The Increased Challenges of Patients With Multiple Diagnoses

As a clinician, you likely see patients who have multiple chronic conditions every day. Approximately one in four adults has more than one chronic condition.1 Although this is especially likely in the elderly (85+ years),2 it is also true across all age brackets.1 Such comorbidity has been increasing over time: between 2003-2009, incidence of comorbid chronic conditions rose 40% for patients in Ontario, Canada—from over 17% to over 24% of patients.3 These individuals face a range of challenges, including difficulty finding and keeping a job,4 increased risk of major health decline,5 and increased mortality.5

Patients with multiple chronic issues can be difficult to treat, in part because chronic conditions often have a more than additive effect on symptoms: patients tend to experience more disability with two chronic conditions than either individual condition alone would suggest.6 In addition, treating multiple chronic conditions may require a very different approach than treating each individual condition.6,7

Marcelle Pick, NP, discusses how the framework of Functional Medicine helps to treat patients with multiple comorbidities.

Some of the key elements for successfully treating these complex patients have been identified in recent research, including security, continuity, and genuineness.8 But how do you provide this connection? Treating patients with multiple comorbidities raises many challenges, but Functional Medicine provides a framework for approaching chronic diseases that helps address the root causes of the problem.

Join us at Applying Functional Medicine in Clinical Practice (AFMCP) to get tools and patient education materials to help you rapidly assess and design personalized treatments that address the underlying causes of each patient’s chronic illness. You’ll walk out the door armed with the latest in medical research, as well as hands-on experience using a range of tools that can help improve outcomes for your sickest patients.

Register for AFMCP


  1. Ward BW, Schiller JS, Goodman RA. Multiple chronic conditions among US adults: a 2012 update. Prev Chronic Dis. 2014;11:E62. doi:10.5888/pcd11.130389.
  2. Collerton J, Jagger C, Yadegarfar ME, et al. Deconstructing complex multimorbidity in the very old: findings from the Newcastle 85+ study. BioMed Res Int. 2016;2016:8745670. doi:10.1155/2016/8745670.
  3. Pefoyo AJ, Bronskill SE, Gruneir A, et al. The increasing burden and complexity of multimorbidity. BMC Public Health. 2015;15:415. doi:10.1186/s12889-015-1733-2.
  4. Ward BW. Multiple chronic conditions and labor force outcomes: a population study of U.S. adults. Am J Ind Med. 2015;58(9):943-54. doi:10.1002/ajim.22439.
  5. Koroukian SM, Warner DF, Owusu C, Given CW. Multimorbidity redefined: prospective health outcomes and the cumulative effect of co-occurring conditions. Prev Chronic Dis. 2015;12:E55. doi:10.5888/pcd12.140478.
  6. Vogeli C, Shields AE, Lee TA, et al. Multiple chronic conditions: prevalence, health consequences, and implications for quality, care management, and costs. J Gen Intern Med. 2007;22(Suppl 3):391-95. doi:10.1007/s11606-007-0322-1.
  7. Tinetti ME, Bogardus ST Jr, Agostini JV. Potential pitfalls of disease-specific guidelines for patients with multiple conditions. N Engl J Med. 2004;351(27):2870-74. doi:10.1056/NEJMsb042458.
  8. Grinberg C, Hawthorne M, LaNoue M, Brenner J, Mautner D. The core of care management: the role of authentic relationships in caring for patients with frequent hospitalizations. Popul Health Manag. 2016;19(4):248-56. doi:10.1089/pop.2015.0097.

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