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patterns of multimorbidity

Mario V Vettore, Gabriela de F Meira, Maria A B Rebelo, Janete M Rebelo Vieira, Carolina Machuca
The aim of this study was to describe the patterns of multimorbidities of oral clinical conditions in children. The association between social position and number of oral clinical conditions, and the relationship of social position and number of oral clinical conditions with oral health-related quality of life [OHRQoL, measured using the Brazilian Child-Oral Impacts on Daily Performance (Child-OIDP)] were also investigated. The study analysed data on 7,208 children, 12 yr of age, from the Brazilian Oral Health Survey (SBBrasil Project)...
October 8, 2016: European Journal of Oral Sciences
Ellen K Cromley, Maureen Wilson-Genderson, Allison R Heid, Rachel A Pruchno
Multimorbidity, the presence of two or more chronic conditions in an individual, presents a major challenge for meeting the health care needs of older adults. This study advances understanding of multiple chronic conditions by using local colocation quotients to reveal spatial associations for five chronic conditions (arthritis, diabetes, heart disease, hypertension, and pulmonary disease) in a statewide panel of older adults in New Jersey. Among adults with three or more conditions, large concentrations of Arthritis-Heart Disease-Pulmonary Disease, Arthritis-Hypertension-Pulmonary Disease, and Diabetes-Heart Disease-Hypertension were observed, each triad located in different regions of the state...
October 2, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
Mayilee Canizares, Monique Gignac, Sheilah Hogg-Johnson, Richard H Glazier, Elizabeth M Badley
OBJECTIVE: In light of concerns for meeting the provision of healthcare services given the large numbers of ageing baby boomers, we compared the trajectories of primary care and specialist services use across the lifecourse of 5 birth cohorts and examined factors associated with birth cohort differences. DESIGN: Longitudinal panel. SETTING: Canadian National Population Health Survey (1994-2011). POPULATION: Sample of 10 186 individuals aged 20-69 years in 1994-1995 and who were from 5 birth cohorts: Generation X (Gen X; born: 1965-1974), Younger Baby Boomers (born: 1955-1964), Older Baby Boomers (born: 1945-1954), World War II (born: 1935-1944) and pre-World War II (born: 1925-1934)...
2016: BMJ Open
Petra Hopman, Marianne J Heins, Joke C Korevaar, Mieke Rijken, François G Schellevis
PURPOSE: To examine health care utilization of people with multiple chronic diseases in The Netherlands compared to people with a single chronic disease, and to identify subgroups of multimorbid patients according to health care utilization. METHODS: All patients diagnosed with one or more chronic diseases in 2008-2009 (N=54,051) were selected from the nationwide NIVEL Primary Care Database, and data on their GP contacts and medication in 2010 were retrieved. Data on hospital admissions, household size and income were added...
September 15, 2016: European Journal of Internal Medicine
Elizabeth Reisinger Walker, Benjamin G Druss
The health of individuals in the U.S.A. is increasingly being defined by complexity and multimorbidity. We examined the patterns of co-occurrence of mental illness, substance abuse/dependence, and chronic medical conditions and the cumulative burden of these conditions and living in poverty on self-rated health. We conducted a secondary data analysis using publically-available data from the National Survey on Drug Use and Health (NSDUH), which is an annual nationally-representative survey. Pooled data from the 2010-2012 NSDUH surveys included 115,921 adults 18 years of age or older...
September 3, 2016: Psychology, Health & Medicine
Jessica Li, Mark Green, Ben Kearns, Eleanor Holding, Christine Smith, Annette Haywood, Cindy Cooper, Mark Strong, Clare Relton
BACKGROUND: Multimorbidity is increasingly being recognized as a serious public health concern. Research into its determinants, prevalence, and management is needed and as the risk of experiencing multiple chronic conditions increases over time, attention should be given to investigating the development of multimorbidity through prospective cohort design studies. Here we examine the baseline patterns of multimorbidity and their association with health outcomes for residents in Yorkshire, England using data from the Yorkshire Health Study...
2016: BMC Public Health
Elizabeth R Pfoh, Zackary Berger, Ramin Mojtabai, Jenny Bailey, Sydney M Dy
Pay-for-value initiatives include both depression and smoking screening. Evaluating how patterns of care differ for an established screening (smoking) versus newer screening (depression) can help programs better implement these measures. Our objective is to evaluate (1) patterns of smoking and depression screening and (2) how patient factors affect screening patterns. We analyzed retrospectively collected electronic health record data from 4,763 Medicare-patients in 34 primary care practices between 2010 and 2012...
