Similar Multimorbidity Patterns in Primary Care Patients from Two European Regions: Results of a Factor Analysis
Open Access
- 23 June 2014
- journal article
- research article
- Published by Public Library of Science (PLoS) in PLOS ONE
- Vol. 9 (6), e100375
- https://doi.org/10.1371/journal.pone.0100375
Abstract
To compare the similarities among the multimorbidity patterns identified in primary care patients from two European regions (Spain and the Netherlands) with similar organisational features of their primary care systems, using validated methodologies. This observational, retrospective, multicentre study analysed information from primary care electronic medical records. Multimorbidity patterns were assessed using exploratory factor analysis of the diagnostic information of patients over 14 years of age. The analysis was stratified by age groups and sex. The analysis of Dutch data revealed a higher prevalence of multimorbidity which corresponds with the clustering of a higher number of diseases in each of the patterns. Relevant clinical similarities were found between both countries for three multimorbidity patterns that were previously identified in the original Spanish study: cardiometabolic, mechanical and psychiatric-substance abuse. In addition, the clinical evolution towards complexity of the cardiometabolic pattern with advancing age -already demonstrated in the original study- was corroborated in the Dutch context. A clear association between mechanical and psychosocial disorders was unique to the Dutch population, as well as the recurrent presentation of the psychiatric-substance abuse pattern in all age and sex groups. The similarities found for the cardiometabolic, mechanical and psychiatric-substance abuse patterns in primary care patients from two different European countries could offer initial clues for the elaboration of clinical practice guidelines, if further evidenced in other contexts. This study also endorses the use of primary care electronic medical records for the epidemiologic characterization of multimorbidity.Keywords
This publication has 24 references indexed in Scilit:
- Guidelines for people not for diseases: the challenges of applying UK clinical guidelines to people with multimorbidityAge and Ageing, 2012
- Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional studyThe Lancet, 2012
- Multimorbidity in primary care: a systematic review of prospective cohort studiesBritish Journal of General Practice, 2012
- Toward a More Cogent Approach to the Challenges of MultimorbidityAnnals of Family Medicine, 2012
- Multimorbidity Patterns in Primary Care: Interactions among Chronic Diseases Using Factor AnalysisPLOS ONE, 2012
- The influence of population characteristics on variation in general practice based morbidity estimationsBMC Public Health, 2011
- Which chronic diseases and disease combinations are specific to multimorbidity in the elderly? Results of a claims data based cross-sectional study in GermanyBMC Public Health, 2011
- Epidemiology and impact of multimorbidity in primary care: a retrospective cohort studyBritish Journal of General Practice, 2011
- Multimorbidity Patterns in the Elderly: A New Approach of Disease Clustering Identifies Complex Interrelations between Chronic ConditionsPLOS ONE, 2010
- Use of mental health services for anxiety, mood, and substance disorders in 17 countries in the WHO world mental health surveysThe Lancet, 2007