Lesedi Ledwaba-Chapman1, Alessandra Bisquera2, Martin Gulliford3, Hiten Dodhia3, Stevo Durbaba3, Mark Ashworth3, Yanzhong Wang2. 1. King's College London, School of Population Health & Environmental Sciences, London, UK; NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK. Electronic address: Lesedi_Jethro.Ledwaba-Chapman@kcl.ac.uk. 2. King's College London, School of Population Health & Environmental Sciences, London, UK; NIHR Biomedical Research Centre, Guy's and St Thomas' NHS Foundation Trust and King's College London, London, UK. 3. King's College London, School of Population Health & Environmental Sciences, London, UK.
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.
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.