OBJECTIVES

: To explore the impact multimorbidity (two or more chronic medical conditions) has on economic burden of illness in diabetes patients.

METHODS

: Data were drawn from 2016 Adelphi Diabetes Disease Specific Programme (DSP) conducted across 5EU/USA. The Diabetes DSP is a real-world, cross-sectional survey involving completion of physician-reported forms for their next 12 consulting diabetes patients, both T1DM and T2DM. The same patients are invited to complete a patient-reported form. Patients were classified by total number of comorbidities in addition to diabetes (0; 1-2; 3-4; 5+). Adherence measured via the validated, patient-reported Morisky Medication Adherence Scale (MMAS-8). All results p< RESULTS

: A total of 352 specialists, 501 PCPs and 12,634 diabetes patients were recruited. Of these, comorbidity prevalence was as follows: diabetes-only presentation with zero additional comorbidities (20%, n=2527), 1-2 comorbidities (37%, n=4708), 3-4 comorbidities (26%, n=3261), 5+ comorbidities (17%, n=2111). 5+ comorbid patients are likely to be older than patients with zero comorbidities (66 vs. 45 years), have low adherence (34% vs. 14%). 21% with 5+ comorbidities suffer depression and/or anxiety. Economic assessment equally demonstrated higher impact in 5+ comorbid patients compared to zero: caregiver presence (16% vs. 2%); consultations for all conditions per year (5.8 vs. 3.3); diabetes-related hospitalizations (16% vs. 2%). 5+ comorbid patients were less knowledgeable about their diabetes and treatment options (8% vs. 2%), had a higher pill burden for all comorbidities (10.4 vs. 2.0) and less involvement in treatment decisions (14% vs. 5%). No observed difference in number of comorbidities between primary and secondary care presentation.

CONCLUSIONS

: A current absence of any guidelines addressing multimorbidity further complicates management amongst multimorbid patients. Highly comorbid patients are likely to have a progressively higher economic burden of illness. Coupled with higher psychological distress and higher pill burden, these patients may warrant additional care when choosing management options.