigations, treatment and
manage individual diseases or episodes of illness follow-up.
rather than patients with complex multiple health
care needs. Taking history is an important and strategic
moment of acquaintanceship between the two
Many nations including Kenya are using huge that the doctor should not squander.
resources to increase the proportion of single-disease
interventions instead of integrating multimorbidity Often-times, it ends up influencing, determining,
interventions into existing healthcare systems to directing and cementing patient compliance with
support implementation and sustainability and to the rest of the ‘doctor’s orders’.
apply and build on the evidence regarding effective
interventions for single diseases to people with Paying attention to the patient’s multimobidities
multimorbidity. adds to the over-all recovery and subsequent
wellness. Without proper attention and care of the
People with multimorbidity also have high rates of patient, his or her treatment (however perfect) will
emergency hospital admissions and attendance at be incomplete, states the journal.

Kenya Medical Directory 35