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3. Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial

Author

del Cura-González, Isabel, López-Rodríguez, Juan A., Leiva-Fernández, Francisca, Gimeno-Feliu, Luis A., Pico-Soler, Victoria, Bujalance-Zafra, Mª. Josefa, Domínguez-Santaella, Miguel, Polentinos-Castro, Elena, Poblador-Plou, Beatriz, Ara-Bardají, Paula, Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, Castillo-Jiménez, Marcos, Lozano-Hernández, Cristina, Gimeno-Miguel, Antonio, González-Rubio, Francisca, Medina-García, Rodrigo, González-Hevilla, Alba, Gil-Conesa, Mario, Martín-Fernández, Jesús, Valderas, José M., Marengoni, Alessandra, Muth, Christiane, Prados-Torres, J. Daniel, and Prados-Torres, Alexandra

Published
2022
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4. Influence of social determinants of health on quality of life in patients with multimorbidity and polypharmacy.

Author

Ruiz-Baena, José María, Moreno-Juste, Aida, Poblador-Plou, Beatriz, Castillo-Jimena, Marcos, Calderón-Larrañaga, Amaia, Lozano-Hernández, Cristina, Gimeno-Miguel, Antonio, and Gimeno-Feliú, Luis A.

Subjects
QUALITY of life, SOCIAL determinants of health, SOCIAL influence, SOCIAL classes, REGRESSION analysis
Abstract

Background: Multimorbidity is one of the biggest challenges faced by modern medicine, especially when managing older patients who are also often taking multiple medications. Multimorbidity is influenced by social determinants of health, giving rise to health inequalities in the population. Here, we sought to determine the influence of social determinants of health on quality of life in patients with multimorbidity and polypharmacy. Methods and materials: This cross-sectional observational study included 573 patients aged 65–74 with multimorbidity (≥3 diseases) and polypharmacy (≥5 drugs). Corresponding data was taken drawn from the Spanish MULTIPAP study, and included social and demographic variables, and data on health-related quality of life and overall self-perceived health status, assessed using the 5-level version of the EuroQol 5-dimensional questionnaire (EQ-5D-5L). Descriptive, bivariate and multivariate analyses with logistic regression models were performed. Results: Mean patient age was 69.7 years, 55.8% of patients were female, 59.7% belonged to low social classes (V, VI), a monthly income of €1051–€1850 predominated, and the median number of diseases in the same patient was 6. Factors associated with higher quality of life were (odds ratio, OR) male gender (OR = 1.599, p = 0.013), a higher educational level (OR = 1.991, p = 0.036), an absence of urban vulnerability (OR = 1.605, p = 0.017), and the presence of medium social support (OR = 1.689, p = 0.017). Having a higher number of diseases was associated with poorer quality of life (OR = 0.912, p = 0.017). Conclusions: Our findings describe associations between social determinants of health and quality of life in patients aged 65–74 years with multimorbidity and polypharmacy. More illnesses, female gender, a lower education level, urban vulnerability, and less social support are associated with poorer quality of life, underscoring the need for a biopsychosocial approach in patient care. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Mental health and risk of death and hospitalization in COVID–19 patients. Results from a large-scale population-based study in Spain.

Author

Moreno-Juste, Aida, Poblador-Plou, Beatriz, Ortega-Larrodé, Cristina, Laguna-Berna, Clara, González-Rubio, Francisca, Aza-Pascual-Salcedo, Mercedes, Bliek-Bueno, Kevin, Padilla, María, de-la-Cámara, Concepción, Prados-Torres, Alexandra, Gimeno-Feliú, Luis A., and Gimeno-Miguel, Antonio

Subjects
MENTAL health, COVID-19, INVOLUNTARY hospitalization, PATERNAL age effect, COGNITION disorders, PERSONALITY disorders, MENTAL illness, OLANZAPINE
Abstract

