Research challenges for family medicine in a changing Europe. Reflections afteran EGPRN conference on multimorbidity (Dubrovnik, 2009)

Figures & data

Figure 1. The ecology of medical care - health problems from community, through primary care to hospitals’ The figure has earlier been published in references 9, 10.

Table I. The top-10 morbidity in Dutch general practice (13).

Acute, ‘everyday’	Chronic
Respiratory tract infection	Obesity
Functional complaints	Hypertension
Dermatitis	Chronic nervous complaints
Urinary tract infection	Deafness
Tonsillitis	Malignancy
Myalgia neck, shoulder, arm	COPD
Ear wax	Chronic ischaemic heart disease
Minor trauma	Myocardial infarction
Low back pain	Hyperlipaemia
Vaginitis	Psoriasis

Table II. family physicians’ performance in patients with depression and multi-morbidity.

Observed practice• More interventions when depression is more severe (reflecting patients’ ‘needs’)• In case of comorbidity less specific interventions were offered

Interpretation• Concerns of side effects and interactions of multiple specific therapy• Non-specific interventions are more attractive

Conclusion• Practice empirism is way ahead of research and science

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