A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy
| Autor: | Paul Glasziou, Henrik Rudolf, Donna Bosch-Lenders, Walter E. Haefeli, Daniela Küllenberg de Gaudry, Ulrich Thiem, Ghainsom Kom, Ferdinand M. Gerlach, Hans J. Trampisch, Joerg J Meerpohl, Jeanet W. Blom, Petra J. M. Elders, Benno Flaig, Rafael Perera, Truc Sophia Dinh, Andreas D. Meid, Karin M A Swart, Kym I E Snell, Ana Isabel González-González, Christiane Muth, Marjan van den Akker |
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| Přispěvatelé: | General practice, ACS - Diabetes & metabolism, APH - Health Behaviors & Chronic Diseases, APH - Aging & Later Life, APH - Societal Participation & Health, RS: CAPHRI - R6 - Promoting Health & Personalised Care, Family Medicine, RS: CAPHRI - R5 - Optimising Patient Care |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Male
Chronic condition Aging drug burden index Epidemiology Patient-centered care Logistic regression functional status outcomes RC952 0302 clinical medicine Quality of life Older patients MISSING-INDICATOR METHOD Germany prognostic model 030212 general & internal medicine VERSION Netherlands Aged 80 and over primary-care Middle Aged Prognosis COMMUNITY Quality of Female life medicine.medical_specialty multimorbidity elderly VALIDATION 03 medical and health sciences PEOPLE medicine important difference Multimorbidity Humans Generalizability theory polypharmacy Aged Polypharmacy Clinical Deterioration business.industry Models Theoretical PERFORMANCE R1 Physical therapy Prognostic model business 030217 neurology & neurosurgery |
| Zdroj: | González-González, A I, Meid, A D, Dinh, T S, Blom, J W, van den Akker, M, Elders, P J M, Thiem, U, De Gaudry, D K, Swart, K M A, Rudolf, H, Bosch-Lenders, D, Trampisch, H J, Meerpohl, J J, Gerlach, F M, Flaig, B, Kom, G, Snell, K I E, Perera, R, Haefeli, W E, Glasziou, P P & Muth, C 2021, ' A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy ', Journal of Clinical Epidemiology, vol. 130, pp. 1-12 . https://doi.org/10.1016/j.jclinepi.2020.10.006 Journal of Clinical Epidemiology Journal of Clinical Epidemiology, 130, 1-12. Elsevier USA Journal of Clinical Epidemiology, 130, 1-12. Elsevier Science Journal of Clinical Epidemiology, 130, 1-12. ELSEVIER SCIENCE INC |
| ISSN: | 1878-5921 0895-4356 |
| DOI: | 10.1016/j.jclinepi.2020.10.006 |
| Popis: | Objectives: To develop and validate a prognostic model to predict deterioration in health-related quality of life (dHRQoL) in older general practice patients with at least one chronic condition and one chronic prescription. Study Design and Setting: We used individual participant data from five cluster-randomized trials conducted in the Netherlands and Germany to predict dHRQoL, defined as a decrease in EQ-5D-3 L index score of ≥5% after 6-month follow-up in logistic regression models with stratified intercepts to account for between-study heterogeneity. The model was validated internally and by using internal–external cross-validation (IECV). Results: In 3,582 patients with complete data, of whom 1,046 (29.2%) showed deterioration in HRQoL, and 12/87 variables were selected that were related to single (chronic) conditions, inappropriate medication, medication underuse, functional status, well-being, and HRQoL. Bootstrap internal validation showed a C-statistic of 0.71 (0.69 to 0.72) and a calibration slope of 0.88 (0.78 to 0.98). In the IECV loop, the model provided a pooled C-statistic of 0.68 (0.65 to 0.70) and calibration-in-the-large of 0 (−0.13 to 0.13). HRQoL/functionality had the strongest prognostic value. Conclusion: The model performed well in terms of discrimination, calibration, and generalizability and might help clinicians identify older patients at high risk of dHRQoL. |
| Databáze: | OpenAIRE |
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