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

Author

Listed:
  • Ignatios Ioakeim-Skoufa

    (EpiChron Research Group, IIS Aragón, 50009 Zaragoza, Spain
    These authors contributed equally to this work and served as first co-authors.)

  • Beatriz Poblador-Plou

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Health Services Research on Chronic Patients Network (REDISSEC), ISCIII, 28222 Madrid, Spain
    These authors contributed equally to this work and served as first co-authors.)

  • Jonás Carmona-Pírez

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Aragon Health Service (SALUD), Delicias-Sur Primary Care Health Centre, 50003 Zaragoza, Spain)

  • Jesús Díez-Manglano

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Aragon Health Service (SALUD), Internal Medicine Service, Royo Villanova Hospital, 50015 Zaragoza, Spain)

  • Rokas Navickas

    (Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
    Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania)

  • Luis Andrés Gimeno-Feliu

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Health Services Research on Chronic Patients Network (REDISSEC), ISCIII, 28222 Madrid, Spain
    Aragon Health Service (SALUD), San Pablo Primary Care Health Centre, 50003 Zaragoza, Spain
    Department of Medicine, University of Zaragoza, 50009 Zaragoza, Spain)

  • Francisca González-Rubio

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Health Services Research on Chronic Patients Network (REDISSEC), ISCIII, 28222 Madrid, Spain
    Aragon Health Service (SALUD), Delicias-Sur Primary Care Health Centre, 50003 Zaragoza, Spain
    Grupo de Trabajo de Utilización de Fármacos de la SemFYC, 28004 Madrid, Spain)

  • Elena Jureviciene

    (Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
    Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania)

  • Laimis Dambrauskas

    (Faculty of Medicine, Vilnius University, LT-03101 Vilnius, Lithuania
    Department of Biomedical Research, Vilnius University Hospital Santaros Klinikos, LT-08661 Vilnius, Lithuania)

  • Alexandra Prados-Torres

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Health Services Research on Chronic Patients Network (REDISSEC), ISCIII, 28222 Madrid, Spain
    These authors contributed equally to this work and served as senior co-authors.)

  • Antonio Gimeno-Miguel

    (EpiChron Research Group, Aragon Health Sciences Institute (IACS), IIS Aragón, Miguel Servet University Hospital, 50009 Zaragoza, Spain
    Health Services Research on Chronic Patients Network (REDISSEC), ISCIII, 28222 Madrid, Spain
    These authors contributed equally to this work and served as senior co-authors.)

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.

Suggested Citation

  • Ignatios Ioakeim-Skoufa & Beatriz Poblador-Plou & Jonás Carmona-Pírez & Jesús Díez-Manglano & Rokas Navickas & Luis Andrés Gimeno-Feliu & Francisca González-Rubio & Elena Jureviciene & Laimis Dambraus, 2020. "Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study," IJERPH, MDPI, vol. 17(12), pages 1-15, June.
  • Handle: RePEc:gam:jijerp:v:17:y:2020:i:12:p:4242-:d:371264
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    References listed on IDEAS

