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Nursing Research and Practice
Volume 2013 (2013), Article ID 192782, 10 pages
http://dx.doi.org/10.1155/2013/192782
Review Article

The Conceptualization and Measurement of Comorbidity: A Review of the Interprofessional Discourse

1Department of Biobehavioral Health Sciences, NewCourtland Center for Transitions & Health, University of Pennsylvania, Room 337 Fagin Hall, 418 Curie Boulevard, Philadelphia, PA 19104-4217, USA
2NewCourtland Center for Transitions & Health, University of Pennsylvania, The Pennsylvania State University, University Park, PA 16802, USA
3New York University, New York, NY 10003, USA
4Federal University of Rio Grande do Sul, School of Nursing, 90040-060 Porto Alegre, RS, Brazil
5School of Nursing & Midwifery, Flinders University, Adelaide, South Australia, SA 5001, Australia
6NewCourtland Center for Transitions and Health, University of Pennsylvania, Philadelphia, PA 19109-4217, USA

Received 8 July 2013; Accepted 16 August 2013

Academic Editor: Linda Moneyham

Copyright © 2013 Salimah H. Meghani et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Chronic medical conditions often occur in combination. Understanding underlying mechanisms causing diseases and their interactions may make it possible to address multiple complex conditions with single or consolidated treatment approaches and improve patients’ health outcomes while reducing costs. Objectives. We present a synthesis of the current interprofessional discourse on the issues surrounding comorbidities. Methods. A targeted review of the literature was conducted using published editorials, commentaries, and review articles. Results. Errors in conceptualization and measurement plague our current understanding of comorbidities. Two potential paths to generating knowledge involve the use of etiological or epidemiological approach. An etiological approach investigates the risk factors and underlying mechanisms potentially leading to consolidation of diagnosis and treatments. Because of the rudimentary stage of knowledge development in this area, this approach will require time and significant research investments. In contrast, the epidemiological approach relies on statistical identification of disease entities that cooccur beyond random chance; this approach carries an accompanying risk of diagnostic and treatment proliferation. Discussion. The concept of comorbidity, its nature, and measurement is in need of meaningful debate by the scientific and clinical communities. Recommendations in the domains of conceptualization, research, and measurement are discussed.