Applying resolved and remission codes reduced prevalence of multimorbidity in an urban multi-ethnic population

Lesedi Ledwaba-Chapman; Alessandra Bisquera; Martin Gulliford; Hiten Dodhia; Stevo Durbaba; Mark Ashworth; Yanzhong Wang

doi:10.1016/j.jclinepi.2021.09.005

Applying resolved and remission codes reduced prevalence of multimorbidity in an urban multi-ethnic population

Lesedi Ledwaba-Chapman, Alessandra Bisquera, Martin Gulliford, Hiten Dodhia, Stevo Durbaba, Mark Ashworth, Yanzhong Wang

Lambeth Primary Care Trust

Research output: Contribution to journal › Article › peer-review

8 Citations (Scopus)

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Abstract

Objective: To estimate the prevalence and determinants of multimorbidity in an urban, multi-ethnic area over 15-years and investigate the effect of applying resolved/remission codes on prevalence estimates. Study design and setting: This is a population-based retrospective cross-sectional study using electronic health records of adults registered between 2005 –2020 in general practices in one inner London borough (n = 826,936). Classification of resolved/remission was based on clinical coding defined by the patient's general practitioner. Results: The crude and age-adjusted prevalence of multimorbidity over the study period were 21.2% (95% CI: 21.1 –21.3) and 30.8% (30.6 –31.0), respectively. Applying resolved/remission codes decreased the crude and age-adjusted prevalence estimates to 18.0% (95% CI: 17.9 –18.1) and 27.5% (27.4 –27.7). Asthma (53.2%) and depression (20.2%) were responsible for most resolved and remission codes. Substance use (Adjusted Odds Ratio 10.62 [95% CI: 10.30 –10.95]), high cholesterol (2.48 [2.44 –2.53]), and moderate obesity (2.19 [2.15 –2.23]) were the strongest risk factor determinants of multimorbidity outside of advanced age. Conclusion: Our study highlights the importance of applying resolved/remission codes to obtain an accurate prevalence and the increased burden of multimorbidity in a young, urban, and multi-ethnic population. Understanding modifiable risk factors for multimorbidity can assist policymakers in designing effective interventions to reduce progression to multimorbidity.

Original language	English
Pages (from-to)	135-148
Number of pages	14
Journal	Journal of Clinical Epidemiology
Volume	140
Early online date	10 Sept 2021
DOIs	https://doi.org/10.1016/j.jclinepi.2021.09.005
Publication status	Published - 9 Oct 2021

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title = "Applying resolved and remission codes reduced prevalence of multimorbidity in an urban multi-ethnic population",

abstract = "Objective: To estimate the prevalence and determinants of multimorbidity in an urban, multi-ethnic area over 15-years and investigate the effect of applying resolved/remission codes on prevalence estimates. Study design and setting: This is a population-based retrospective cross-sectional study using electronic health records of adults registered between 2005 –2020 in general practices in one inner London borough (n = 826,936). Classification of resolved/remission was based on clinical coding defined by the patient's general practitioner. Results: The crude and age-adjusted prevalence of multimorbidity over the study period were 21.2% (95% CI: 21.1 –21.3) and 30.8% (30.6 –31.0), respectively. Applying resolved/remission codes decreased the crude and age-adjusted prevalence estimates to 18.0% (95% CI: 17.9 –18.1) and 27.5% (27.4 –27.7). Asthma (53.2%) and depression (20.2%) were responsible for most resolved and remission codes. Substance use (Adjusted Odds Ratio 10.62 [95% CI: 10.30 –10.95]), high cholesterol (2.48 [2.44 –2.53]), and moderate obesity (2.19 [2.15 –2.23]) were the strongest risk factor determinants of multimorbidity outside of advanced age. Conclusion: Our study highlights the importance of applying resolved/remission codes to obtain an accurate prevalence and the increased burden of multimorbidity in a young, urban, and multi-ethnic population. Understanding modifiable risk factors for multimorbidity can assist policymakers in designing effective interventions to reduce progression to multimorbidity.",

author = "Lesedi Ledwaba-Chapman and Alessandra Bisquera and Martin Gulliford and Hiten Dodhia and Stevo Durbaba and Mark Ashworth and Yanzhong Wang",

note = "Funding Information: This research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Funding Information: This research was supported by a grant from Impact on Urban Health, United Kingdom (Charity No: 1160316) [grant number EIC180901]. Publisher Copyright: {\textcopyright} 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

