Impact of Socioeconomic Inequalities in Transition Between Health, Multimorbidity and Death Amongst Older People
What is the Impact of Socioeconomic Inequalities in the Rates of Transition Between Health, Multimorbidity and Death Amongst Older People in England?
Přehled studie
Postavení
Podmínky
Intervence / Léčba
Detailní popis
The association between social inequality and cause-specific mortality and single disease morbidity has been studied extensively. However, it remains unclear whether having two or more chronic diseases concurrently (or 'multimorbidity') plays a role in contributing to the inequalities gap in survival. This is particularly relevant given an ageing population and the trend of a widening in the life expectancy gap across several European countries.
Multimorbidity incidence increases rapidly with age. Estimates of the prevalence of multimorbidity in older people range from 55% to 98%, mainly due to the selection of diseases included, population coverage (hospital, community) and data source (self-reported surveys or clinical records). However, across all studies there is a clear and consistent pattern of higher prevalence rates at older ages, with multimorbidity.
Many aspects of the patient health trajectory remain under-explored. Patient case-mixes are likely to vary across socioeconomic groups, alongside a host of prognostic factors, including the clustering of multiple risk factors, age of onset, and disease presentation, progression and management in the presence of multiple health conditions.
Typ studie
Zápis (Očekávaný)
Kontakty a umístění
Studijní místa
-
-
-
London, Spojené království, WC1 E7H
- University College London
-
-
Kritéria účasti
Kritéria způsobilosti
Věk způsobilý ke studiu
Přijímá zdravé dobrovolníky
Pohlaví způsobilá ke studiu
Metoda odběru vzorků
Studijní populace
Popis
Inclusion Criteria:
- Registered with a participating practice that has agreed to data linkage
- Registered with an 'up to standard' participating general practice for at least 1 year
- Aged 45 and over on Jan 1st 2001 or who turn 45 between 1st Jan 2001 and 25th March 2010, irrespective of initial health status.
Exclusion Criteria:
- Patients with a record unlinked to deprivation due to missing or incomplete postcode of residence.
Studijní plán
Jak je studie koncipována?
Detaily designu
Kohorty a intervence
Skupina / kohorta |
Intervence / Léčba |
|---|---|
|
Healthy
Patients without any of the pre-specified chronic diseases
|
This study is based on the retrospective analysis of linked electronic health records.
|
|
Multimorbid
Patients having any two or more of the pre-specified chronic diseases
|
This study is based on the retrospective analysis of linked electronic health records.
|
Co je měření studie?
Primární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Yearly multimorbidity incidence rate
Časové okno: 10 years
|
Numerator: Of patients with either 0 or 1 chronic diseases as on 1st Jan of the year, all those who become multimorbid by 31st Dec of the year. Denominator: patient years at risk of patients with either 0 or 1 chronic diseases as on 1st Jan of the year |
10 years
|
|
Yearly multimorbidity prevalence
Časové okno: 10 years
|
Numerator: all those with 2 or more listed diseases on 1st July of the year.
Denominator: All eligible patients on 1st July of the year, irrespective of disease status on that date.
|
10 years
|
|
Yearly all-cause mortality rates
Časové okno: 10 years
|
Numerator: number of deaths until 31st Dec of the year amongst the patients included in the denominator. Denominator: Person years at risk of patients with 0,1,2 or more diseases on 1st Jan of the year. |
10 years
|
|
Overall life expectancy
Časové okno: 10 years
|
Incident rates of transitions between no disease, 1 disease, 2+ diseases, and death.
|
10 years
|
|
Health state-specific life expectancies
Časové okno: 10 years
|
Incident rates of transitions between four health states - no disease, 1 disease, 2+ diseases, and death.
|
10 years
|
Sekundární výstupní opatření
Měření výsledku |
Popis opatření |
Časové okno |
|---|---|---|
|
Yearly non-accidental mortality rates
Časové okno: 10 years
|
As outcome 3 but excluding accidental deaths from the numerator
|
10 years
|
Spolupracovníci a vyšetřovatelé
Sponzor
Spolupracovníci
Vyšetřovatelé
- Ředitel studie: Madhavi Bajekal, PhD, University College, London
Termíny studijních záznamů
Hlavní termíny studia
Začátek studia
Primární dokončení (Aktuální)
Dokončení studie (Očekávaný)
Termíny zápisu do studia
První předloženo
První předloženo, které splnilo kritéria kontroly kvality
První zveřejněno (Odhad)
Aktualizace studijních záznamů
Poslední zveřejněná aktualizace (Odhad)
Odeslaná poslední aktualizace, která splnila kritéria kontroly kvality
Naposledy ověřeno
Více informací
Termíny související s touto studií
Klíčová slova
Další identifikační čísla studie
- 14_179
Tyto informace byly beze změn načteny přímo z webu clinicaltrials.gov. Máte-li jakékoli požadavky na změnu, odstranění nebo aktualizaci podrobností studie, kontaktujte prosím register@clinicaltrials.gov. Jakmile bude změna implementována na clinicaltrials.gov, bude automaticky aktualizována i na našem webu .