ArticleBMJ open2016
Comparison of count-based multimorbidity measures in predicting emergency admission and functional decline in older community-dwelling adults: a prospective cohort study.
Article in BMJ open, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 3 of them syntheses that pooled it.
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Who cites it
30 citing papers in PubMed, 3 syntheses or guidelines pooled it, 49 citations in OpenAlex.
- Promising algorithms to perilous applications: a systematic review of risk stratification tools for predicting healthcare utilisation.BMJ health & care informatics · 2024Pooled it
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- Measuring multimorbidity beyond counting diseases: systematic review of community and population studies and guide to index choice.BMJ (Clinical research ed.) · 2020Pooled it
- Trial
- Effect of medicines management versus standard care on readmissions in multimorbid patients: a randomised controlled trial.BMJ open · 2020Trial
- Adverse Drug Reaction-Related Hospital Admissions and Adverse Drug Events and Their Association with Short- and Long-Term Health Outcomes in Older Adults.Geriatrics (Basel, Switzerland) · 2026Article
- A head-to-head comparison of the validity and predictive ability for health outcomes of diagnosis versus medication-based comorbidity indices.Aging clinical and experimental research · 2025Article
- Patterns of multimorbidity in older adults with multiple myeloma: An analysis of SEER-Medicare.PloS one · 2025Article
- A Multimorbidity Analysis of Hospitalized Patients With COVID-19 in Northwest Italy: Longitudinal Study Using Evolutionary Machine Learning and Health Administrative Data.JMIR public health and surveillance · 2024Article
- Impact of nurse-led interprofessional work in older patients with heart failure and multimorbidity: A retrospective cohort study.American heart journal plus : cardiology research and practice · 2024Article
- Simple approaches to characterising multiple long-term conditions (multimorbidity) and rates of emergency hospital admission: Findings from 495,465 UK Biobank participants.Journal of internal medicine · 2023Article
- Functional limitation in the older Brazilian adults: Association with multimorbidity and socioeconomic conditions.PloS one · 2023Article
- A systematic review of risk stratification tools internationally used in primary care settings.Health science reports · 2021Review
- Defining Multimorbidity and Its Impact in Older United States Veterans Newly Treated for Multiple Myeloma.Journal of the National Cancer Institute · 2021Article
- Article
- An analysis of frailty and multimorbidity in 20,566 UK Biobank participants with type 2 diabetes.Communications medicine · 2021Article
- Patterns of emergency admissions for ambulatory care sensitive conditions: a spatial cross-sectional analysis of observational data.BMJ open · 2020Observational
- Article
- Agreement between self-reported morbidity and pharmacy claims data for prescribed medications in an older community based population.BMC geriatrics · 2020Article
- Comorbidity phenotypes and risk of mortality in patients with ischaemic heart disease in the UK.Heart (British Cardiac Society) · 2020Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesMultimorbidity, defined as the presence of 2 or more chronic medical conditions in an individual, is associated with poorer health outcomes. Several multimorbidity measures exist, and the challenge is to decide which to use preferentially in predicting health outcomes. The study objective was to compare the performance of 5 count-based multimorbidity measures in predicting emergency hospital admission and functional decline in older community-dwelling adults attending primary care.
setting15 general practices (GPs) in Ireland.
participantsn=862, ≥70 years, community-dwellers followed-up for 2 years (2010-2012). Exposure at baseline: Five multimorbidity measures (disease counts, selected conditions counts, Charlson comorbidity index, RxRisk-V, medication counts) calculated using GP medical record and linked national pharmacy claims data. PRIMARY OUTCOMES: (1) Emergency admission and ambulatory care sensitive (ACS) admission (GP medical record) and (2) functional decline (postal questionnaire). STATISTICAL ANALYSIS: Descriptive statistics and measure discrimination (c-statistic, 95% CIs), adjusted for confounders.
resultsMedian age was 77 years and 53% were women. Prevalent rates ranged from 37% to 91% depending on which measure was used to define multimorbidity. All measures demonstrated poor discrimination for the outcome of emergency admission (c-statistic range: 0.62, 0.65), ACS admission (c-statistic range: 0.63, 0.68) and functional decline (c-statistic range: 0.55, 0.61). Medication-based measures were equivalent to diagnosis-based measures.
conclusionsThe choice of measure may have a significant impact on prevalent rates. Five multimorbidity measures demonstrated poor discrimination in predicting emergency admission and functional decline, with medication-based measures equivalent to diagnosis-based measures. Consideration of multimorbidity in isolation is insufficient for predicting these outcomes in community settings.
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