Identifying multimorbidity clusters with the highest primary care use: 15 years of evidence from a multi-ethnic metropolitan population.
Marina Soley-Bori,Alessandra Bisquera,Mark Ashworth,Yanzhong Wang,Stevo Durbaba,Hiten Dodhia,Julia Fox-Rushby +6 more
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In this paper, the authors assess the association between multimorbidity clusters and primary care consultations over time, using a retrospective longitudinal (panel) study design, using data from 826 166 patients registered at GP practices in London between 2005 and 2020.Abstract:
Background People with multimorbidity have complex healthcare needs. Some co-occurring diseases interact with each other to a larger extent than others and may have a different impact on primary care use. Aim To assess the association between multimorbidity clusters and primary care consultations over time. Design and setting A retrospective longitudinal (panel) study design was used. Data comprised electronic primary care health records of 826 166 patients registered at GP practices in an ethnically diverse, urban setting in London between 2005 and 2020. Method Primary care consultation rates were modelled using generalised estimating equations. Key controls included the total number of long-term conditions, five multimorbidity clusters, and their interaction effects, ethnic group, and polypharmacy (proxy for disease severity). Models were also calibrated by consultation type and ethnic group. Results Individuals with multimorbidity used two to three times more primary care services than those without multimorbidity (incidence rate ratio 2.30, 95% confidence interval = 2.29 to 2.32). Patients in the alcohol dependence, substance dependence, and HIV cluster (Dependence+) had the highest rate of increase in primary care consultations as additional long-term conditions accumulated, followed by the mental health cluster (anxiety and depression). Differences by ethnic group were observed, with the largest impact in the chronic liver disease and viral hepatitis cluster for individuals of Black or Asian ethnicity. Conclusion This study identified multimorbidity clusters with the highest primary care demand over time as additional long-term conditions developed, differentiating by consultation type and ethnicity. Targeting clinical practice to prevent multimorbidity progression for these groups may lessen future pressures on primary care demand by improving health outcomes.read more
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Age- and Sex-Specific Differences in Multimorbidity Patterns and Temporal Trends on Assessing Hospital Discharge Records in Southwest China: Network-Based Study
TL;DR: A retrospective cohort analysis based on hospital discharge records of about 5.0 million individuals of all ages from 2015 to 2019 in a megacity in southwest China identified specific differences in the co-occurrence of chronic diagnoses by sex and age, which could help in the design of clinical interventions for inpatient multimorbidity.
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Multimorbidity and comorbidity patterns in the English National Health Service
TL;DR: Kuan et al. as discussed by the authors examined frequencies of common combinations of diseases and identified non-random disease associations in people of all ages and multiple ethnicities in an observational population-based study including nearly four million participants.
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Multimorbidity and mortality: A data science perspective
TL;DR: It is found that the prevalence and the severity of multimorbidity, as quantified by the number of co-occurring chronic conditions, increase progressively with age, and people living in more deprived areas are more likely to be multimOrbid compared to those living inMore affluent areas at all ages.
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Prevalence and global trends of polypharmacy in patients with chronic liver disease: A systematic review and meta-analysis
TL;DR: In this paper , a systematic review and meta-analysis is conducted to estimate the prevalence of polypharmacy in patients with chronic liver disease and to comprehensively synthesize the socio-demographic factors that drive this.
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Cohort profile: The South London Stroke Register - a population-based register measuring the incidence and outcomes of stroke.
Iain J. Marshall,Charles D.A. Wolfe,Eva Stefanie Emmett,Hatem Abdelaziz Mohamed Wafa,Yanzhong Wang,Abdel Douiri,Ajay Bhalla,Matthew O'Connell +7 more
TL;DR: The South London Stroke Register (SLSR) is a population-based cohort study, which was established in 1995 to study the causes, incidence, and outcomes of stroke as mentioned in this paper .
References
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