Multimorbidity is now the norm rather than the exception in primary care practice, challenging disease-centred models of care . While family doctors routinely manage patients with multiple chronic conditions, health systems still lack internationally comparable evidence on how multimorbidity affects patient-reported health outcomes and experiences. The OECD Patient-Reported Indicator Surveys (PaRIS) address this gap by placing patients’ voices at the centre of quality assessment, with a specific focus on people living with chronic conditions in primary care.The study addresses how distinct multimorbidity profiles relate to patient-reported physical health, mental health, and well-being; to what extent do individual factors (polypharmacy, healthcare utilisation, continuity of care relationship, symptom burden, and confidence to self-manage) alter these associations between patient-reported outcome measures and multimorbidity profiles and whether these associations vary systematically across sociodemographic groups, by age, gender, income, and education.PaRIScollected data from over 107 000 patients aged 45 and over in 1 800 primary care practices across 19 countries in 2023-2024, by using the PaRIS Patient Questionnaire. The multimorbidity analyses focus on respondents reporting two or more chronic conditions which are regrouped into five multimorbidity profiles. Outcomes include patient-reported physical health, mental health and well-being. The association between the outcomes and explanatory variables are assessed using multi-level analysis, given the nested structure of PaRIS (patients in practices, which are in countries).The results will be available at the time of the conference. They will include physical health, mental health and well-being scores among people with five different multimorbidity profiles. It will also show the influence of utilisation of healthcare (primary care, emergency care or hospital care), polypharmacy, confidence in self-management and continuity of relationship on the relationship between multimorbidity profiles and patient-reported outcomes.The discussion will focus on the comparison with existing literature and policy and practice recommendations in primary care.Increasing number of people living with chronic conditions call for further actions on the reorganisation of primary care delivery and practice. The results of this work will provide actionable information on the management of multimorbidity in primary care practices.

Many people with type 2 diabetes also have other health conditions. The literature states that about 90% of these people have at least one additional condition. These health issues increase the overall disease burden, or comorbidity, making it harder for patients to perform daily activities and follow their treatment plans.This study aimed to investigate the relationship between comorbidity burden, medication adherence, and quality of life in patients with type 2 diabetes mellitus.This cross-sectional study was conducted among patients with type 2 diabetes who visited Family Health Centers in Manisa Province. Data were gathered using the Sociodemographic Data Form, Weighted Functional Comorbidity Index, Medication Adherence Report Scale, and the SF-12 Quality of Life Scale.A total of 201 patients with type 2 diabetes participated in the study. The average age was 58.99±11.09 years, with 103 participants (51.2%) aged 60 or older. Being 60 or older, female gender, obesity, low income and education levels, and low physical activity were associated with higher comorbidity burdens. Patients taking multiple oral antidiabetic drugs (OADs) or a combination of OAD and insulin therapy had higher medication adherence scores. A weak-to-very weak but statistically significant negative correlation was observed between the Weighted Functional Comorbidity Index and the Physical Components Score, the Mental Components Score, and the medication adherence scores. As the Physical Components Score, Mental Components Score, and medication adherence scores increased, the comorbidity index decreased.This study, in line with existing research, found that higher comorbidity burden negatively affects medication adherence. A 2022 study by Doya et al. revealed that type 2 diabetes patients with additional health conditions were twice as likely to adhere to their medications compared to those without.It was demonstrated that comorbidity burden increases with age in diabetic patients. Additionally, a higher comorbidity burden is associated with lower medication adherence. Furthermore, increased comorbidity burden adversely affects both the physical and mental aspects of quality of life. Overall, this study emphasizes the importance of a holistic approach in the assessment and management of patients with type 2 diabetes mellitus.