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doi = "10.1016/j.jclinepi.2021.09.005",

language = "English",

volume = "140",

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AU - Ledwaba-Chapman, Lesedi

AU - Bisquera, Alessandra

AU - Gulliford, Martin

AU - Dodhia, Hiten

AU - Durbaba, Stevo

AU - Ashworth, Mark

AU - Wang, Yanzhong

N1 - Funding Information: This research was supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy's and St Thomas' NHS Foundation Trust and King's College London. The views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health. Funding Information: This research was supported by a grant from Impact on Urban Health, United Kingdom (Charity No: 1160316) [grant number EIC180901]. Publisher Copyright: © 2021 The Author(s) Copyright: Copyright 2021 Elsevier B.V., All rights reserved.

PY - 2021/10/9

Y1 - 2021/10/9

N2 - Objective: To estimate the prevalence and determinants of multimorbidity in an urban, multi-ethnic area over 15-years and investigate the effect of applying resolved/remission codes on prevalence estimates. Study design and setting: This is a population-based retrospective cross-sectional study using electronic health records of adults registered between 2005 –2020 in general practices in one inner London borough (n = 826,936). Classification of resolved/remission was based on clinical coding defined by the patient's general practitioner. Results: The crude and age-adjusted prevalence of multimorbidity over the study period were 21.2% (95% CI: 21.1 –21.3) and 30.8% (30.6 –31.0), respectively. Applying resolved/remission codes decreased the crude and age-adjusted prevalence estimates to 18.0% (95% CI: 17.9 –18.1) and 27.5% (27.4 –27.7). Asthma (53.2%) and depression (20.2%) were responsible for most resolved and remission codes. Substance use (Adjusted Odds Ratio 10.62 [95% CI: 10.30 –10.95]), high cholesterol (2.48 [2.44 –2.53]), and moderate obesity (2.19 [2.15 –2.23]) were the strongest risk factor determinants of multimorbidity outside of advanced age. Conclusion: Our study highlights the importance of applying resolved/remission codes to obtain an accurate prevalence and the increased burden of multimorbidity in a young, urban, and multi-ethnic population. Understanding modifiable risk factors for multimorbidity can assist policymakers in designing effective interventions to reduce progression to multimorbidity.

AB - Objective: To estimate the prevalence and determinants of multimorbidity in an urban, multi-ethnic area over 15-years and investigate the effect of applying resolved/remission codes on prevalence estimates. Study design and setting: This is a population-based retrospective cross-sectional study using electronic health records of adults registered between 2005 –2020 in general practices in one inner London borough (n = 826,936). Classification of resolved/remission was based on clinical coding defined by the patient's general practitioner. Results: The crude and age-adjusted prevalence of multimorbidity over the study period were 21.2% (95% CI: 21.1 –21.3) and 30.8% (30.6 –31.0), respectively. Applying resolved/remission codes decreased the crude and age-adjusted prevalence estimates to 18.0% (95% CI: 17.9 –18.1) and 27.5% (27.4 –27.7). Asthma (53.2%) and depression (20.2%) were responsible for most resolved and remission codes. Substance use (Adjusted Odds Ratio 10.62 [95% CI: 10.30 –10.95]), high cholesterol (2.48 [2.44 –2.53]), and moderate obesity (2.19 [2.15 –2.23]) were the strongest risk factor determinants of multimorbidity outside of advanced age. Conclusion: Our study highlights the importance of applying resolved/remission codes to obtain an accurate prevalence and the increased burden of multimorbidity in a young, urban, and multi-ethnic population. Understanding modifiable risk factors for multimorbidity can assist policymakers in designing effective interventions to reduce progression to multimorbidity.

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U2 - 10.1016/j.jclinepi.2021.09.005

DO - 10.1016/j.jclinepi.2021.09.005

M3 - Article

SN - 0895-4356

VL - 140

SP - 135

EP - 148

JO - Journal of Clinical Epidemiology

JF - Journal of Clinical Epidemiology

ER -

Applying resolved and remission codes reduced prevalence of multimorbidity in an urban multi-ethnic population

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