Trajectories and Experiences of Patients With Multimorbidity in the National Health Service of Spain: a Mixed Methods Study (LOXO-MULTIPAP)
试验速览
- 阶段
- 不适用
- 状态
- Enrolling By Invitation
- 发起方
- 入组人数
- 3,239,950
- 试验地点
- 1
- 主要终点
- Multimorbidity
研究概览
简要总结
The overall objective of the study is to analyze the evolution of multimorbidity, its most relevant patterns and trajectories in the Spanish National Health System population, from 2012 to 2022, and to analyze the factors that determine it, as well as the experience of professionals and patients in navigating the health system and in shared decision making.
Multimorbidity trajectories can help identify homogeneous groups of individuals with similar needs and prognoses, and help practitioners and health systems to personalize clinical interventions and preventive strategies. Capturing this dynamism is the only way to better understand the natural history of multimorbidity and shed light on hitherto unexplained findings.
详细描述
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Design: Mixed-method study.
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Quantitative study: retrospective and prospective observational study. It integrates demographic and clinical information from electronic medical records and clinical-administrative databases. It involves the harmonisation of the cohorts of users of the public health system of the 7 participating regions.
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Qualitative study with a phenomenological and ethnographic approach using focus group techniques, semi-structured interviews and Photovoice to find out the perspective of patients and professionals in shared decision-making.
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Systematic literature review on the effectiveness of interventions on training, multimorbidity and polypharmacy in health professionals.
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Analysis:
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Quantitative study: Cluster, network and trajectory analysis
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Qualitative study: Thematic content analysis that will be triangulated among the members of the research team. Meanings will be interpreted and an explanatory framework will be created with the contributions of each type of informant.
研究设计
- 研究类型
- Observational
- 观察模型
- Other
- 时间视角
- Other
入排标准
- 年龄范围
- 60 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- 未提供
排除标准
- 未提供
结局指标
主要结局
Multimorbidity
时间窗: Baseline
Presence of two or more diagnoses of any of the 60 diseases categorised by the Swedish National Study of Ageing and Care (SNAC-K20) (It is a classification, not a scale)
Death
时间窗: Start date 31/12/2012, 1 year
Death and abandonment: the occurrence of this event will be measured, regardless of the cause
Drugs
时间窗: 1 year
300 ATC Swedish National Study of Ageing and Care (SNAC-K20) 8It is a classification, not a scale)
Use of service
时间窗: 1 year
Primary Care medical/nursing visits, emergencies, referrals, admissions
Morbidity
时间窗: Baseline/ 1 year
Defined with ICD-10, laboratory defined in the Swedish National Study of Ageing and Care (SNAC-K20). It is a classification, not a scale
Frailty
时间窗: Baseline/ 1 year
EFRAIL (It consists of 5 dichotomous questions. Scoring from 0 to 5. Interpretation: * Probable frailty: 3 to 5 points. * Probable pre-fragility: 1 to 2 points. * No fragility or robustness: 0 points)
次要结局
- Social support(Baseline)
- Functioning and disability(Baseline/ 1 year)
- Adherence(Baseline)
- Health releated quality of life(Baseline)
研究者
Isabel Del Cura-Gonzalez
Principal - Coordinator researcher
Gerencia de Atención Primaria, Madrid