Evidence map›Paper›PMID 29530918›Full record

ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2018

The epidemiology of multimorbidity in primary care: a retrospective cohort study.

Anna Cassell, Duncan Edwards, Amelia Harshfield, Kirsty Rhodes, James Brimicombe, Rupert Payne, Simon Griffin

Open access · hybridAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 287 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
287citing papers in PubMed, 16 pooled it
30.5field-weighted citation impact, top 1% 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

287 citing papers in PubMed, 16 syntheses or guidelines pooled it, 567 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Pooled it
  13. Pooled it
  14. The use of general anaesthesia in special care dentistry: A clinical guideline from the British Society for Disability and Oral Health.Special care in dentistry : official publication of the American Association of Hospital Dentists, the Academy of Dentistry for the Handicapped, and the American Society for Geriatric Dentistry · 2022
    Guideline
  15. Pooled it
  16. Pooled it
  17. Trial
  18. Trial
  19. Trial
  20. Trial

227 more citing papers are in PubMed but not listed here.

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

7 authors at 3 institutions in 1 country.

Anna CassellSchool of Medicine, University of Utah, Salt Lake City, US.
Duncan EdwardsDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Amelia HarshfieldDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Kirsty RhodesMRC Biostatistics Unit, University of Cambridge, Cambridge, UK.
James BrimicombeDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
Rupert PayneCentre for Academic Primary Care, University of Bristol, Bristol, UK.
Simon GriffinDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK.
University of Cambridge · GBMRC Biostatistics Unit · GBUniversity of Bristol · GB

Funding

Department of Health DRF-2013-06-049Medical Research Council MC_UP_0801/1Medical Research Council MC_UU_12015/4
6 · The paper itself

Abstract

backgroundMultimorbidity places a substantial burden on patients and the healthcare system, but few contemporary epidemiological data are available.

aimTo describe the epidemiology of multimorbidity in adults in England, and quantify associations between multimorbidity and health service utilisation. DESIGN AND

settingRetrospective cohort study, undertaken in England.

methodThe study used a random sample of 403 985 adult patients (aged ≥18 years), who were registered with a general practice on 1 January 2012 and included in the Clinical Practice Research Datalink. Multimorbidity was defined as having two or more of 36 long-term conditions recorded in patients' medical records, and associations between multimorbidity and health service utilisation (GP consultations, prescriptions, and hospitalisations) over 4 years were quantified.

resultsIn total, 27.2% of the patients involved in the study had multimorbidity. The most prevalent conditions were hypertension (18.2%), depression or anxiety (10.3%), and chronic pain (10.1%). The prevalence of multimorbidity was higher in females than males (30.0% versus 24.4% respectively) and among those with lower socioeconomic status (30.0% in the quintile with the greatest levels of deprivation versus 25.8% in that with the lowest). Physical-mental comorbidity constituted a much greater proportion of overall morbidity in both younger patients (18-44 years) and those patients with a lower socioeconomic status. Multimorbidity was strongly associated with health service utilisation. Patients with multimorbidity accounted for 52.9% of GP consultations, 78.7% of prescriptions, and 56.1% of hospital admissions.

conclusionMultimorbidity is common, socially patterned, and associated with increased health service utilisation. These findings support the need to improve the quality and efficiency of health services providing care to patients with multimorbidity at both practice and national level.

Indexed as

MultimorbidityPrimary Health CareAdultAgedAged, 80 and overAge FactorsChronic DiseaseCross-Sectional StudiesFemaleHospitalizationHumansMaleMiddle AgedPatient Acceptance of Health CarePrevalenceRetrospective Studiescomorbidityhealth service utilisationmultimorbidityprimary health care

Identifiers

PMID29530918
PMCPMC5863678
OpenAlexW2791881027

What OpenQuestion holds

Textmetadata
LicenceTDM
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.