Aujoulat Paul, Le Reste Jean Yves, Beurton-Couraud Lucas, Barais Marie, Chiron Benoit, Barraine Pierre, Guillou-Landreat Morgane, Le Goff Delphine
Department of general practice, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR 29238, France.
ER 7479 SPURBO, University of Western Brittany, 22, av. Camille Desmoulins, Brest, FR 29238, France.
Prim Health Care Res Dev. 2025 Aug 4;26:e68. doi: 10.1017/S1463423625100145.
The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. This survey assessed which criteria in the EGPRN concept of multimorbidity could detect decompensating patients in residential care within a primary care cohort at a six-month follow-up.
Family physicians included all multimorbid patients encountered in their residential care homes from July to December 2014. Inclusion criteria were those of the EGPRN definition of multimorbidity. Exclusion criteria were patients under legal protection and those unable to complete the 2-year follow-up. Decompensation was defined as the occurrence of death or hospitalization for more than seven days. Statistical analysis was undertaken with uni- and multi-variate analysis at a six-month follow-up using a combination of approaches including both automatic classification and expert decision. A multiple correspondence analysis and a hierarchical clustering on principal components confirmed the consistency of the results. Finally, a logistic regression was performed to identify and quantify risk factors for decompensation.Findings: About 12 family physicians participated in the study. In the study, 64 patients were analyzed. On analyzing the characteristics of the participants, two statistically significant variables between the two groups (decompensation and Nothing To Report): pain (p = 0.004) and the use of psychotropic drugs (p = 0.019) were highlighted. The final model of the logistic regression showed pain as the main decompensation risk factor.
Action should be taken by the health teams and their physicians to prevent decompensation in patients in residential care who are experiencing pain.
欧洲全科医生研究网络（EGPRN）通过在全欧洲进行系统的文献综述和定性研究，设计并验证了一个关于多重疾病的综合定义。这项调查评估了EGPRN多重疾病概念中的哪些标准能够在初级保健队列中对接受住院护理的患者进行为期六个月的随访时，检测出病情失代偿的患者。
家庭医生纳入了2014年7月至12月期间在其住院护理机构中遇到的所有患有多种疾病的患者。纳入标准为EGPRN多重疾病定义中的标准。排除标准为受法律保护的患者以及无法完成两年随访的患者。失代偿被定义为死亡或住院超过七天的情况。在六个月的随访时，采用包括自动分类和专家决策在内的多种方法进行单变量和多变量分析。多重对应分析和主成分层次聚类证实了结果的一致性。最后，进行逻辑回归以识别和量化失代偿的风险因素。
约12名家庭医生参与了该研究。在该研究中，对64名患者进行了分析。在分析参与者的特征时，突出显示了两组（失代偿组和无异常组）之间两个具有统计学意义的变量：疼痛（p = 0.004）和使用精神药物（p = 0.019）。逻辑回归的最终模型显示疼痛是主要的失代偿风险因素。
卫生团队及其医生应采取行动，预防在住院护理中经历疼痛的患者出现失代偿情况。
