Multimorbidity patterns and their related characteristics in European older adults: A longitudinal perspective

Zacarías-Pons, Lluís; Vilalta-Franch, Joan; Turró‐Garriga, Oriol; Sáez, Marc; Garré-Olmo, Josep

doi:10.1016/j.archger.2021.104428

Cited by 10 publications

(21 citation statements)

References 24 publications

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“…On another note, multiple chronic health problems in the same individual (known as multimorbidity) can constitute profiles or patterns, some of which have already been described in older patients [ 7 , 8 ]. Multimorbidity, together with geriatric syndromes and frailty, frequently coexisting in the ageing process, increase clinical complexity and can lead to significant medicalization [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort Study

Baré

Lleal

Sevilla-Sánchez

et al. 2023

IJERPH

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There is no published evidence on the possible differences in multimorbidity, inappropriate prescribing, and adverse outcomes of care, simultaneously, from a sex perspective in older patients. We aimed to identify those possible differences in patients hospitalized because of a chronic disease exacerbation. A multicenter, prospective cohort study of 740 older hospitalized patients (≥65 years) was designed, registering sociodemographic variables, frailty, Barthel index, chronic conditions (CCs), geriatric syndromes (GSs), polypharmacy, potentially inappropriate prescribing (PIP) according to STOPP/START criteria, and adverse drug reactions (ADRs). Outcomes were length of stay (LOS), discharge to nursing home, in-hospital mortality, cause of mortality, and existence of any ADR and its worst consequence. Bivariate analyses between sex and all variables were performed, and a network graph was created for each sex using CC and GS. A total of 740 patients were included (53.2% females, 53.5% ≥85 years old). Women presented higher prevalence of frailty, and more were living in a nursing home or alone, and had a higher percentage of PIP related to anxiolytics or pain management drugs. Moreover, they presented significant pairwise associations between CC, such as asthma, vertigo, thyroid diseases, osteoarticular diseases, and sleep disorders, and with GS, such as chronic pain, constipation, and anxiety/depression. No significant differences in immediate adverse outcomes of care were observed between men and women in the exacerbation episode.

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Section: Introductionmentioning

confidence: 99%

Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort Study

Baré

Lleal

Sevilla-Sánchez

et al. 2023

IJERPH

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“…The majority of articles were conducted among adults and only three study included children 53–55. More than half (n=38/64) were cross-sectional and 26/64 used longitudinal data9 10 42 54 56–76 (table 2).…”

Section: Resultsmentioning

confidence: 99%

“…Educational attainment was the preferred measure of socioeconomic position (n=38/64), and 38 studies used multiple measures of socioeconomic position as exposures. The majority of studies (n=51/64) simply documented the presence of multimorbidity, and approximately one-third (n=13/64) additionally examined different patterns of multimorbidity9 40 41 45 47 53 55 67–70 72 75 77 78 (table 2).…”

Section: Resultsmentioning

confidence: 99%

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

et al. 2022

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ObjectiveTo document socioepidemiological theories used to explain the relationship between socioeconomic disadvantage and multimorbidity.DesignScoping review.MethodsA search strategy was developed and then applied to multiple electronic databases including Medline, Embase, PsychInfo, Web of Science, Scielo, Applied Social Sciences, ERIC, Humanities Index and Sociological Abstracts. After the selection of studies, data were extracted using a data charting plan. The last search was performed on the 28 September 2021. Extracted data included: study design, country, population subgroups, measures of socioeconomic inequality, assessment of multimorbidity and conclusion on the association between socioeconomic variables and multimorbidity. Included studies were further assessed on their use of theory, type of theories used and context of application. Finally, we conducted a meta-narrative synthesis to summarise the results.ResultsA total of 64 studies were included in the review. Of these, 33 papers included theories as explanations for the association between socioeconomic position and multimorbidity. Within this group, 16 explicitly stated those theories and five tested at least one theory. Behavioural theories (health behaviours) were the most frequently used, followed by materialist (access to health resources) and psychosocial (stress pathways) theories. Most studies used theories as post hoc explanations for their findings or for study rationale. Supportive evidence was found for the role of material, behavioural and life course theories in explaining the relationship between social inequalities and multimorbidity.ConclusionGiven the widely reported social inequalities in multimorbidity and its increasing public health burden, there is a critical gap in evidence on pathways from socioeconomic disadvantage to multimorbidity. Generating evidence of these pathways will guide the development of intervention and public policies to prevent multimorbidity among people living in social disadvantage. Material, behavioural and life course pathways can be targeted to reduce the negative effect of low socioeconomic position on multimorbidity.

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“…Various definitions and research methodologies have been developed in order to shed light on the concept of multimorbidity, and there is accumulating evidence suggesting that chronic conditions give rise to association patterns [ 5 , 6 , 7 ]. Although there is no standard yet, many publications have successfully identified multimorbidity patterns [ 8 , 9 ], some of which are repeatedly found among different studies [ 10 ]. Furthermore, some patterns have been associated with outcomes such as lower function, higher healthcare utilisation, poor prognosis or higher mortality [ 11 , 12 , 13 , 14 , 15 , 16 ].…”

Section: Introductionmentioning

confidence: 99%

Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication—MoPIM Cohort Study

Lleal¹,

Baré²,

Ortonobes³

et al. 2022

IJERPH

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Multimorbidity is increasing and poses a challenge to the clinical management of patients with multiple conditions and drug prescriptions. The objectives of this work are to evaluate if multimorbidity patterns are associated with quality indicators of medication: potentially inappropriate prescribing (PIP) or adverse drug reactions (ADRs). A multicentre prospective cohort study was conducted including 740 older (≥65 years) patients hospitalised due to chronic pathology exacerbation. Sociodemographic, clinical and medication related variables (polypharmacy, PIP according to STOPP/START criteria, ADRs) were collected. Bivariate analyses were performed comparing previously identified multimorbidity clusters (osteoarticular, psychogeriatric, minor chronic disease, cardiorespiratory) to presence, number or specific types of PIP or ADRs. Significant associations were found in all clusters. The osteoarticular cluster presented the highest prevalence of PIP (94.9%) and ADRs (48.2%), mostly related to anxiolytics and antihypertensives, followed by the minor chronic disease cluster, associated with ADRs caused by antihypertensives and insulin. The psychogeriatric cluster presented PIP and ADRs of neuroleptics and the cardiorespiratory cluster indicators were better overall. In conclusion, the associations that were found reinforce the existence of multimorbidity patterns and support specific medication review actions according to each patient profile. Thus, determining the relationship between multimorbidity profiles and quality indicators of medication could help optimise healthcare processes. Trial registration number: NCT02830425.

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Multimorbidity patterns and their related characteristics in European older adults: A longitudinal perspective

Cited by 10 publications

References 24 publications

Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort Study

Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort Study

Theoretical explanations for socioeconomic inequalities in multimorbidity: a scoping review

Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication—MoPIM Cohort Study

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