Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study

Abstract

The correct management of patients with multimorbidity remains one of the main challenges for healthcare systems worldwide. In this study, we analyze the existence of multimorbidity patterns in the general population based on gender and age. We conducted a cross-sectional study of individuals of all ages from the EpiChron Cohort, Spain (1,253,292 subjects), and analyzed the presence of systematic associations among chronic disease diagnoses using exploratory factor analysis. We identified and clinically described a total of 14 different multimorbidity patterns (12 in women and 12 in men), with some relevant differences in the functions of age and gender. The number and complexity of the patterns was shown to increase with age in both genders. We identified associations of circulatory diseases with respiratory disorders, chronic musculoskeletal diseases with depression and anxiety, and a very consistent pattern of conditions whose co-occurrence is known as metabolic syndrome (hypertension, diabetes, obesity, and dyslipidaemia), among others. Our results demonstrate the potential of using real-world data to conduct large-scale epidemiological studies to assess the complex interactions among chronic conditions. This could be useful in designing clinical interventions for patients with multimorbidity, as well as recommendations for healthcare professionals on how to handle these types of patients in clinical practice.

Multimorbidity clusters in patients with chronic obstructive airway diseases in the EpiChron Cohort

“…Our study revealed that multimorbidity is more common in patients with chronic obstructive airway diseases than in the general population and with a higher mean number of chronic diseases per patient 14 . This finding highlights the importance of implementing person-centered approaches in this population in clinical practice.…”

“…The MeDALL study found a strong association of asthma, allergic rhinitis, and eczema in children, suggesting the possible existence of an allergic cluster in the pediatric population 24 . Another study reported the existence of an allergic pattern in children, while in the population 15–29 years of age, growth and developmental disorders were also associated with asthma and dermatitis 14 . The same study found that in men 30–44 years old, this pattern included psoriasis.…”

“…This finding highlights the importance of implementing person-centered approaches in this population in clinical practice. The co-existence of conditions from different specialties in the same cluster constitutes a challenging situation for both clinicians and patients 14 . Interventions for the clinical management of populations with multimorbidity have focused primarily on other non-communicable chronic diseases than respiratory disorders 2 , and the small number of randomized clinical trials in patients with multiple chronic conditions results in uncertainty for the effectiveness of such interventions 15 .…”

Patterns and Related Influencing Factors of Multiple Chronic Diseases Among the Elderly Based on Data Mining in Shanxi, China

“…Although the established interventions for the management of chronic diseases have the potential to improve the care of the elderly, they are only focused on a single disease [8]. At present, the health management and clinical treatment of elderly patients with multiple chronic diseases have become one of the major challenges faced by the medical and health system worldwide [9].…”

Population Health and Health Services: Old Challenges and New Realities in the COVID-19 Era

“…A growing concern is the continuos grow in the complexity of long-term contions, as the paper by Ioakeim-Skoufa indicates [ 11 ]. Rodríguez-Blázquez et al reports on the implementation of a multimorbidity care model in several countries, and regardless of the significant diversity in organizational aspects of the different settings where this model was implemented, there was a consistent improvement in the quality of care indicating the need to integrate an orientation towards multimorbidity in our health care systems [ 12 ].…”