Juul-Larsen Helle Gybel, Christensen Line Due, Andersen Ove, Bandholm Thomas, Kaae Susanne, Petersen Janne
Clinical Research Centre, Optimed, Amager and Hvidovre Hospital, University of Copenhagen, Kettegaard Allé 30, 2650, Hvidovre, Copenhagen, Denmark.
Department of Clinical Medicine, Faculty of Health, University of Copenhagen, Copenhagen, Denmark.
Eur Geriatr Med. 2019 Jun;10(3):431-444. doi: 10.1007/s41999-019-00188-y. Epub 2019 Apr 10.
The aim of the study was to develop a comprehensive open-source measurement guide of the most prevalent chronic conditions among persons aged 65+ based on registry data of both diagnoses and prescribed drugs [the chronic condition measurement guide (CCMG)]. Furthermore, to investigate proof of concept of the measurement guide, different years of history and in- and excluding data on prescribed drugs. Finally, to investigate the measurement guide with other measurement guides designed to identify chronic conditions in persons aged 65+.
The measurement guide was based on the 200 most prevalent chronic ICD10 codes in the Danish population 65+ years in 2015; the 200 most prevalent chronic ICD10 codes and causes of death in a cohort of 209,337 people who died of non-traumatic causes (January 2011-January 2016). Prescribed drugs were included in the measurement guide based on a literature review and specialist opinions.
We identified 83 different chronic conditions based on 1241 unique ICD-10 codes. Multimorbidity prevalence ranged from 10% (1-year history, excluding prescribing information) to 69% (15-year history, including prescribing information). We identified 95% of the persons with multimorbidity using the 29 most prevalent chronic conditions. Inclusion of these 29 conditions affected the prevalence of multimorbidity and 1-year mortality when the CCMG was compared with other measurement guides.
The CCMG is easily implemented using registry data. When implementing the measurement guide 10 years of history and drug prescribing information should be used. Using the CCMG to study multimorbidity, we recommend using at least the 29 most prevalent chronic conditions.
本研究的目的是基于诊断和处方药的登记数据，制定一份针对65岁及以上人群中最常见慢性病的综合开源测量指南[慢性病测量指南（CCMG）]。此外，为了研究该测量指南的概念验证，考虑不同年份的病史以及是否纳入处方药数据。最后，将该测量指南与其他旨在识别65岁及以上人群慢性病的测量指南进行比较。
该测量指南基于2015年丹麦65岁及以上人群中200个最常见的慢性ICD10编码；以及209,337名非创伤性死亡人群（2011年1月至2016年1月）队列中的200个最常见慢性ICD10编码和死因。基于文献综述和专家意见，将处方药纳入测量指南。
我们基于1241个独特的ICD-10编码识别出83种不同的慢性病。多重疾病患病率从10%（1年病史，不包括处方信息）到69%（15年病史，包括处方信息）不等。使用29种最常见的慢性病，我们识别出了95%的患有多重疾病的人群。当将CCMG与其他测量指南进行比较时，纳入这29种疾病会影响多重疾病的患病率和1年死亡率。
使用登记数据可轻松实施CCMG。在实施测量指南时，应使用10年的病史和药物处方信息。使用CCMG研究多重疾病时，我们建议至少使用29种最常见的慢性病。