July 20, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
Amy Weimann, Dajun Dai, Tolu Oni
This study utilised data from the National Income Dynamics Study, a longitudinal study with a sample of approximately 28 000 people, to investigate the cross-sectional and spatial distribution of multimorbidity and the association with socioeconomic disadvantage in South Africa for 2008 and 2012. Multimorbidity increased in prevalence from 2.73% to 2.84% in adults between 2008 and 2012 and was associated with age, socioeconomic deprivation, obesity and urban areas. Hypertension was found frequently coexisting with diabetes...
August 2016: Social Science & Medicine
Anders Prior, Morten Fenger-Grøn, Karen Kjær Larsen, Finn Breinholt Larsen, Kirstine Magtengaard Robinson, Marie Germund Nielsen, Kaj Sparle Christensen, Stewart W Mercer, Mogens Vestergaard
Multimorbidity is common and is associated with poor mental health and high mortality. Nevertheless, no studies have evaluated whether mental health may affect the survival of people with multimorbidity. We investigated the association between perceived stress and mortality in people with multimorbidity by following a population-based cohort of 118,410 participants from the Danish National Health Survey 2010 for up to 4 years. Information on perceived stress and lifestyle was obtained from the survey. We assessed multimorbidity using nationwide register data on 39 conditions and identified 4,229 deaths for the 453,648 person-years at risk...
August 1, 2016: American Journal of Epidemiology
Heather E Whitson, Kimberly S Johnson, Richard Sloane, Christine T Cigolle, Carl F Pieper, Lawrence Landerman, Susan N Hastings
OBJECTIVES: To define multimorbidity "classes" empirically based on patterns of disease co-occurrence in older Americans and to examine how class membership predicts healthcare use. DESIGN: Retrospective cohort study. SETTING: Nationally representative sample of Medicare beneficiaries in file years 1999-2007. PARTICIPANTS: Individuals aged 65 and older in the Medicare Beneficiary Survey who had data available for at least 1 year after index interview (N = 14,052)...
August 2016: Journal of the American Geriatrics Society
Martin Scherer, Heike Hansen, Jochen Gensichen, Karola Mergenthal, Steffi Riedel-Heller, Siegfried Weyerer, Wolfgang Maier, Angela Fuchs, Horst Bickel, Gerhard Schön, Birgitt Wiese, Hans-Helmut König, Hendrik van den Bussche, Ingmar Schäfer
BACKGROUND: Multimorbidity is a highly prevalent health problem, which may reduce adherence, produce conflicts in treatment, and is not yet supported by evidence-based clinical recommendations. Many older people suffer from more than one chronic disease as well as from chronic pain. There is some evidence that disease management can become more complex if multimorbid patients suffer from chronic pain. In order to better consider the patients' comorbidity spectrum in clinical pain treatment recommendations, evidence is needed regarding which disease combinations are frequently related with the presence of chronic pain...
2016: BMC Family Practice
Caroline A Jackson, Annette J Dobson, Leigh R Tooth, Gita D Mishra
BACKGROUND: Little is known about patterns of associative multimorbidity and their aetiology. We aimed to identify patterns of associative multimorbidity among mid-aged women and the lifestyle and socioeconomic factors associated with their development. METHODS: Participants were from the Australian Longitudinal Study on Women's Health. We included 4896 women born 1946-51, without multimorbidity in 1998. We identified multimorbidity patterns at survey 6 (2010) using factor analysis, and related these patterns to baseline lifestyle and socioeconomic factors using logistic regression...
2016: PloS One
Kelly M Kenzik, Erin E Kent, Michelle Y Martin, Smita Bhatia, Maria Pisu
PURPOSE: The purpose of the study is to identify chronic condition clusters at pre- and post-cancer diagnosis, evaluate predictors of developing clusters post-cancer, and examine the impact on functional impairment among older cancer survivors. METHODS: We identified 5991 survivors age 65 and older of prostate, breast, colorectal, lung, bladder, kidney, head and neck, and gynecologic cancer and non-Hodgkin lymphoma from the Surveillance, Epidemiology and End Results-Medicare Health Outcomes Survey resource...
May 27, 2016: Journal of Cancer Survivorship: Research and Practice
Roland Nau, Marija Djukic, Manfred Wappler
The care of elderly patients will continue to challenge the healthcare system over the next decades. As a rule geriatric patients suffer from multimorbidities with complex disease patterns, and the ability to cope with everyday life is severely reduced. Treatment is provided by a multiprofessional geriatric team, and the primary goal is improvement of functional status, quality of life in the social environment and autonomy by employing a holistic approach. In Germany geriatric care is provided by physicians from various medical specialties (e...
