Prevalent Multimorbidity Combinations Among Middle-Aged and Older Adults Seen in Community Health Centers.
| Title: | Prevalent Multimorbidity Combinations Among Middle-Aged and Older Adults Seen in Community Health Centers. |
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| Authors: | Quiñones AR; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA. quinones@ohsu.edu.; OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA. quinones@ohsu.edu.; Valenzuela SH; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; Huguet N; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; Ukhanova M; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; Marino M; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; OHSU-PSU School of Public Health, Oregon Health & Science University, Portland, OR, USA.; Lucas JA; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; O'Malley J; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; Research Department, OCHIN Inc., Portland, OR, USA.; Schmidt TD; Research Department, OCHIN Inc., Portland, OR, USA.; Voss R; Research Department, OCHIN Inc., Portland, OR, USA.; Peak K; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; Warren NT; Research Department, OCHIN Inc., Portland, OR, USA.; Heintzman J; Department of Family Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mail code: FM, Portland, OR, 97239, USA.; Research Department, OCHIN Inc., Portland, OR, USA. |
| Source: | Journal of general internal medicine [J Gen Intern Med] 2022 Nov; Vol. 37 (14), pp. 3545-3553. Date of Electronic Publication: 2022 Jan 28. |
| Publication Type: | Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural |
| Language: | English |
| Journal Info: | Publisher: Springer Country of Publication: United States NLM ID: 8605834 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1525-1497 (Electronic) Linking ISSN: 08848734 NLM ISO Abbreviation: J Gen Intern Med Subsets: MEDLINE |
| Imprint Name(s): | Publication: Secaucus, NJ : Springer; Original Publication: [Philadelphia, PA] : Hanley & Belfus, [c1986- |
| MeSH Terms: | Diabetes Mellitus*/epidemiology ; Hypertension*/epidemiology ; Hyperlipidemias*/epidemiology ; Renal Insufficiency, Chronic*/epidemiology; Middle Aged ; Humans ; Aged ; Multimorbidity ; Comorbidity ; Cohort Studies ; Chronic Disease ; Community Health Centers ; Prevalence |
| Abstract: | Background: Multimorbidity (≥ 2 chronic diseases) is associated with greater disability and higher treatment burden, as well as difficulty coordinating self-management tasks for adults with complex multimorbidity patterns. Comparatively little work has focused on assessing multimorbidity patterns among patients seeking care in community health centers (CHCs).; Objective: To identify and characterize prevalent multimorbidity patterns in a multi-state network of CHCs over a 5-year period.; Design: A cohort study of the 2014-2019 ADVANCE multi-state CHC clinical data network. We identified the most prevalent multimorbidity combination patterns and assessed the frequency of patterns throughout a 5-year period as well as the demographic characteristics of patient panels by prevalent patterns.; Participants: The study included data from 838,642 patients aged ≥ 45 years who were seen in 337 CHCs across 22 states between 2014 and 2019.; Main Measures: Prevalent multimorbidity patterns of somatic, mental health, and mental-somatic combinations of 22 chronic diseases based on the U.S. Department of Health and Human Services Multiple Chronic Conditions framework: anxiety, arthritis, asthma, autism, cancer, cardiac arrhythmia, chronic kidney disease (CKD), chronic obstructive pulmonary disease (COPD), congestive heart failure, coronary artery disease, dementia, depression, diabetes, hepatitis, human immunodeficiency virus (HIV), hyperlipidemia, hypertension, osteoporosis, post-traumatic stress disorder (PTSD), schizophrenia, substance use disorder, and stroke.; Key Results: Multimorbidity is common among middle-aged and older patients seen in CHCs: 40% have somatic, 6% have mental health, and 24% have mental-somatic multimorbidity patterns. The most frequently occurring pattern across all years is hyperlipidemia-hypertension. The three most frequent patterns are various iterations of hyperlipidemia, hypertension, and diabetes and are consistent in rank of occurrence across all years. CKD-hyperlipidemia-hypertension and anxiety-depression are both more frequent in later study years.; Conclusions: CHCs are increasingly seeing more complex multimorbidity patterns over time; these most often involve mental health morbidity and advanced cardiometabolic-renal morbidity.; (© 2021. Society of General Internal Medicine.) |
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| Grant Information: | R01 AG061386 United States AG NIA NIH HHS |
| Contributed Indexing: | Keywords: community health centers; multimorbidity; multiple chronic conditions; safety-net clinics; vulnerable populations |
| Entry Date(s): | Date Created: 20220128 Date Completed: 20221024 Latest Revision: 20231102 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC9585110 |
| DOI: | 10.1007/s11606-021-07198-2 |
| PMID: | 35088201 |
| Database: | MEDLINE |
Journal Article; Research Support, Non-U.S. Gov't; Research Support, N.I.H., Extramural