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Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study

OBJECTIVE: To analyse short-term functional decline and associated factors in over 65-year-olds with multimorbidity. DESIGN AND SETTING: Prospective multicentre study conducted in three primary care centres, over an 8-month period. During this period, we also analysed admissions to two referral hosp...

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Autores principales: Martín Lesende, Iñaki, Mendibil Crespo, Luis Ignacio, Castaño Manzanares, Sonia, Otter, Anne-Sophie Denise, Garaizar Bilbao, Irati, Pisón Rodríguez, Jakobe, Negrete Pérez, Ion, Sarduy Azcoaga, Iraide, de la Rua Fernández, María Jesús
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067403/
https://www.ncbi.nlm.nih.gov/pubmed/30056392
http://dx.doi.org/10.1136/bmjopen-2018-022377
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author Martín Lesende, Iñaki
Mendibil Crespo, Luis Ignacio
Castaño Manzanares, Sonia
Otter, Anne-Sophie Denise
Garaizar Bilbao, Irati
Pisón Rodríguez, Jakobe
Negrete Pérez, Ion
Sarduy Azcoaga, Iraide
de la Rua Fernández, María Jesús
author_facet Martín Lesende, Iñaki
Mendibil Crespo, Luis Ignacio
Castaño Manzanares, Sonia
Otter, Anne-Sophie Denise
Garaizar Bilbao, Irati
Pisón Rodríguez, Jakobe
Negrete Pérez, Ion
Sarduy Azcoaga, Iraide
de la Rua Fernández, María Jesús
author_sort Martín Lesende, Iñaki
collection PubMed
description OBJECTIVE: To analyse short-term functional decline and associated factors in over 65-year-olds with multimorbidity. DESIGN AND SETTING: Prospective multicentre study conducted in three primary care centres, over an 8-month period. During this period, we also analysed admissions to two referral hospitals. PARTICIPANTS: Of the 241 patients ≥65 years included randomly in the study, 155 were already part of a multimorbidity programme (stratified by ‘Adjusted Clinical Groups’) and 86 were newly included (patients who met Ollero’s criteria and with ≥1 hospital admission the previous year). Patients who were institutionalised, unable to complete follow-up or receiving dialysis were excluded. OUTCOMES AND VARIABLES: The primary outcome was the decrease in functional status category (Barthel Index or Lawton Scale). Other variables considered were sociodemographic characteristics, comorbidity, medications, number of admissions and functional status on discharge. RESULTS: Patients had a median age of 82 years (P(75) 86) and of five selected chronic conditions (IQR 4–6), and took 11 (IQR 9–14) regular medications; 46.9% were women; 38.2% had impaired function at baseline. Overall, 200 persons completed the follow-up; 10.4% (n=25) of the initial sample died within the 8 months. In 20.5% (95% CI 15.5% to 26.6%) of them we recorded a decrease in functionality, associated with older age (OR 1.1, 95% CI 1.0 to 1.2) and with having ≥1 admission during the follow-up (OR 3.6, 95% CI 1.6 to 7.7). There were 133 hospital admissions in total during the follow-up considering all the patients included, and a functional decline was observed in 35.5% (95% CI 25.7% to 46.7%) of the 76 discharges in which functional status was assessed. CONCLUSIONS: A fifth of patients showed functional decline or loss of independence in just 8 months. These findings are important as functional decline and the increasing care needs are potentially predictable and modifiable. Age and hospitalisation were closely associated with this decline
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spelling pubmed-60674032018-08-02 Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study Martín Lesende, Iñaki Mendibil Crespo, Luis Ignacio Castaño Manzanares, Sonia Otter, Anne-Sophie Denise Garaizar Bilbao, Irati Pisón Rodríguez, Jakobe Negrete Pérez, Ion Sarduy Azcoaga, Iraide de la Rua Fernández, María Jesús BMJ Open General practice / Family practice OBJECTIVE: To analyse short-term functional decline and associated factors in over 65-year-olds with multimorbidity. DESIGN AND SETTING: Prospective multicentre study conducted in three primary care centres, over an 8-month period. During this period, we also analysed admissions to two referral hospitals. PARTICIPANTS: Of the 241 patients ≥65 years included randomly in the study, 155 were already part of a multimorbidity programme (stratified by ‘Adjusted Clinical Groups’) and 86 were newly included (patients who met Ollero’s criteria and with ≥1 hospital admission the previous year). Patients who were institutionalised, unable to complete follow-up or receiving dialysis were excluded. OUTCOMES AND VARIABLES: The primary outcome was the decrease in functional status category (Barthel Index or Lawton Scale). Other variables considered were sociodemographic characteristics, comorbidity, medications, number of admissions and functional status on discharge. RESULTS: Patients had a median age of 82 years (P(75) 86) and of five selected chronic conditions (IQR 4–6), and took 11 (IQR 9–14) regular medications; 46.9% were women; 38.2% had impaired function at baseline. Overall, 200 persons completed the follow-up; 10.4% (n=25) of the initial sample died within the 8 months. In 20.5% (95% CI 15.5% to 26.6%) of them we recorded a decrease in functionality, associated with older age (OR 1.1, 95% CI 1.0 to 1.2) and with having ≥1 admission during the follow-up (OR 3.6, 95% CI 1.6 to 7.7). There were 133 hospital admissions in total during the follow-up considering all the patients included, and a functional decline was observed in 35.5% (95% CI 25.7% to 46.7%) of the 76 discharges in which functional status was assessed. CONCLUSIONS: A fifth of patients showed functional decline or loss of independence in just 8 months. These findings are important as functional decline and the increasing care needs are potentially predictable and modifiable. Age and hospitalisation were closely associated with this decline BMJ Publishing Group 2018-07-28 /pmc/articles/PMC6067403/ /pubmed/30056392 http://dx.doi.org/10.1136/bmjopen-2018-022377 Text en © Author(s) (or their employer(s)) 2018. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
spellingShingle General practice / Family practice
Martín Lesende, Iñaki
Mendibil Crespo, Luis Ignacio
Castaño Manzanares, Sonia
Otter, Anne-Sophie Denise
Garaizar Bilbao, Irati
Pisón Rodríguez, Jakobe
Negrete Pérez, Ion
Sarduy Azcoaga, Iraide
de la Rua Fernández, María Jesús
Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
title Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
title_full Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
title_fullStr Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
title_full_unstemmed Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
title_short Functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (FUNCIPLUR) longitudinal descriptive study
title_sort functional decline and associated factors in patients with multimorbidity at 8 months of follow-up in primary care: the functionality in pluripathological patients (funciplur) longitudinal descriptive study
topic General practice / Family practice
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6067403/
https://www.ncbi.nlm.nih.gov/pubmed/30056392
http://dx.doi.org/10.1136/bmjopen-2018-022377
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