Trajectories and Experiences of People With Multimorbidity in Spain (LOXO-MULTIPAP) Project: a Mixed Methods Study
- Conditions
- Multimorbidity
- Interventions
- Other: Systematic reviewOther: Focus group, semi-structured interviews and PhotovoiceOther: Retrospective and prospective cohort
- Registration Number
- NCT06478745
- Lead Sponsor
- Gerencia de Atención Primaria, Madrid
- Brief Summary
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.
- Detailed Description
* Design: Mixed-method study.
* 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.
* 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.
* Systematic literature review on the effectiveness of interventions on training, multimorbidity and polypharmacy in health professionals.
* Analysis:
* Quantitative study: Cluster, network and trajectory analysis
* 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.
Recruitment & Eligibility
- Status
- ENROLLING_BY_INVITATION
- Sex
- All
- Target Recruitment
- 3239950
Not provided
Not provided
Study & Design
- Study Type
- OBSERVATIONAL
- Study Design
- Not specified
- Arm && Interventions
Group Intervention Description Systematic Review Aim Systematic review Systematic literature review on the effectiveness of interventions on training, multimorbidity and polypharmacy in health professionals. Qualitative Aim Focus group, semi-structured interviews and Photovoice Focus group, semi-structured interviews and Photovoice Quantitative Aim Retrospective and prospective cohort Ambispective longitudinal observational study
- Primary Outcome Measures
Name Time Method Multimorbidity 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 Start date 31/12/2012, 1 year Death and abandonment: the occurrence of this event will be measured, regardless of the cause
Drugs 1 year 300 ATC Swedish National Study of Ageing and Care (SNAC-K20) 8It is a classification, not a scale)
Use of service 1 year Primary Care medical/nursing visits, emergencies, referrals, admissions
Morbidity 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 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)
- Secondary Outcome Measures
Name Time Method Social support Baseline Dukes-Unk-11(This questionnaire consists of 11 items and a Likert-type response scale. The score range is between 11 and 55 points. A score equal to or greater than 32 indicates normal support, while a score of less than 32 indicates low perceived social support)
Functioning and disability Baseline/ 1 year WHODAS (It is composed of 36 items that evaluate the following 6 dimensions. The overall score runs a scale from 0 to 100, with higher values indicating greater disability)
Adherence Baseline Morisky-Green (Patients who answer NO to all four questions are considered compliant with treatment and those who answer YES to one or more are considered non-compliant)
Health releated quality of life Baseline Euroqol 5D-5L (It consists of 2 parts - The EQ-5D descriptive system and the Visual Analog Scale (VAS).
Scale (VAS). In the VAS the individual scores his or her health between two extremes, 0 and 100, the worst and the best state of health imaginable. imaginable)
Trial Locations
- Locations (1)
Isabel del Cura González
🇪🇸Madrid, Spain