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| ID | Type | Description | Link |
|---|---|---|---|
| PI22/00768 Isabel del Cura | Other Grant/Funding Number | Instituto Salud Carlos III-European Regional Develop. Found | |
| PI22/01651 Francisca Leiva | Other Grant/Funding Number | Instituto Salud Carlos III-European Regional Development F. | |
| PI22/00701 Antonio Gimeno | Other Grant/Funding Number | Instituto Salud Carlos III-European Regional Develop. Found | |
| PI22/01684 Bernardino Oliva | Other Grant/Funding Number | Instituto Salud Carlos III-European Regional Develop. Found | |
| PI22/01398 Concepción Violan | Other Grant/Funding Number | Instituto Salud Carlos III-European Regional Develop. Found | |
| PI22/01665 Rafael Rotaeche | Other Grant/Funding Number | Instituto Salud Carlos III-European Regional Develop. Found |
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| Name | Class |
|---|---|
| PI. Bernardino Oliva. Instituto Investigación Sanitaria Illes Balears | UNKNOWN |
| Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina | OTHER |
| PI Antonio Gimeno. Instituto de Investigación Sanitaria Aragón. |
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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.
Design: Mixed-method study.
Analysis:
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Quantitative Aim | Ambispective longitudinal observational study |
| |
| Qualitative Aim | Focus group, semi-structured interviews and Photovoice |
| |
| Systematic Review Aim | Systematic literature review on the effectiveness of interventions on training, multimorbidity and polypharmacy in health professionals. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Retrospective and prospective cohort | Other |
|
| Measure | Description | Time Frame |
|---|---|---|
| Multimorbidity | 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) | Baseline |
| Death | Death and abandonment: the occurrence of this event will be measured, regardless of the cause | Start date 31/12/2012, 1 year |
| Drugs | 300 ATC Swedish National Study of Ageing and Care (SNAC-K20) 8It is a classification, not a scale) | 1 year |
| Use of service | Primary Care medical/nursing visits, emergencies, referrals, admissions | 1 year |
| Morbidity | Defined with ICD-10, laboratory defined in the Swedish National Study of Ageing and Care (SNAC-K20). It is a classification, not a scale | Baseline/ 1 year |
| Frailty | EFRAIL (It consists of 5 dichotomous questions. Scoring from 0 to 5. Interpretation:
| Baseline/ 1 year |
| Measure | Description | Time Frame |
|---|---|---|
| Adherence | 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) | Baseline |
| Social support |
| Measure | Description | Time Frame |
|---|---|---|
| Age | Years | Baseline |
| Sex | Male/Female | Baseline |
Inclusion criteria:
Exclusion criteria:
- Not having used the national health system in the last year
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Patientes aged 60 years or older with 2 or more chronic diseases diagnosed before 2012-01-01. Population registered at Primary Health Centres in Spain.
Sampling Method: Not Applicable
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| Name | Affiliation | Role |
|---|---|---|
| Isabel del Cura González, PhD,MD | Gerencia Asistencial de Atención Primaria | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Isabel del Cura González | Madrid | 28035 | Spain |
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| PI. Rafael Rotaeche. Instituto Investigación Bioguipuzcoa. Osakidetza | UNKNOWN |
| PI. Francisca Leiva. Instituto de Investigacion Biomedica de Malaga. | UNKNOWN |
| CI. Julian Librero. Navarra Biomed. Servicio Navarro de Salud | UNKNOWN |
| Fundación Investigacion en Innovacion Biomédica en Atención Primaria FIIBAP | UNKNOWN |
| Instituto de Investigación Sanitaria Gregorio Marañón | OTHER |
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| Focus group, semi-structured interviews and Photovoice | Other | The participants will be people with multimorbidity over 60 years of age recruited from Primary Care centers in Spain. A theoretical sampling will be carried out. Data will be collected through video and audio recordings from a total of 16 focus groups and 20 interviews in 7 regions, and will finally be transcribed for a triangulated thematic analysis. Two groups will be carried out with participation-action research methodology - Photovoice. |
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| Systematic review | Other | No patient recruitment required |
|
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)
| Baseline |
| Functioning and disability | 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) | Baseline/ 1 year |
| Health releated quality of life | 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) | Baseline |
| Country |
Country of origin |
| Baseline |
| Deprivation Index | MEDEA (Values from 1 to 5. Higher values indicate a more unfavorable socioeconomic situation) | Baseline |
| ID | Term |
|---|---|
| D012189 | Retrospective Studies |
| D017144 | Focus Groups |
| ID | Term |
|---|---|
| D016022 | Case-Control Studies |
| D016021 | Epidemiologic Studies |
| D016020 | Epidemiologic Study Characteristics |
| D004812 | Epidemiologic Methods |
| D008919 | Investigative Techniques |
| D015331 | Cohort Studies |
| D017531 | Health Care Evaluation Mechanisms |
| D011787 | Quality of Health Care |
| D017530 | Health Care Quality, Access, and Evaluation |
| D011634 | Public Health |
| D004778 | Environment and Public Health |
| D003625 | Data Collection |
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