Evidence map›Paper›PMID 29095849›Full record

ArticlePloS one2017

Multimorbid outpatients: A high frequency of FP appointments and/or family difficulties, should alert FPs to the possibility of death or acute hospitalization occurring within six months; A primary care feasibility study.

Jean Yves Le Reste, Patrice Nabbe, Alice Billot Grasset, Bernard Le Floch, Pauline Grall, Jeremy Derriennic, Michele Odorico, Sophie Lalande, Delphine le Goff, Marie Barais and 4 more

Open access · goldAbstract read
In one paragraph

Article in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 42% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 2 institutions in 2 countries.

Jean Yves Le ResteEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.ORCID http://orcid.org/0000-0003-0883-3595
Patrice NabbeEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Alice Billot GrassetEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Bernard Le FlochEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Pauline GrallEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Jeremy DerriennicEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Michele OdoricoEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Sophie LalandeEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Delphine le GoffEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Marie BaraisEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Benoit ChironEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Heidrun LingnerAllgemein Medizin Hochschule Hannover, Hannover, Germany.
Morgane GuillouEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Pierre BarraineEA 7479 SPURBO, Department of general practice, Université de Bretagne occidentale, Brest, France.
Université de Bretagne Occidentale · FRHochschule Hannover · DE

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. This definition was tested as a model to assess death or acute hospitalization in multimorbid outpatients.

objectiveTo assess which criteria in the EGPRN concept of multimorbidity could detect outpatients at risk of death or acute hospitalization in a primary care cohort at a 6-month follow-up and to assess whether a large scale cohort with FPs would be feasible.

methodFamily Physicians included a random sample of multimorbid patients who attended appointments in their offices from July to December 2014. Inclusion criteria were those of the EGPRN definition of Multimorbidity. Exclusion criteria were patients under legal protection and those unable to complete the 2-year follow-up. Statistical analysis was undertaken with uni- and multivariate analysis at a 6-month follow-up using a combination of approaches including both automatic classification and expert decision making. A Multiple Correspondence Analysis (MCA) completed the process with a projection of illustrative variables. A logistic regression was finally performed in order to identify and quantify risk factors for decompensation.

results19 FPs participated in the study. 96 patients were analyzed. 3 different clusters were identified. MCA showed the central function of psychosocial factors and peaceful versus conflictual relationships with relatives in all clusters. While taking into account the limit of a small cohort, age, frequency of family physician visits and extent of family difficulties were the factors which predicted death or acute hospitalization.

conclusionA large scale cohort seems feasible in primary care. A sense of alarm should be triggered to prevent death or acute hospitalization in multimorbid older outpatients who have frequent family physician visits and who experience family difficulties.

Indexed as

Appointments and SchedulesGeneral PractitionersHospitalizationMultiple Chronic ConditionsOutpatientsAgedEuropeFeasibility StudiesFemaleHumansMaleOccupationsRisk Factors

Identifiers

PMID29095849
PMCPMC5667834
OpenAlexW2767176407

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.