The COVID–19 pandemic has created unprecedented challenges for health care systems globally. This study aimed to explore the presence of mental illness in a Spanish cohort of COVID-19-infected population and to evaluate the association between the presence of specific mental health conditions and the risk of death and hospitalization. This is a retrospective cohort study including all individuals with confirmed infection by SARS-CoV-2 from the PRECOVID (Prediction in COVID–19) Study (Aragon, Spain). Mental health illness was defined as the presence of schizophrenia and other psychotic disorders, anxiety, cognitive disorders, depression and mood disorders, substance abuse, and personality and eating disorders. Multivariable logistic regression models were used to examine the likelihood of 30-day all-cause mortality and COVID–19 related hospitalization based on baseline demographic and clinical variables, including the presence of specific mental conditions, by gender. We included 144,957 individuals with confirmed COVID–19 from the PRECOVID Study (Aragon, Spain). The most frequent diagnosis in this cohort was anxiety. However, some differences were observed by sex: substance abuse, personality disorders and schizophrenia were more frequently diagnosed in men, while eating disorders, depression and mood, anxiety and cognitive disorders were more common among women. The presence of mental illness, specifically schizophrenia spectrum and cognitive disorders in men, and depression and mood disorders, substance abuse, anxiety and cognitive and personality disorders in women, increased the risk of mortality or hospitalization after COVID–19, in addition to other well-known risk factors such as age, morbidity and treatment burden. Identifying vulnerable patient profiles at risk of serious outcomes after COVID–19 based on their mental health status will be crucial to improve their access to the healthcare system and the establishment of public health prevention measures for future outbreaks. [ABSTRACT FROM AUTHOR]

Published
2024
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10. Multimorbidity patterns in COVID-19 patients and their relationship with infection severity: MRisk-COVID study

Author

Lleal, Marina, primary, Corral-Vazquez, Celia, additional, Baré, Montserrat, additional, Comet, Ricard, additional, Herranz, Susana, additional, Baigorri, Francisco, additional, Gimeno-Miguel, Antonio, additional, Raurich, Maria, additional, Fortià, Cristina, additional, Navarro, Marta, additional, Poblador-Plou, Beatriz, additional, and Baré, Marisa, additional

Published
2023
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12. Drug Repurposing in Oncology: A Systematic Review of Randomized Controlled Clinical Trials

Author

Ioakeim-Skoufa, Ignatios, primary, Tobajas-Ramos, Natalia, additional, Menditto, Enrica, additional, Aza-Pascual-Salcedo, Mercedes, additional, Gimeno-Miguel, Antonio, additional, Orlando, Valentina, additional, González-Rubio, Francisca, additional, Fanlo-Villacampa, Ana, additional, Lasala-Aza, Carmen, additional, Ostasz, Ewelina, additional, and Vicente-Romero, Jorge, additional

Published
2023
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15. Prevalence and Influence on Prognosis of Mental Health Comorbidities in Long-term Breast Cancer Survivors: Results From the Surbcan Study

Author

Padilla-Ruiz, María, primary, Gimeno-Miguel, Antonio, additional, Rivas-Ruiz, Francisco, additional, Martínez-Casanova, Mª Carmen, additional, Jansana, Anna, additional, Prados-Torres, Alexandra, additional, Poblador-Plou, Beatriz, additional, Cura, Isabel Del, additional, Sanz-Cuesta, Teresa, additional, Ibáñez, Berta, additional, Castells, Xavier, additional, Sala, María, additional, and Redondo, Maximino, additional

Published
2022
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17. FAIR4Health - Public resources

