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Table 3 Defining controlled multiple chronic condition outcomes

From: Enhanced care planning and clinical-community linkages versus usual care to address basic needs of patients with multiple chronic conditions: a clinician-level randomized controlled trial

MCC Eligible population Controlled MCC
Diabetes Diabetic patients A1c < 8
Blood pressure [83] 18–59 years or any age, diabetes/kidney disease Blood pressure ≤ 140/90
60 years and older, no diabetes/kidney disease Blood pressure ≤ 150/90
Cardiovascular prevention [84, 85] 40–75 years and  10% cardiovascular risk Taking a statin
50–69 years and  10% cardiovascular risk Taking an aspirin
Healthy behaviors [73] All patients ≥ 5 servings vegetables and fruit per day
All patients ≥ 150 min exercise per week
Depression [86] Patients with MDD None to mild depression on PHQ-2