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Predicting poorer health outcomes in older community-dwelling patients with multimorbidity: Prospective cohort study assessing the accuracy of different multimorbidity definitions

BMJ Open Jan 10, 2019

Sasseville M, et al. - In this secondary analysis of a prospective cohort study with a 2-year follow-up period (2010–2012), researchers compared the accuracy of medication- and diagnosis-based multimorbidity measures at higher cut-points to identify older community-dwelling patients who are at risk of poorer health outcomes. Of the 904 baseline participants, 53 died during follow-up and 673 completed the follow-up questionnaire. Using two measures of multimorbidity, a medication classes count (MCC) cut-off of ≥ 10 and a chronic disease count (CDC) of ≥ 3 chronic diseases had low sensitivity in relation to predicting mortality, self-reported health-related quality of life, mental health and physical functioning—although the CDC was slightly more sensitive for the majority of outcomes. Neither measure showed high sensitivity. However, using a definition of ≥ 10 regular classes of medications to define multimorbidity, MCC had a higher specificity to predict poorer health results.

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