In This Section      
Print This Page

Multimorbidity

 Older Adults with Multiple Chronic Conditions

Forty-eight percent of older adults have three or more chronic conditions, and the number of older adults with multiple chronic conditions will continue to increase dramatically. The presence of multiple chronic conditions independently predicts adverse outcomes, including quality of life, mortality, disability, and complications of treatment beyond the effects of the individual conditions. Currently, there is a significant gap in our understanding of how best to provide care for patients with multiple chronic conditions.

Research Focus

In recent work, Johns Hopkins researchers, led by Dr. Cynthia Boyd, have shown that implementing multiple single-disease clinical practice guidelines in older adults with multiple chronic conditions may result in polypharmacy and nonadherence, both of which detrimentally influence patient safety and clinical outcomes. Additional work has demonstrated how the entire process of clinical practice guideline development will need to be modified in order to develop appropriate clinical practice guidelines for patients with multiple chronic conditions.

Current Research Studies

  • Treatment burden in multiple chronic conditions
  • Development of clinical practice guidelines for patients with multiple chronic conditions
  • Clinical preventive services for patients with multiple chronic conditions
  • Improving patient-clinician communication and shared decision making in patients with multiple chronic conditions
  • Patterns of multiple chronic conditions
  • Performance measurement for patients with multiple chronic conditions
  • Methodological approaches to assess the balance of benefits and harms
  • Incorporating prognosis into the care of older adults
  • Reducing use of potentially inappropriate therapies in older adults

 

Faculty investigators

Photo of Dr. Cynthia Melinda Boyd, M.D., M.P.H.

Boyd, Cynthia Melinda, M.D., M.P.H.

Professor of Medicine
Expertise, Disease and Conditions: Cognitive Decline in Older Adults, General Internal Medicine, Geriatric Consultation and Preventative Health, Geriatric Medicine, Osteoporosis, Paget's Disease, Primary Care of Older Adults, Sleep Disorders
Research Interests: Older people, Comorbidity, Hospitalization, Disability, Functional recovery, Chronic disease care, Quality of life
 
Photo of Dr. Ariel Ruth Green, M.D., M.P.H.

Green, Ariel Ruth, M.D., M.P.H.

Assistant Professor of Medicine
Expertise, Disease and Conditions: Cognitive Decline in Older Adults, Dementia, General Internal Medicine, Geriatric Consultation and Preventative Health, Geriatric Medicine, Polypharmacy, Primary Care of Older Adults
Research Interests: Reducing use of potentially harmful medicines in older adults, shared decision making, dementia
 
Photo of Dr. Bruce Allen Leff, M.D.

Leff, Bruce Allen, M.D.

Professor of Medicine
Director, The Center for Transformative Geriatric Research
Director, Program in Geriatric Health Services Research
Co-Director, Johns Hopkins Home-Based Medicine
Co-director, Medicine Clerkship
Medical Director, Business Development and Strategic Alliances
Expertise, Disease and Conditions: Geriatric Medicine, Polypharmacy, Primary Care of Older Adults
Research Interests: Home care and medical house calls, Multimorbidity, Development, evaluation, and dissemination of novel models of care for older adults, notably Hospital at Home, Guided care and geriatric "portfolio" models, Case-mix issues, Medical education
 
Photo of Dr. Matthew Kendall McNabney, M.D.

McNabney, Matthew Kendall, M.D.

Associate Professor of Medicine
Program Director, Fellowship Training Program in Geriatric Medicine and Gerontology
Medical Director, Program for All-Inclusive Care of the Elderly (PACE)
Expertise, Disease and Conditions: Geriatric Medicine
Research Interests: Geriatrics curriculum development and evaluation for medical trainees, Models of care delivery with a focus on long-term care
 
Photo of Dr. Nancy Li Schoenborn, M.D.

Schoenborn, Nancy Li, M.D.

Assistant Professor of Medicine
Assistant Professor of Oncology
Expertise, Disease and Conditions: Geriatric Medicine
Research Interests: Cancer screening in older adults that incorporate patient preferences and life expectancy.
 

Collaborators at Johns Hopkins