Asthma and gastroesophageal reflux disease (GERD) are common chronic conditions in early adolescence and frequently present with overlapping respiratory and gastrointestinal symptoms. In low-resource settings, these interactions lead to avoidable morbidity and reduced participation in school and daily activities. Understanding these associations is essential to strengthen equitable and humanistic adolescent care in primary healthcare systems.To determine the prevalence of asthma and GERD among early adolescents, assess associations between asthma and gastrointestinal symptoms, GERD and respiratory symptoms, and evaluate the impact of GERD on health-related quality of life (HRQoL).A school-based cross-sectional study was conducted among adolescents aged 13–14 years in six randomly selected schools in Anuradhapura District. Asthma and GERD were assessed using the validated ISAAC questionnaire and  GerdQ. Health-related quality of life (HRQoL) was measured using the PedsQL 4.0 inventory. Logistic regression was used to examine associations between asthma, GERD, and related symptoms.A total of 1,127 students participated (response rate 99.5%; mean age 13.6 years; 44.8% male). Prevalence of current asthma was 16.1%, and GERD symptoms were present in 17.1%. A significant association was observed between asthma and GERD (AOR 2.3, 95% CI 1.6–3.3, p<0.0001). Gastrointestinal symptoms—including heartburn (32.0%), upper abdominal pain (26.5%), regurgitation (21.5%), and nausea (19.9%)—were significantly associated with asthma (all p<0.0001). GERD was associated with wheezing (38.1%), nocturnal dry cough (54.0%), difficulty breathing (21.8%), and chest tightness (23.3%) (all p<0.0001). Adolescents with GERD had significantly lower total HRQoL scores (75.3 ± 13.2) compared to those without GERD (82.0 ± 10.8; p<0.0001), with impairments across physical, emotional, social, and school functioning.Co-existing asthma and GERD markedly increase both respiratory and gastrointestinal symptom burden and substantially reduce HRQoL. These overlapping presentations represent an under-identified clinical challenge in adolescent primary care.Integrating early screening for GERD in adolescents with asthma and for asthma in those with GERD can improve symptom control and support a more equitable, humanistic approach to adolescent healthcare.

Comorbidity is extremely common in the chronic kidney disease (CKD) population. The in-depth exploration of the comorbidity patterns in CKD patients and analysis of the differences in medical consumption corresponding to different comorbidity combinations are of great significance for optimizing clinical diagnosis and treatment strategies and rationally allocating medical resources.To achieve precise classification of CKD patients, conduct an in-depth investigation into the differences in medical consumption among various clustered groups, and provide a scientific basis for optimizing the allocation of medical resources and formulating personalized intervention plans for CKD patients.This study used data from the China Health and Retirement Longitudinal Study (CHARLS) database, including 1,693 participants with CKD. Through k-means cluster analysis of 18 chronic diseases, to identify comorbidity clusters with significant clinical heterogeneity. Cox regression model was used to explore the association between the clustered groups and the incidence of cardiovascular event.This study identified three clusters. The fully adjusted Cox regression analyses indicated that compared with Cluster 1, Cluster 2 had a hazard ratio (HR) of 1.60, and Cluster 3 had an HR of 2.69, suggesting the highest of new-onset cardiovascular events in Cluster 3. The results of the logistic regression model indicated that, compared to Cluster 1, for hospital stays, the odds ratio (OR) was 1.75 for Cluster 2 and 2.43 for Cluster 3, while for doctor visits/outpatient visits, the OR was 1.78 for Cluster 2 and 1.50 for Cluster 3. These findings confirm that the number of hospitals stays for Clusters 2 and 3 is significantly higher than that for Cluster 1, and the frequency of hospital stays, as an important component of medical consumption, further reflects the differences in medical resource utilization among the three clusters.The findings underscore the importance of classifying CKD patients by comorbidity clusters for precise risk stratification, highlighting the potential of targeted interventions tailored to each cluster’s representative disease features to improve prognosis and optimize medical resource allocation, and serving as a healthcare strategy for high-risk CKD populations.CKD patients could be divide to three distinct comorbidity clusters with significant heterogeneity in clinical characteristics and outcomes.

Subclinical hypothyroidism (SCH), defined by elevated thyroid-stimulating hormone with normal free thyroxine, is common in adults and has been linked to adverse renal outcomes. However, the extent to which SCH increases the risk of incident chronic kidney disease (CKD) remains uncertain.To evaluate whether subclinical hypothyroidism is associated with an increased risk of incident chronic kidney disease in adults , through a systematic review and meta-analysis.A systematic review was conducted in accordance with PRISMA 2020 guidelines. Multiple databases were searched for studies evaluating the association between SCH and CKD. Five studies including over 4 million patients met inclusion criteria. A random effects meta-analysis was performed to to estimate pooled risk ratios (RR) for CKD incidence. Risk of bias was evaluated using ROBINS-I.Pooled analysis showed that SCH was associated with a higher risk of CKD (RR 1.19, 95% CI: 1.10–1.29). Moderate heterogeneity was observed (I² = 48.9%). Sensitivity analyses confirmed the robustness of findings, and no major publication bias was detected on funnel plot analysis.These findings suggest that SCH confers an approximately 20% higher relative risk of developing CKD. The association persisted across diverse populations and study designs , reinforcing a potential causal link mediated by renal hemodynamic changes, endothelial dysfunction , or low-grade inflammation. Recognizing thyroid function as a renal risk factor could enhance early screening strategies and preventive interventions in primary care.SCH is associated with an increased risk of CKD. Our findings suggest that thyroid status may be a relevant factor in renal risk assessment and highlight the need for prospective trials to determine whether early identification and management of SCH can modify CKD outcomes.