A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy

Gonzalez-Gonzalez AI, Meid AD, Dinh TS, Blom JW, van den Akker M, Elders PJM, Thiem U, De Gaudry DK, Swart KMA, Rudolf H, Bosch-Lenders D, et al. (2021)
Journal of Clinical Epidemiology 130: 1-12.

Zeitschriftenaufsatz | Veröffentlicht | Englisch
 
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Autor*in
Gonzalez-Gonzalez, Ana I.; Meid, Andreas D.; Dinh, Truc S.; Blom, Jeanet W.; van den Akker, Marjan; Elders, Petra J. M.; Thiem, Ulrich; De Gaudry, Daniela Kuellenberg; Swart, Karin M. A.; Rudolf, Henrik; Bosch-Lenders, Donna; Trampisch, Hans-Joachim
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Abstract / Bemerkung
Objectives: To develop and validate a prognostic model to predict deterioration in health-related quality of life (dHRQoL) in older general practice patients with at least one chronic condition and one chronic prescription. Study Design and Setting: We used individual participant data from five cluster-randomized trials conducted in the Netherlands and Germany to predict dHRQoL, defined as a decrease in EQ-5D-3 L index score of > 5% after 6-month follow-up in logistic regression models with stratified intercepts to account for between-study heterogeneity. The model was validated internally and by using internal -external cross-validation (IECV). Results: In 3,582 patients with complete data, of whom 1,046 (29.2%) showed deterioration in HRQoL, and 12/87 variables were selected that were related to single (chronic) conditions, inappropriate medication, medication underuse, functional status, well-being, and HRQoL. Bootstrap internal validation showed a C-statistic of 0.71 (0.69 to 0.72) and a calibration slope of 0.88 (0.78 to 0.98). In the IECV loop, the model provided a pooled C-statistic of 0.68 (0.65 to 0.70) and calibration-in-the-large of 0 (-0.13 to 0.13). HRQoL/functionality had the strongest prognostic value. Conclusion: The model performed well in terms of discrimination, calibration, and generalizability and might help clinicians identify older patients at high risk of dHRQoL. Registration: PROSPERO ID: CRD42018088129. (c) 2020 Elsevier Inc. All rights reserved.
Stichworte
Multimorbidity; Polypharmacy; Elderly; Patient-centered care; Quality of; life; Functional status; Prognostic model
Erscheinungsjahr
2021
Zeitschriftentitel
Journal of Clinical Epidemiology
Band
130
Seite(n)
1-12
ISSN
0895-4356
eISSN
1878-5921
Page URI
https://pub.uni-bielefeld.de/record/2952735

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Gonzalez-Gonzalez AI, Meid AD, Dinh TS, et al. A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy. Journal of Clinical Epidemiology. 2021;130:1-12.
Gonzalez-Gonzalez, A. I., Meid, A. D., Dinh, T. S., Blom, J. W., van den Akker, M., Elders, P. J. M., Thiem, U., et al. (2021). A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy. Journal of Clinical Epidemiology, 130, 1-12. https://doi.org/10.1016/j.jclinepi.2020.10.006
Gonzalez-Gonzalez, A. I., Meid, A. D., Dinh, T. S., Blom, J. W., van den Akker, M., Elders, P. J. M., Thiem, U., De Gaudry, D. K., Swart, K. M. A., Rudolf, H., et al. (2021). A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy. Journal of Clinical Epidemiology 130, 1-12.
Gonzalez-Gonzalez, A.I., et al., 2021. A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy. Journal of Clinical Epidemiology, 130, p 1-12.
A.I. Gonzalez-Gonzalez, et al., “A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy”, Journal of Clinical Epidemiology, vol. 130, 2021, pp. 1-12.
Gonzalez-Gonzalez, A.I., Meid, A.D., Dinh, T.S., Blom, J.W., van den Akker, M., Elders, P.J.M., Thiem, U., De Gaudry, D.K., Swart, K.M.A., Rudolf, H., Bosch-Lenders, D., Trampisch, H.-J., Meerpohl, J.J., Gerlach, F.M., Flaig, B., Kom, G., Snell, K.I.E., Perera, R., Haefeli, W.E., Glasziou, P.P., Muth, C.: A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy. Journal of Clinical Epidemiology. 130, 1-12 (2021).
Gonzalez-Gonzalez, Ana I., Meid, Andreas D., Dinh, Truc S., Blom, Jeanet W., van den Akker, Marjan, Elders, Petra J. M., Thiem, Ulrich, De Gaudry, Daniela Kuellenberg, Swart, Karin M. A., Rudolf, Henrik, Bosch-Lenders, Donna, Trampisch, Hans-Joachim, Meerpohl, Joerg J., Gerlach, Ferdinand M., Flaig, Benno, Kom, Ghainsom, Snell, Kym I. E., Perera, Rafael, Haefeli, Walter E., Glasziou, Paul P., and Muth, Christiane. “A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy”. Journal of Clinical Epidemiology 130 (2021): 1-12.

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