Development of the “chronic condition measurement guide”: a new tool to measure chronic conditions in older people based on ICD-10 and ATC-codes

  • Helle Gybel Juul-LarsenEmail author
  • Line Due Christensen
  • Ove Andersen
  • Thomas Bandholm
  • Susanne Kaae
  • Janne Petersen
Research Paper

Key summary points


To develop a comprehensive open-source measurement guide of the most prevalent chronic conditions among persons aged 65+ based on registry data of both diagnoses and prescribed drugs [“The Chronic Condition Measurement Guide (CCMG)].


Based on the Danish population aged 65 years and older we developed the CCMG identifying 83 different chronic conditions based on registry data of both diagnoses and prescribed drugs. By applying the CCMG to a large national cohort of all Danish citizens aged 65 or above, we found that the prevalence of multimorbidity ranged from 10 to 69% using different years of history and in- or excluding information about drug prescribing.


The CCMG is easily implemented using registry data and we recommend using 10 years of history and drug prescribing information.



The aim of the study was to develop a comprehensive open-source measurement guide of the most prevalent chronic conditions among persons aged 65+ based on registry data of both diagnoses and prescribed drugs [the chronic condition measurement guide (CCMG)]. Furthermore, to investigate proof of concept of the measurement guide, different years of history and in- and excluding data on prescribed drugs. Finally, to investigate the measurement guide with other measurement guides designed to identify chronic conditions in persons aged 65+.


The measurement guide was based on the 200 most prevalent chronic ICD10 codes in the Danish population 65+ years in 2015; the 200 most prevalent chronic ICD10 codes and causes of death in a cohort of 209,337 people who died of non-traumatic causes (January 2011–January 2016). Prescribed drugs were included in the measurement guide based on a literature review and specialist opinions.


We identified 83 different chronic conditions based on 1241 unique ICD-10 codes. Multimorbidity prevalence ranged from 10% (1-year history, excluding prescribing information) to 69% (15-year history, including prescribing information). We identified 95% of the persons with multimorbidity using the 29 most prevalent chronic conditions. Inclusion of these 29 conditions affected the prevalence of multimorbidity and 1-year mortality when the CCMG was compared with other measurement guides.


The CCMG is easily implemented using registry data. When implementing the measurement guide 10 years of history and drug prescribing information should be used. Using the CCMG to study multimorbidity, we recommend using at least the 29 most prevalent chronic conditions.


Chronic conditions People aged 65+ Multimorbidity Measurement 



The Authors like to thank Henrik Hedegaard Klausen MD, PhD, Beata Malmqvist MD, PhD, Ejvind Frausing MD, Ane Kathrine Skielbo MD, PhD, Thomas Huneck Haupt MD, PhD for validating the drugs used in the Chronic Condition Measurement Guide.

Compliance with ethical standards

Conflict of interest

The authors report no conflicts of interest in this work.

Ethical approval

This study has been approved by The Data Protection Agency (Project no. 704775 at Statistics Denmark). No approval from The Danish Research Ethics Committees for The Capital Region was needed since only national registry data have been used.

Informed consent

As this is a registry study based on national registers no informed consent exists.

Supplementary material

41999_2019_188_MOESM1_ESM.docx (26 kb)
Supplementary material 1 (DOCX 26 kb)
41999_2019_188_MOESM2_ESM.docx (25 kb)
Supplementary material 2 (DOCX 26 kb)


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Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  • Helle Gybel Juul-Larsen
    • 1
    • 2
    • 3
    Email author
  • Line Due Christensen
    • 1
    • 4
  • Ove Andersen
    • 1
    • 2
  • Thomas Bandholm
    • 1
    • 2
    • 3
    • 5
  • Susanne Kaae
    • 6
  • Janne Petersen
    • 1
    • 7
    • 8
  1. 1.Clinical Research Centre, Optimed, Amager and Hvidovre HospitalUniversity of CopenhagenHvidovreDenmark
  2. 2.Department of Clinical Medicine, Faculty of HealthUniversity of CopenhagenCopenhagenDenmark
  3. 3.Department of Occupational and Physical Therapy, Physical Medicine and Rehabilitation Research-Copenhagen (PMR-C), Amager and Hvidovre HospitalUniversity of CopenhagenHvidovreDenmark
  4. 4.The Capital Region Pharmacy, Copenhagen University Hospital HvidovreHvidovreDenmark
  5. 5.Department of Orthopedic Surgery, Amager and Hvidovre HospitalUniversity of CopenhagenHvidovreDenmark
  6. 6.Social and Clinical Pharmacy, Department of Pharmacy, Faculty of HealthUniversity of CopenhagenCopenhagenDenmark
  7. 7.Section of Biostatistics, Department of Public Health, Faculty of HealthUniversity of CopenhagenCopenhagenDenmark
  8. 8.Centre for Clinical Research and Prevention, Bispebjerg and Frederiksberg HospitalUniversity of CopenhagenCopenhagenDenmark

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