Defining Patient Complexity
Authors: Joseph M. Cerimele
Journal: Annals of Internal Medicine (2012)

Letters17 April 2012Defining Patient ComplexityRichard W. Grant, MD, MPH, Clemens S. Hong, MD, MPH, and Steven J. Atlas, MD, MPHRichard W. Grant, MD, MPHFrom Kaiser Permanente Northern California, Oakland, CA 94612, and Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this author, Clemens S. Hong, MD, MPHFrom Kaiser Permanente Northern California, Oakland, CA 94612, and Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this author, and Steven J. Atlas, MD, MPHFrom Kaiser Permanente Northern California, Oakland, CA 94612, and Massachusetts General Hospital, Boston, MA 02114.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-156-8-201204170-00016 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:Dr. Olde Rikkert and colleagues address the challenge of identifying persons at high risk for negative health outcomes. Although we focused on complexity, they argue that frailty may represent another construct that physicians could use to identify such patients and cite a method by Rockwood and Mitnitski (1) that uses electronically available data, such as prescriptions and diagnoses, to assess cumulative frailty over time.We agree that frailty is an important concept in the care of elderly patients that may have important implications for screening and treatment. Although there is undoubtedly some overlap between complexity and frailty, particularly ...References1. Rockwood K, Mitnitski A. Frailty defined by deficit accumulation and geriatric medicine defined by frailty. Clin Geriatr Med. 2011;27:17-26. [PMID: 21093719] CrossrefMedlineGoogle Scholar2. Katon WJ, Lin EH, Von Korff M, Ciechanowski P, Ludman EJ, Young B, et al. Collaborative care for patients with depression and chronic illnesses. N Engl J Med. 2010;363:2611-20. [PMID: 21190455] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: From Kaiser Permanente Northern California, Oakland, CA 94612, and Massachusetts General Hospital, Boston, MA 02114.Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M11-0862. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoDefining Patient Complexity From the Primary Care Physician's Perspective Richard W. Grant , Jeffrey M. Ashburner , Clemens S. Hong , Yuchiao Chang , Michael J. Barry , and Steve J. Atlas Defining Patient Complexity Marcel G.M. Olde Rikkert , Henk J. Schers , and Rene J.F. Melis Defining Patient Complexity Joseph M. Cerimele and Lauren A. Peccoralo Metrics Cited ByEpidural steroid compared to placebo injection in sciatica: a systematic review and meta-analysisNovel Analgesics with Peripheral TargetsCellular and molecular aspects of degenerative disc disease and potential strategies of biological therapyANMCO/ISS/AMD/ANCE/ARCA/FADOI/GICR-IACPR/SICI-GISE/SIBioC/SIC/SICOA/SID/SIF/SIMEU/SIMG/SIMI/SISA Joint Consensus Document on cholesterol and cardiovascular risk: diagnostic–therapeutic pathway in Italy 17 April 2012Volume 156, Issue 8Page: 607KeywordsCardiovascular diseasesConflicts of interestDisclosureElderlyForecastingFrailtyHealth carePrimary carePsychiatry and mental health ePublished: 17 April 2012 Issue Published: 17 April 2012 CopyrightCopyright © 2012 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...