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队列特征描述:香港基层医疗中老年多病种前瞻性研究。

Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong.

机构信息

JC School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong, China.

Centre for Population Health Sciences, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK.

出版信息

BMJ Open. 2020 Feb 20;10(2):e027279. doi: 10.1136/bmjopen-2018-027279.

Abstract

PURPOSE

This is an ongoing prospective cohort aiming to examine the biopsychosocial health profiles and predictors of health outcomes of older patients with multimorbidity in primary care in Hong Kong.

PARTICIPANTS

From April 2016 to October 2017, 1077 patients aged 60+ years with at least two chronic diseases were recruited in four public primary care clinics in the New Territories East Region of Hong Kong.

FINDINGS TO DATE

After weighting, the patients had 4.1 (1.8) chronic conditions and 2.5 (1.9) medications on average; 37% forgot taking medication sometimes; 71% rated their health as fair or poor; 17% were frail; 73% reported one (21%) or two or more (52%) body pain areas; 62% were overweight/obese; 23% reported chewing difficulty, 18% reported incontinence; 36% had current stage 1/2 hypertension; 38% had handgrip strength below the cut-off; 10% screened positive in sarcopenia; 17% had mild or severer cognitive impairment; 17% had mild to severe depression; 16% had mild to severe anxiety; 50% had subthreshold to severe insomnia; 28% indicated being lonely; 12% needed help in at least one out of the five daily functions and the EuroQoL-5-Dimensions-5-Level index score was 0.81 (0.20) and its Visual Analogue Scale (VAS) score was 67.6 (14.6). In the past 12 months, 17% were hospitalised, 92% attended general outpatient clinics, 70% attended specialist outpatient clinics and 10% used elderly daycare centre services, the median out-of-pocket health cost was HK$1000 (US$150). Female and male patients showed significant differences in many biopsychosocial health aspects.

FUTURE PLANS

With assessments and clinical data, the cohort can be used for understanding longitudinal trajectories of biopsychosocial health profiles of Chinese older patients with multimorbidity in primary care. We are also initially planning cohort studies on factors associated with various health outcomes, as well as quality of life and healthcare use.

COHORT REGISTRATION NUMBER

ChiCTR-OIC-16008477.

摘要

目的

这是一项正在进行的前瞻性队列研究,旨在调查香港基层医疗中患有多种慢性病的老年患者的生物心理社会健康状况特征及其健康结果的预测因素。

参与者

2016 年 4 月至 2017 年 10 月,在香港新界东区的四家公立基层医疗诊所招募了 1077 名 60 岁以上至少患有两种慢性病的患者。

目前的发现

经过加权处理,患者平均患有 4.1(1.8)种慢性疾病和 2.5(1.9)种药物;37%的患者有时会忘记服药;71%的患者自评健康状况为一般或较差;17%的患者身体虚弱;73%的患者报告有一个(21%)或两个或更多(52%)身体疼痛部位;62%的患者超重/肥胖;23%的患者报告咀嚼困难,18%的患者报告尿失禁;36%的患者患有当前 1/2 期高血压;38%的患者握力低于临界值;10%的患者筛查出肌肉减少症阳性;17%的患者有轻度或更严重的认知障碍;17%的患者有轻度至重度抑郁;16%的患者有轻度至重度焦虑;50%的患者有亚临床至严重失眠;28%的患者感到孤独;12%的患者在至少五项日常功能中有一项需要帮助,欧洲五维健康量表(EQ-5D)得分为 0.81(0.20),视觉模拟量表(VAS)评分为 67.6(14.6)。在过去 12 个月中,17%的患者住院,92%的患者就诊于普通门诊,70%的患者就诊于专科门诊,10%的患者使用老年日托中心服务,自付医疗费用中位数为 1000 港元(150 美元)。女性和男性患者在许多生物心理社会健康方面存在显著差异。

未来计划

通过评估和临床数据,该队列可用于了解香港基层医疗中患有多种慢性病的中国老年患者的生物心理社会健康状况特征的纵向轨迹。我们还计划初步开展关于与各种健康结果相关的因素以及生活质量和医疗保健使用的队列研究。

队列注册号

ChiCTR-OIC-16008477。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/efee/7045043/7dd3d360d2b2/bmjopen-2018-027279f01.jpg

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