Challenges for GP in Longitudinal Care forChronic Patients: An 18-Year Follow-Up

Background: Chronic diseases have become a dominant healthcare problem, especially affecting general medicine. The simultaneous occurence of multiple chronic diseases (multimorbidity) and polypharmacy represent a scientific and professional challenge and draw attention to the importance of developing new standards in general practice. Objectives: To study the dynamics of development of multimorbidity and the impact of multimorbidity on the frequency of the use of family medicine services and polypharmacy on the population of chronic patients of one family medicine practice during 18 years. Methods: Retrospective cohort study on a sample population of 183 chronic patients of one family medicine practice during the period from 1994 to 2012. Results: The aging of patients brought a new chronic diseases. The number of chronic diseases increased more than five times during research period. The number of visits increased two times. The average number of drugs per patients increased two times. Conclusions: The results of this study have clear implications for public health and health policy. The growing burden of multimorbidity and its impact on family medicine services and drug prescription is inevitable.