Author

Martinez-Garcia, Alicia, Hernández, Tony, Sinaci, A. Anil, Chronaki, Catherine, Cornet, Ronald, Méndez, Eva, Gencturk, Mert, Calderón, Carlos, Kovacevic, Tomi, Bokan, Darijo, Cangioli, Giorgio, angioletti, carmen, Löbe, Matthias, Rochat, Jessica, Hörbst, Alexander, Weber, Patrick, Venkataraman, Shanmugasundaram, Gimeno-Miguel, Antonio, Correro, Carlos, Schweitzer, Marco, Matthies, Franz, Fernandez, Teresa, Teoman, Alper, Naranjo-Saucedo, Ana, Sveinsdottir, Thordis, Alvarez, Celia, Hernández, Iván, Quintero, Miriam, Monteau, Sophie, Mateos, David, Poblador-Plou, Beatriz, Carmona-Pirez, Jonas, Inau, Esther, Horton, Laurence, Aso, Santiago, Villarán, Esther, Goldman, Jean-Philippe, and Ganapathy, Nagarajan

Abstract

Here we'll post the public documents of the project, including deliverables and dissemination materials, among others

Published
2022
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20. Multimorbidity Clusters in the Oldest Old: Results from the EpiChron Cohort

Author

Ioakeim-Skoufa, Ignatios, primary, Clerencia-Sierra, Mercedes, additional, Moreno-Juste, Aida, additional, Elías de Molins Peña, Carmen, additional, Poblador-Plou, Beatriz, additional, Aza-Pascual-Salcedo, Mercedes, additional, González-Rubio, Francisca, additional, Prados-Torres, Alexandra, additional, and Gimeno-Miguel, Antonio, additional

Published
2022
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21. Clinical characteristics of heart failure patients with mid-range ejection fraction

Author

Gracia Gutiérrez, Anyuli, primary, Grados Saso, Daniel, additional, Esteban Cabello, Elena I., additional, Salas Trigo, Eva M., additional, Sánchez Marteles, Marta, additional, Garcés Horna, Vanesa, additional, Ioakeim-Skoufa, Ignatios, additional, Gimeno-Miguel, Antonio, additional, Prados-Torres, Alexandra, additional, and Ruiz Laiglesia, Fernando J., additional

Published
2022
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22. FAIR4Health: Findable, Accessible, Interoperable and Reusable data to foster Health Research

Author

Alvarez-Romero, Celia, primary, Martínez-García, Alicia, additional, Sinaci, A. Anil, additional, Gencturk, Mert, additional, Méndez, Eva, additional, Hernández-Pérez, Tony, additional, Liperoti, Rosa, additional, Angioletti, Carmen, additional, Löbe, Matthias, additional, Ganapathy, Nagarajan, additional, Deserno, Thomas M., additional, Almada, Marta, additional, Costa, Elisio, additional, Chronaki, Catherine, additional, Cangioli, Giorgio, additional, Cornet, Ronald, additional, Poblador-Plou, Beatriz, additional, Carmona-Pírez, Jonás, additional, Gimeno-Miguel, Antonio, additional, Poncel-Falcó, Antonio, additional, Prados-Torres, Alexandra, additional, Kovacevic, Tomi, additional, Zaric, Bojan, additional, Bokan, Darijo, additional, Hromis, Sanja, additional, Djekic Malbasa, Jelena, additional, Rapallo Fernández, Carlos, additional, Velázquez Fernández, Teresa, additional, Rochat, Jessica, additional, Gaudet-Blavignac, Christophe, additional, Lovis, Christian, additional, Weber, Patrick, additional, Quintero, Miriam, additional, Perez-Perez, Manuel M., additional, Ashley, Kevin, additional, Horton, Laurence, additional, and Parra Calderón, Carlos Luis, additional

Published
2022
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23. How to Improve Healthcare for Patients with Multimorbidity and Polypharmacy in Primary Care : A Pragmatic Cluster-Randomized Clinical Trial of the MULTIPAP Intervention

