Five-year trajectories of multimorbidity patterns in an elderly Mediterranean population using Hidden Markov Models
dc.contributor.author | Violán, C | |
dc.contributor.author | Fernández-Bertolín, S | |
dc.contributor.author | Guisado-Clavero, M | |
dc.contributor.author | Foguet-Boreu, Q | |
dc.contributor.author | Valderas, JM | |
dc.contributor.author | Vidal Manzano, J | |
dc.contributor.author | Roso-Llorach, A | |
dc.contributor.author | Cabrera-Bean, M | |
dc.date.accessioned | 2020-10-13T12:43:57Z | |
dc.date.issued | 2020-10-09 | |
dc.description.abstract | This study aimed to analyse the trajectories and mortality of multimorbidity patterns in patients aged 65 to 99 years in Catalonia (Spain). Five year (2012–2016) data of 916,619 participants from a primary care, population-based electronic health record database (Information System for Research in Primary Care, SIDIAP) were included in this retrospective cohort study. Individual longitudinal trajectories were modelled with a Hidden Markov Model across multimorbidity patterns. We computed the mortality hazard using Cox regression models to estimate survival in multimorbidity patterns. Ten multimorbidity patterns were originally identified and two more states (death and drop-outs) were subsequently added. At baseline, the most frequent cluster was the Non-Specific Pattern (42%), and the least frequent the Multisystem Pattern (1.6%). Most participants stayed in the same cluster over the 5 year follow-up period, from 92.1% in the Nervous, Musculoskeletal pattern to 59.2% in the Cardio-Circulatory and Renal pattern. The highest mortality rates were observed for patterns that included cardio-circulatory diseases: Cardio-Circulatory and Renal (37.1%); Nervous, Digestive and Circulatory (31.8%); and Cardio-Circulatory, Mental, Respiratory and Genitourinary (28.8%). This study demonstrates the feasibility of characterizing multimorbidity patterns along time. Multimorbidity trajectories were generally stable, although changes in specific multimorbidity patterns were observed. The Hidden Markov Model is useful for modelling transitions across multimorbidity patterns and mortality risk. Our findings suggest that health interventions targeting specific multimorbidity patterns may reduce mortality in patients with multimorbidity. | en_GB |
dc.description.sponsorship | Carlos III Institute of Health, Ministry of Economy and Competitiveness (Spain) | en_GB |
dc.description.sponsorship | European Regional Development Fund | en_GB |
dc.description.sponsorship | Department of Health of the Catalan Government | en_GB |
dc.description.sponsorship | Catalan Government | en_GB |
dc.identifier.citation | Vol. 10, article 16879 | en_GB |
dc.identifier.doi | 10.1038/s41598-020-73231-9 | |
dc.identifier.grantnumber | PI16/00639 | en_GB |
dc.identifier.grantnumber | SLT002/16/00058 | en_GB |
dc.identifier.grantnumber | AGAUR 2017 SGR 578 | en_GB |
dc.identifier.uri | http://hdl.handle.net/10871/123204 | |
dc.language.iso | en | en_GB |
dc.publisher | Nature Research | en_GB |
dc.rights | © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. Te images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. | en_GB |
dc.title | Five-year trajectories of multimorbidity patterns in an elderly Mediterranean population using Hidden Markov Models | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2020-10-13T12:43:57Z | |
exeter.article-number | 16879 | en_GB |
dc.description | This is the final version. Available on open access from Nature Research via the DOI in this record | en_GB |
dc.identifier.journal | Scientific Reports | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | en_GB |
dcterms.dateAccepted | 2020-09-09 | |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2020-10-09 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2020-10-13T12:40:23Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2020-10-13T12:44:02Z | |
refterms.panel | A | en_GB |
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the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.