June 2016: Der Nervenarzt
Alexandra A N'Goran, Jeremie Blaser, Anouk Deruaz-Luyet, Nicolas Senn, Peter Frey, Dagmar M Haller, Ryan Tandjung, Andreas Zeller, Bernard Burnand, Lilli Herzig
BACKGROUND: Chronic conditions and multimorbidity (MM) are major concerns in family medicine (FM). OBJECTIVES: Based on the International Classification of Primary Care, Second Edition (ICPC-2), this study aimed to list (i)the chronic conditions and (ii)those most relevant to MM in FM. METHODS: A panel of FM experts used a four-step process to identify chronic conditions among ICPC-2 items and list chronic conditions most relevant in MM. They also evaluated the importance of eight criteria, previously identified in the literature, for characterizing chronic conditions...
August 2016: Family Practice
K A Volaklis, M Halle, B Thorand, A Peters, K H Ladwig, H Schulz, W Koenig, C Meisinger
BACKGROUND: Data on the association between handgrip strength and multimorbidity (MMB) are missing. AIM: The purpose of this study was to examine if handgrip strength is related to MMB in a large population-based sample of older persons. METHODS: The cross-sectional analysis was based on 1079 older people (aged 65-94years), who participated in the KORA-Age study in the Augsburg region, southern Germany. Participants underwent an interview and extensive examinations, including anthropometric measurements, registration of chronic diseases, determination of health-related behaviors (smoking, alcohol intake and physical activity), collection of blood samples, and muscle strength measurement using hand-grip dynamometry...
June 2016: European Journal of Internal Medicine
Bruno Pereira Nunes, Fabio Alberto Camargo-Figuera, Marília Guttier, Paula Duarte de Oliveira, Tiago N Munhoz, Alicia Matijasevich, Andréa Dâmaso Bertoldi, Fernando César Wehrmeister, Marysabel Pinto Telis Silveira, Elaine Thumé, Luiz Augusto Facchini
OBJECTIVES: The aim of this study was to evaluate occurrences and patterns of multimorbidity in adults from a southern Brazilian city. METHODS: A population-based cross-sectional study was carried out in 2012 through face-to-face interviews with adults (20 or more years) living in Pelotas, southern Brazil. Multimorbidity was evaluated by a list of 11 morbidities (based on medical diagnosis; Patient Health Questionnaire 9 for depression; and Anatomical Therapeutic Chemical index) and operationalized according to two cutoff points: ≥2 and ≥3 morbidities...
April 22, 2016: International Journal of Public Health
Máire O'Dwyer, Jure Peklar, Philip McCallion, Mary McCarron, Martin C Henman
OBJECTIVES: (1) To evaluate the prevalence of polypharmacy (5-9 medicines) and excessive polypharmacy (10+ medicines) and (2) to determine associated demographic and clinical characteristics in an ageing population with intellectual disabilities (IDs). DESIGN: Observational cross-sectional study. SETTING: Wave One (2009/2010) of the Intellectual Disability Supplement to the Irish Longitudinal Study on Ageing (IDS-TILDA). PARTICIPANTS: A nationally representative sample of 753 persons with ID, aged between 41 and 90 years...
2016: BMJ Open
Christopher Harrison, Joan Henderson, Graeme Miller, Helena Britt
OBJECTIVE: To measure prevalence of multimorbidity and complex multimorbidity in the Australian population from a nationally representative prospective study and to identify the most prevalent patterns of chronic conditions and body systems affected. METHODS: A sub-study of the nationally representative BEACH program, using a random sample of 8,707 patients at encounters with 290 general practitioners. All diagnosed chronic conditions were recorded for each patient...
June 2016: Australian and New Zealand Journal of Public Health
Matthias Eckardt, Christian Brettschneider, Hendrik van den Bussche, Hans-Helmut König
In this paper we analysed healthcare costs in a sample of elderly patients suffering from multimorbidity. On the one hand, multimorbid individuals consume a disproportionally large share of healthcare resources. On the other hand, the patient specific number and combination of co-occurring single diseases result in inhomogeneous data leading to biased estimates when using traditional regression techniques. Therefore, we applied a mixture of regressions in order to control for unobserved heterogeneity focussing on the identification of multimorbidity patterns...
March 16, 2016: Health Economics
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