Author

Del Cura-González, Isabel, López-Rodriguez, Juan A., Leiva-Fernández, Francisca, Gimeno-Miguel, Antonio, Poblador-Plou, Beatriz, López-Verde, Fernando, Lozano-Hernández, Cristina, Pico-Soler, Victoria, Bujalance-Zafra, Mª Josefa, Gimeno-Feliu, Luis A., Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, González-Rubio, Francisca, García-de-Blas, Francisca, Polentinos-Castro, Elena, Sanz-Cuesta, Teresa, Castillo-Jimena, Marcos, Alonso-Garcia, Marcos, Calderón-Larrañaga, Amaia, Valderas, José M., Marengoni, Alessandra, Muth, Christiane, Prados-Torres, Juan Daniel, Prados-Torres, Alexandra, Del Cura-González, Isabel, López-Rodriguez, Juan A., Leiva-Fernández, Francisca, Gimeno-Miguel, Antonio, Poblador-Plou, Beatriz, López-Verde, Fernando, Lozano-Hernández, Cristina, Pico-Soler, Victoria, Bujalance-Zafra, Mª Josefa, Gimeno-Feliu, Luis A., Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, González-Rubio, Francisca, García-de-Blas, Francisca, Polentinos-Castro, Elena, Sanz-Cuesta, Teresa, Castillo-Jimena, Marcos, Alonso-Garcia, Marcos, Calderón-Larrañaga, Amaia, Valderas, José M., Marengoni, Alessandra, Muth, Christiane, Prados-Torres, Juan Daniel, and Prados-Torres, Alexandra

Abstract

(1) Purpose: To investigate a complex MULTIPAP intervention that implements the Ariadne principles in a primary care population of young-elderly patients with multimorbidity and polypharmacy and to evaluate its effectiveness for improving the appropriateness of prescriptions. (2) Methods: A pragmatic cluster-randomized clinical trial was conducted involving 38 family practices in Spain. Patients aged 65-74 years with multimorbidity and polypharmacy were recruited. Family physicians (FPs) were randomly allocated to continue usual care or to provide the MULTIPAP intervention based on the Ariadne principles with two components: FP training (eMULTIPAP) and FP patient interviews. The primary outcome was the appropriateness of prescribing, measured as the between-group difference in the mean Medication Appropriateness Index (MAI) score change from the baseline to the 6-month follow-up. The secondary outcomes were quality of life (EQ-5D-5L), patient perceptions of shared decision making (collaboRATE), use of health services, treatment adherence, and incidence of drug adverse events (all at 1 year), using multi-level regression models, with FP as a random effect. (3) Results: We recruited 117 FPs and 593 of their patients. In the intention-to-treat analysis, the between-group difference for the mean MAI score change after a 6-month follow-up was -2.42 (95% CI from -4.27 to -0.59) and, between baseline and a 12-month follow-up was -3.40 (95% CI from -5.45 to -1.34). There were no significant differences in any other secondary outcomes. (4) Conclusions: The MULTIPAP intervention improved medication appropriateness sustainably over the follow-up time. The small magnitude of the effect, however, advises caution in the interpretation of the results given the paucity of evidence for the clinical benefit of the observed change in the MAI.

Published
2022
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24. Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and Their Association with Mortality through a Frequent Pattern Growth Association Algorithm

Author

Carmona-Pírez, Joná, Poblador-Plou, Beatriz, Poncel-Falcó, Antonio, Rochat, Jessica, Alvarez-Romero, Celia, Martínez-García, Alicia, Angioletti, Carmen, Almada, Marta, Gencturk, Mert, Sinaci, A Anil, Ternero-Vega, Jara Eloisa, Gaudet-Blavignac, Christophe, Lovis, Christian, Liperoti, Rosa, Costa, Elisio, Parra-Calderón, Carlos Lui, Moreno-Juste, Aida, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, Liperoti, Rosa (ORCID:0000-0003-3740-1687), Carmona-Pírez, Joná, Poblador-Plou, Beatriz, Poncel-Falcó, Antonio, Rochat, Jessica, Alvarez-Romero, Celia, Martínez-García, Alicia, Angioletti, Carmen, Almada, Marta, Gencturk, Mert, Sinaci, A Anil, Ternero-Vega, Jara Eloisa, Gaudet-Blavignac, Christophe, Lovis, Christian, Liperoti, Rosa, Costa, Elisio, Parra-Calderón, Carlos Lui, Moreno-Juste, Aida, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, and Liperoti, Rosa (ORCID:0000-0003-3740-1687)

