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. 2015 Nov 2;10(11):e0141155.
doi: 10.1371/journal.pone.0141155. eCollection 2015.

Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis

Quintí Foguet-Boreu  1 , Concepción Violán  2 , Teresa Rodriguez-Blanco  2 , Albert Roso-Llorach  2 , Mariona Pons-Vigués  1 , Enriqueta Pujol-Ribera  1 , Yolima Cossio Gil  2 , Jose M Valderas  3
Affiliations

Multimorbidity Patterns in Elderly Primary Health Care Patients in a South Mediterranean European Region: A Cluster Analysis

Quintí Foguet-Boreu et al. PLoS One. .

Abstract

Objective: The purpose of this study was to identify clusters of diagnoses in elderly patients with multimorbidity, attended in primary care.

Design: Cross-sectional study.

Setting: 251 primary care centres in Catalonia, Spain.

Participants: Individuals older than 64 years registered with participating practices.

Main outcome measures: Multimorbidity, defined as the coexistence of 2 or more ICD-10 disease categories in the electronic health record. Using hierarchical cluster analysis, multimorbidity clusters were identified by sex and age group (65-79 and ≥80 years).

Results: 322,328 patients with multimorbidity were included in the analysis (mean age, 75.4 years [Standard deviation, SD: 7.4], 57.4% women; mean of 7.9 diagnoses [SD: 3.9]). For both men and women, the first cluster in both age groups included the same two diagnoses: Hypertensive diseases and Metabolic disorders. The second cluster contained three diagnoses of the musculoskeletal system in the 65- to 79-year-old group, and five diseases coincided in the ≥80 age group: varicose veins of the lower limbs, senile cataract, dorsalgia, functional intestinal disorders and shoulder lesions. The greatest overlap (54.5%) between the three most common diagnoses was observed in women aged 65-79 years.

Conclusion: This cluster analysis of elderly primary care patients with multimorbidity, revealed a single cluster of circulatory-metabolic diseases that were the most prevalent in both age groups and sex, and a cluster of second-most prevalent diagnoses that included musculoskeletal diseases. Clusters unknown to date have been identified. The clusters identified should be considered when developing clinical guidance for this population.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Sampling framework.
Abbreviations: PHCT, primary health care teams; SIDIAP-Q, Information System for the Development of Research in Primary Care- Quality
Fig 2
Fig 2. Percentage of individuals (%) with overlapping of the three most prevalent clusters by sex and age group.
See this image and copyright information in PMC

References

    1. Violan C, Foguet-Boreu Q, Flores-Mateo G, Salisbury C, Blom J, Freitag M, et al. Prevalence, determinants and patterns of multimorbidity in primary care: a systematic review of observational studies. PLoS One 2014;9:e102149 10.1371/journal.pone.0102149 - DOI - PMC - PubMed
    1. Marengoni A, Angleman S, Melis R, Mangialasche F, Karp A, Garmen A, et al. Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev 2011;10:430–9. 10.1016/j.arr.2011.03.003 - DOI - PubMed
    1. Prados-Torres A, Calderón-Larrañaga A, Hancco-Saavedra J, Poblador-Plou B, van den Akker M. et al. Multimorbidity patterns: a systematic review. J Clin Epidemiol 2014;67:254–66. 10.1016/j.jclinepi.2013.09.021 - DOI - PubMed
    1. Fortin M, Stewart M, Poitras ME, Almirall J, Maddocks H. A systematic review of prevalence studies on multimorbidity: toward a more uniform methodology. Ann Fam Med 2012;10:142–51. 10.1370/afm.1337 - DOI - PMC - PubMed
    1. Schäfer I, Hansen H, Schön G, Höfels S, Altiner A, Dahlhaus A, et al. The influence of age, gender and socio-economic status on multimorbidity patterns in primary care. First results from the multicare cohort study. BMC Health Serv Res 2012;12:89 10.1186/1472-6963-12-89 - DOI - PMC - PubMed

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