Ask the Geriatricians: Managing Multiple Health Problems

Ask the Expert - Multiple Health Problems: Boyd and McNabney

Matthew K. McNabney, MD
Associate Professor of Medicine
Johns Hopkins University School of Medicine 

Cynthia M. Boyd, MD, MPH
Professor of Medicine
Johns Hopkins University School of Medicine

Drs. Boyd and McNabney are Co-Chairs of the AGS Expert Panel on the Care of Older Adults with Multimorbidity.  

Q:  What is multimorbidity?

A:  Multimorbidity is the medical term for having multiple ongoing (chronic) health problems—“multi” means many and “morbidity” means disease. Heart disease, diabetes, high blood pressure, and arthritis are examples of ongoing health problems. 50% of adults age 65 and older have three or more health problems.

Q:  Why is it difficult to manage multiple health problems in older adults?

A:  Taking care of older patients with multiple chronic health problems can be tricky, even for healthcare professionals who specialize in caring for older adults. For example, medicines can cause side effects and may interact with one another. Therefore, it can be challenging to safely prescribe medications for older adults with multiple medical problems, because each condition may require a different medication. A drug prescribed for one disorder may cause or make another problem worse.

Most medical trials (research studies) used to test new drugs and other treatments often exclude older adults with multimorbidity. This means that there is less information about how drugs and other treatments affect patients with multiple health problems. As a result, most guidelines for healthcare providers focus on how they should manage a single disease or disorder, instead of how to manage a patient with multiple disorders.

Q:  I have more than one ongoing health problem.  What can I do to best manage them? 

A:  You are your best advocate for your care! The more you understand about your health problems and your care, the better able you will be to work with your healthcare professionals about your concerns. 

The HealthInAging.org tip sheet on Living with Multiple Health Problems outlines specific steps to help you work with your healthcare provider in managing your care.   

Good communication between you and your healthcare professional is essential in good care. It is important that you provide your healthcare professional with all of the information about your health and that you ask questions. You can find tips on communicating with your healthcare provider here.

Q:  What are some other resources available on managing multiple health problems?

A: There are a number of resources with more information on how to manage more than one health problem at a time. We recommend the following websites:

Medication Overload: America’s Other Drug Problem - How the drive to prescribe is harming older adults

Patient Priorities Care: Resources for patients and caregivers on choosing health priorities

Patient Priorities Care: Conversation Guide for Patients and Caregivers for Identifying Their Health Priorities

Patient Priorities Care: Patient Summary of Health Priorities

Patient Priorities Care: Tips for Patients to Communicate with Clinicians

 

Last Updated September 2019