Dataset Information

Distinct trajectories of multimorbidity in primary care were identified using latent class growth analysis.

ABSTRACT:

Objectives

To investigate the use of latent class growth analysis (LCGA) in understanding onset and changes in multimorbidity over time in older adults.

Study design and setting

This study used primary care consultations for 42 consensus-defined chronic morbidities over 3 years (2003-2005) by 24,615 people aged >50 years at 10 UK general practices, which contribute to the Consultations in Primary Care Archive database. Distinct groups of people who had similar progression of multimorbidity over time were identified using LCGA. These derived trajectories were tested in another primary care consultation data set with linked self-reported health status.

Results

Five clusters of people representing different trajectories were identified: those who had no recorded chronic problems (40%), those who developed a first chronic morbidity over 3 years (10%), a developing multimorbidity group (37%), a group with increasing number of chronic morbidities (12%), and a multi-chronic group with many chronic morbidities (1%). These trajectories were also identified using another consultation database and associated with self-reported physical and mental health.

Conclusion

There are distinct trajectories in the development of multimorbidity in primary care populations, which are associated with poor health. Future research needs to incorporate such trajectories when assessing progression of disease and deterioration of health.

SUBMITTER: Strauss VY

PROVIDER: S-EPMC4165436 | biostudies-literature | 2014 Oct

REPOSITORIES: biostudies-literature

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Publications

Distinct trajectories of multimorbidity in primary care were identified using latent class growth analysis.

Strauss Vicky Y VY Jones Peter W PW Kadam Umesh T UT Jordan Kelvin P KP

Journal of clinical epidemiology 20140723 10

<h4>Objectives</h4>To investigate the use of latent class growth analysis (LCGA) in understanding onset and changes in multimorbidity over time in older adults.<h4>Study design and setting</h4>This study used primary care consultations for 42 consensus-defined chronic morbidities over 3 years (2003-2005) by 24,615 people aged >50 years at 10 UK general practices, which contribute to the Consultations in Primary Care Archive database. Distinct groups of people who had similar progression of multi ...[more]

PMID: 25063556

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Project description:BackgroundPatient-reported outcome measures (PROMs) are an extensively used tool to assess and improve the quality of healthcare services. PROMs can be related to individual demographic and clinical characteristics in patients undergoing hip arthroplasty (HA). The aim of this study is to identify distinct subgroups of patients with unique trajectories of PROMS scores and to determine patients' features associated with these subgroups.MethodsWe conducted a prospective, cohort study in which PROMs questionnaires (Euro Quality 5 Dimensions 3L, EQ-5D-3L, Euro-Quality-Visual-Analytic-Score, EQ-VAS, Hip disability and Osteoarthritis Outcome Score, HOOS-PS) were administered to patients undergoing elective HA pre-operatively, and at 6 and 12 months after surgery. For each measure, latent class growth analysis and growth mixture models were used to identify subgroups of patients with distinct trajectories of scores. Demografic and clinical predictors of the latent classes in growth mixture model were identified using a 3-step approach.ResultsWe found three distinct trajectories for each PROM score. These trajectories indicated a response heterogeneity to the HA among the patients (n = 991). Patient's gender, ASA score, and obesity were significantly associated with different PROMs trajectories.ConclusionsWe identified three distinct trajectories for each of the three PROMs indicators. Several demographic and clinical characteristics are associated with the different trajectories of PROMs at 6 and 12 months after HA and could be used to identify groups of patients with different outcomes following HA surgery. These findings underline the importance of patient-centered care, supporting the usefulness of integrating PROMs data alongside routinely collected healthcare records for guiding clinical care and maximizing patients' positive outcomes.Trial registrationProtocol version (1.0) and trial registration data are available on the platform www.Clinicaltrialgov with the identifier NCT03790267, posted on December 31, 2018.

Dataset Information

Distinct trajectories of multimorbidity in primary care were identified using latent class growth analysis.

Objectives

Study design and setting

Results

Conclusion

Publications

Distinct trajectories of multimorbidity in primary care were identified using latent class growth analysis.

Similar Datasets

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