Abstract

The current availability of electronic health records represents an excellent research opportunity on multimorbidity, one of the most relevant public health problems nowadays. However, it also poses a methodological challenge due to the current lack of tools to access, harmonize and reuse research datasets. In FAIR4Health, a European Horizon 2020 project, a workflow to implement the FAIR (findability, accessibility, interoperability and reusability) principles on health datasets was developed, as well as two tools aimed at facilitating the transformation of raw datasets into FAIR ones and the preservation of data privacy. As part of this project, we conducted a multicentric retrospective observational study to apply the aforementioned FAIR implementation workflow and tools to five European health datasets for research on multimorbidity. We applied a federated frequent pattern growth association algorithm to identify the most frequent combinations of chronic diseases and their association with mortality risk. We identified several multimorbidity patterns clinically plausible and consistent with the bibliography, some of which were strongly associated with mortality. Our results show the usefulness of the solution developed in FAIR4Health to overcome the difficulties in data management and highlight the importance of implementing a FAIR data policy to accelerate responsible health research.

Published
2022

25. FAIR4Health: Findable, Accessible, Interoperable and Reusable data to foster Health Research

Author

European Commission, Instituto de Salud Carlos III, Álvarez-Romero, Celia [0000-0001-8647-9515], Sinaci, A. Anil [0000-0003-4397-3382], Gencturk, Mert [0000-0003-2697-5722], Méndez-Rodríguez, Eva [0000-0002-5337-4722], Hernández-Pérez, Tony [0000-0001-8404-9247], Angioletti, Carmen [0000-0002-0341-1679], Löbe, Matthias [0000-0002-2344-0426], Ganapathy, Nagarajan [0000-0002-3743-5388], Almada, Marta [0000-0001-6575-1698], Costa, Elisio [0000-0003-1158-1480], Chronaki, Catherine [0000-0001-6638-8448], Cornet, Ronald0000-0002-1704-5980, Poblador-Plou, Beatriz0000-0002-5119-5093, Carmona-Pírez, Jonás0000-0002-6268-8803, Gaudet-Blavignac, Christophe [0000-0001-6527-5898], Lovis, Christian [0000-0002-2681-8076], Ashley, Kevin [0000-0001-7546-5978], Horton, Laurence [0000-0003-2742-6434], Parra-Calderón, Carlos Luis [0000-0003-2609-575X], Álvarez-Romero, Celia, Martínez-García, Alicia, Sinaci, A. Anil, Gencturk, Mert, Méndez-Rodríguez, Eva, Hernández-Pérez, Tony, Liperoti, Rosa, Angioletti, Carmen, Löbe, Matthias, Ganapathy, Nagarajan, Deserno, Thomas, Almada, Marta, Costa, Elisio, Chronaki, Catherine, Cangioli, Giorgio, Cornet, Ronald, Poblador-Plou, Beatriz, Carmona-Pírez, Jonás, Gimeno-Miguel, Antonio, Poncel-Falcó, Antonio, Prados-Torres, Alexandra, Kovacevic, Tomi, Zaric, Bojan, Bokan, Darijo, Hromis, Sanja, Djekic Malbasa, Jelena, Rapallo Fernández, Carlos, Velázquez Fernández, Teresa, Rochat, Jessica, Gaudet-Blavignac, Christophe, Lovis, Christian, Weber, Patrick, Quintero, Miriam, Pérez-Pérez, Manuel M., Ashley, Kevin, Horton, Laurence, Parra-Calderón, Carlos Luis, European Commission, Instituto de Salud Carlos III, Álvarez-Romero, Celia [0000-0001-8647-9515], Sinaci, A. Anil [0000-0003-4397-3382], Gencturk, Mert [0000-0003-2697-5722], Méndez-Rodríguez, Eva [0000-0002-5337-4722], Hernández-Pérez, Tony [0000-0001-8404-9247], Angioletti, Carmen [0000-0002-0341-1679], Löbe, Matthias [0000-0002-2344-0426], Ganapathy, Nagarajan [0000-0002-3743-5388], Almada, Marta [0000-0001-6575-1698], Costa, Elisio [0000-0003-1158-1480], Chronaki, Catherine [0000-0001-6638-8448], Cornet, Ronald0000-0002-1704-5980, Poblador-Plou, Beatriz0000-0002-5119-5093, Carmona-Pírez, Jonás0000-0002-6268-8803, Gaudet-Blavignac, Christophe [0000-0001-6527-5898], Lovis, Christian [0000-0002-2681-8076], Ashley, Kevin [0000-0001-7546-5978], Horton, Laurence [0000-0003-2742-6434], Parra-Calderón, Carlos Luis [0000-0003-2609-575X], Álvarez-Romero, Celia, Martínez-García, Alicia, Sinaci, A. Anil, Gencturk, Mert, Méndez-Rodríguez, Eva, Hernández-Pérez, Tony, Liperoti, Rosa, Angioletti, Carmen, Löbe, Matthias, Ganapathy, Nagarajan, Deserno, Thomas, Almada, Marta, Costa, Elisio, Chronaki, Catherine, Cangioli, Giorgio, Cornet, Ronald, Poblador-Plou, Beatriz, Carmona-Pírez, Jonás, Gimeno-Miguel, Antonio, Poncel-Falcó, Antonio, Prados-Torres, Alexandra, Kovacevic, Tomi, Zaric, Bojan, Bokan, Darijo, Hromis, Sanja, Djekic Malbasa, Jelena, Rapallo Fernández, Carlos, Velázquez Fernández, Teresa, Rochat, Jessica, Gaudet-Blavignac, Christophe, Lovis, Christian, Weber, Patrick, Quintero, Miriam, Pérez-Pérez, Manuel M., Ashley, Kevin, Horton, Laurence, and Parra-Calderón, Carlos Luis