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    1. Ingmar Schäfer & Eike-Christin von Leitner & Gerhard Schön & Daniela Koller & Heike Hansen & Tina Kolonko & Hanna Kaduszkiewicz & Karl Wegscheider & Gerd Glaeske & Hendrik van den Bussche, 2010. "Multimorbidity Patterns in the Elderly: A New Approach of Disease Clustering Identifies Complex Interrelations between Chronic Conditions," PLOS ONE, Public Library of Science, vol. 5(12), pages 1-10, December.
    2. Esperanza Diaz & Beatriz Poblador-Pou & Luis-Andrés Gimeno-Feliu & Amaia Calderón-Larrañaga & Bernadette N Kumar & Alexandra Prados-Torres, 2015. "Multimorbidity and Its Patterns according to Immigrant Origin. A Nationwide Register-Based Study in Norway," PLOS ONE, Public Library of Science, vol. 10(12), pages 1-18, December.
    3. Palmer, Katie & Marengoni, Alessandra & Forjaz, Maria João & Jureviciene, Elena & Laatikainen, Tiina & Mammarella, Federica & Muth, Christiane & Navickas, Rokas & Prados-Torres, Alexandra & Rijken, Mi, 2018. "Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)," Health Policy, Elsevier, vol. 122(1), pages 4-11.
    4. Valentin Walker & Christine Perret-Guillaume & Emmanuelle Kesse-Guyot & Nelly Agrinier & Serge Hercberg & Pilar Galan & Karen E Assmann & Serge Briançon & Christine Rotonda, 2016. "Effect of Multimorbidity on Health-Related Quality of Life in Adults Aged 55 Years or Older: Results from the SU.VI.MAX 2 Cohort," PLOS ONE, Public Library of Science, vol. 11(12), pages 1-15, December.
    5. Inge Kirchberger & Christa Meisinger & Margit Heier & Anja-Kerstin Zimmermann & Barbara Thorand & Christine S Autenrieth & Annette Peters & Karl-Heinz Ladwig & Angela Döring, 2012. "Patterns of Multimorbidity in the Aged Population. Results from the KORA-Age Study," PLOS ONE, Public Library of Science, vol. 7(1), pages 1-7, January.
    6. Katie Palmer & Angelo Carfì & Carmen Angioletti & Antonella Di Paola & Rokas Navickas & Laimis Dambrauskas & Elena Jureviciene & Maria João Forjaz & Carmen Rodriguez-Blazquez & Alexandra Prados-Torres, 2019. "A Methodological Approach for Implementing an Integrated Multimorbidity Care Model: Results from the Pre-Implementation Stage of Joint Action CHRODIS-PLUS," IJERPH, MDPI, vol. 16(24), pages 1-18, December.
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    Cited by:

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    2. Yaqin Zhong & Hanqing Xi & Xiaojun Guo & Tiantian Wang & Yanan Wang & Jian Wang, 2022. "Gender and Socioeconomic Differences in the Prevalence and Patterns of Multimorbidity among Middle-Aged and Older Adults in China," IJERPH, MDPI, vol. 19(24), pages 1-11, December.
    3. Miguel Ángel Hernández-Rodríguez & Ermengol Sempere-Verdú & Caterina Vicens-Caldentey & Francisca González-Rubio & Félix Miguel-García & Vicente Palop-Larrea & Ramón Orueta-Sánchez & Óscar Esteban-Jim, 2021. "Drug Prescription Profiles in Patients with Polypharmacy in Spain: A Large-Scale Pharmacoepidemiologic Study Using Real-World Data," IJERPH, MDPI, vol. 18(9), pages 1-10, April.
    4. Ignatios Ioakeim-Skoufa & Mercedes Clerencia-Sierra & Aida Moreno-Juste & Carmen Elías de Molins Peña & Beatriz Poblador-Plou & Mercedes Aza-Pascual-Salcedo & Francisca González-Rubio & Alexandra Prad, 2022. "Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort," IJERPH, MDPI, vol. 19(16), pages 1-15, August.
    5. Jonás Carmona-Pírez & Ignatios Ioakeim-Skoufa & Antonio Gimeno-Miguel & Beatriz Poblador-Plou & Francisca González-Rubio & Dolores Muñoyerro-Muñiz & Juliana Rodríguez-Herrera & Juan Antonio Goicoechea, 2022. "Multimorbidity Profiles and Infection Severity in COVID-19 Population Using Network Analysis in the Andalusian Health Population Database," IJERPH, MDPI, vol. 19(7), pages 1-13, March.
    6. Ahmad Alkhatib & Lawrence Achilles Nnyanzi & Brian Mujuni & Geofrey Amanya & Charles Ibingira, 2021. "Preventing Multimorbidity with Lifestyle Interventions in Sub-Saharan Africa: A New Challenge for Public Health in Low and Middle-Income Countries," IJERPH, MDPI, vol. 18(23), pages 1-14, November.
    7. Antonio Sarría-Santamera & Alua Yeskendir & Tilektes Maulenkul & Binur Orazumbekova & Abduzhappar Gaipov & Iñaki Imaz-Iglesia & Lorena Pinilla-Navas & Teresa Moreno-Casbas & Teresa Corral, 2021. "Population Health and Health Services: Old Challenges and New Realities in the COVID-19 Era," IJERPH, MDPI, vol. 18(4), pages 1-5, February.

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