Co-morbidity: we need a guideline for each patient not a guideline for each disease

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Abstract
Imagine you are a GP seeing a 79-year-old woman who has osteoporosis, type 2 diabetes mellitus, hypertension and chronic obstructive pulmonary disease, all of moderate severity. She is complaining of worsening pain in her left knee when walking, which you think might be osteoarthritis and start to investigate. While doing that you are wondering if you are following all the recommendations of the five individual disease guidelines. This issue of a patient with multi-morbidity each addressed by single-disease guidelines is a common scenario that faces most primary care physicians.