Multimorbidity was highly prevalent in this middle-aged to older cohort of patients with AF. Importantly, those with multimorbidity are at increased risk of death over a follow-up period of 5 10 years. These findings suggest that such patients should be prioritized for interventions to optimize their management and in some cases to adjust their lifestyle to reduce the impact of their co-morbidities on survival. There may be a small number of multimorbid and frail patients with AF, likely to have poor life expectancy, who should be offered conservative and less invasive treatment options. However, it is possible that, in the past, patients with multimorbidity may have been denied effective treatments that might have improved their outcome, and we would suggest that in most cases effective treatments and interventions should not be withheld from these high-risk individuals. The problem of co-morbidity and multimorbidity needs to be given greater consideration in future AF guidelines
Exploring multimorbidity in UK Biobank - patterns of illness reporting and effects of comorbidity and multimorbidity on health outcomes
Our aim is to determine the extent and patterns of morbidity reporting and treatment use, and to investigate the impact of comorbidity, multimorbidity and polypharmacy on healthcare outcomes. We will also investigate prognostic factors and the specific impact of having chronic pain and/or depression on individuals with chronic illness. Research questions include but are not limited to:
- What are the patterns of morbidity reporting?
- What are the patterns of polypharmacy reporting among people with co/multimorbidity?
- What are health related outcomes of people with co/multimorbidity and do these vary by combination of conditions, e.g. pain and depression?
This research will investigate reporting of chronic illness, including heart disease, stroke, arthritis, osteoporosis, and depression, all of which are priorities for UK Biobank; and examine treatment, including polypharmacy, and outcomes for people with multiple conditions, taking into account sociodemographic and other factors. We will examine casual pathways and prognostic factors and this will allow us to gain a better understanding of multimorbidity and to consider potential management and treatment approaches for individuals with multimorbidity. The proposed research therefore aims to promote improved understanding and treatment of a wide range of illnesses. Initial statistical models will utilise assessment centre data to determine patterns of morbidity reporting and relationships with sociodemographic, lifestyle and other factors. We intend to use assay data to determine relationships between chronic illness reporting and biomarkers. Medications will be examined to determine the treatment burden that individuals with multiple conditions experience. Subsequent analysis will build on this initial work and allow investigation of the relationship over time between chronic illness and health-related outcomes using hospitalisation, primary care, and mortality data, taking into account other factors measured at the assessment centre, which may also affect these relationships.
|Lead investigator:||Dr Barbara Nicholl|
|Lead institution:||University of Glasgow|
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