Abstract

Due to the nature of health data, its sharing and reuse for research are limited by ethical, legal and technical barriers. The FAIR4Health project facilitated and promoted the application of FAIR principles in health research data, derived from the publicly funded health research initiatives to make them Findable, Accessible, Interoperable, and Reusable (FAIR). To confirm the feasibility of the FAIR4Health solution, we performed two pathfinder case studies to carry out federated machine learning algorithms on FAIRified datasets from five health research organizations. The case studies demonstrated the potential impact of the developed FAIR4Health solution on health outcomes and social care research. Finally, we promoted the FAIRified data to share and reuse in the European Union Health Research community, defining an effective EU-wide strategy for the use of FAIR principles in health research and preparing the ground for a roadmap for health research institutions. This scientific report presents a general overview of the FAIR4Health solution: from the FAIRification workflow design to translate raw data/metadata to FAIR data/metadata in the health research domain to the FAIR4Health demonstrators' performance.

Published
2022

26. Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and Their Association with Mortality through a Frequent Pattern Growth Association Algorithm

Author

European Commission, Instituto de Salud Carlos III, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (España), Red de Investigación en Comunicación Comunitaria, Alternativa y Participativa (España), Instituto de Investigación Sanitaria Aragón, Carmona-Pírez, Jonás, Poblador-Plou, Beatriz, Poncel-Falcó, Antonio, Rochat, Jessica, Álvarez-Romero, Celia, Martínez-García, Alicia, Angioletti, Carmen, Almada, Marta, Gencturk, Mert, Sinaci, A. Anil, Ternero Vega, Jara Eloísa, Gaudet-Blavignac, Christophe, Lovis, Christian, Liperoti, Rosa, Costa, Elisio, Parra-Calderón, Carlos Luis, Moreno-Juste, Aida, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, European Commission, Instituto de Salud Carlos III, Red de Investigación en Servicios de Salud en Enfermedades Crónicas (España), Red de Investigación en Comunicación Comunitaria, Alternativa y Participativa (España), Instituto de Investigación Sanitaria Aragón, Carmona-Pírez, Jonás, Poblador-Plou, Beatriz, Poncel-Falcó, Antonio, Rochat, Jessica, Álvarez-Romero, Celia, Martínez-García, Alicia, Angioletti, Carmen, Almada, Marta, Gencturk, Mert, Sinaci, A. Anil, Ternero Vega, Jara Eloísa, Gaudet-Blavignac, Christophe, Lovis, Christian, Liperoti, Rosa, Costa, Elisio, Parra-Calderón, Carlos Luis, Moreno-Juste, Aida, Gimeno-Miguel, Antonio, and Prados-Torres, Alexandra

Abstract

The current availability of electronic health records represents an excellent research opportunity on multimorbidity, one of the most relevant public health problems nowadays. However, it also poses a methodological challenge due to the current lack of tools to access, harmonize and reuse research datasets. In FAIR4Health, a European Horizon 2020 project, a workflow to implement the FAIR (findability, accessibility, interoperability and reusability) principles on health datasets was developed, as well as two tools aimed at facilitating the transformation of raw datasets into FAIR ones and the preservation of data privacy. As part of this project, we conducted a multicentric retrospective observational study to apply the aforementioned FAIR implementation workflow and tools to five European health datasets for research on multimorbidity. We applied a federated frequent pattern growth association algorithm to identify the most frequent combinations of chronic diseases and their association with mortality risk. We identified several multimorbidity patterns clinically plausible and consistent with the bibliography, some of which were strongly associated with mortality. Our results show the usefulness of the solution developed in FAIR4Health to overcome the difficulties in data management and highlight the importance of implementing a FAIR data policy to accelerate responsible health research.

Published
2022

28. Multimorbidity Profiles and Infection Severity in COVID-19 Population Using Network Analysis in the Andalusian Health Population Database

Author

Carmona-Pírez, Jonás, primary, Ioakeim-Skoufa, Ignatios, additional, Gimeno-Miguel, Antonio, additional, Poblador-Plou, Beatriz, additional, González-Rubio, Francisca, additional, Muñoyerro-Muñiz, Dolores, additional, Rodríguez-Herrera, Juliana, additional, Goicoechea-Salazar, Juan Antonio, additional, Prados-Torres, Alexandra, additional, and Villegas-Portero, Román, additional

Published
2022
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29. Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial.

Author

Cura-Gonzalez, Isabel del, primary, Rodriguez, Juan A Lopez-, additional, Leiva-Fernández, Francisca, additional, Gimeno-Feliu, Luis A, additional, Pico-Soler, Victoria, additional, Bujalance-Zafra, Mª Josefa, additional, Domínguez-Santaella, Miguel, additional, Polentinos-Castro, Elena, additional, Poblador-Plou, Beatriz, additional, Ara-Bardají, Paula, additional, Pascual-Salcedo, Mercedes Aza-, additional, Rogero-Blanco, Marisa, additional, Castillo-Jiménez, Marcos, additional, Lozano-Hernández, Cristina, additional, Gimeno-Miguel, Antonio, additional, González-Rubio, Francisca, additional, Medina-García, Rodrigo, additional, González-Hevilla, Alba, additional, Gil-Conesa, Mario, additional, Martín-Fernández, Jesús, additional, Valderas, José M, additional, Marengoni, Alessandra, additional, Muth, Christiane, additional, Prados-Torres, J Daniel, additional, Prados-Torres, Alexandra, additional, and Group, MULTIPAP PLUS, additional

Published
2022
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30. Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and Their Association with Mortality through a Frequent Pattern Growth Association Algorithm

Author

Carmona-Pírez, Jonás, primary, Poblador-Plou, Beatriz, additional, Poncel-Falcó, Antonio, additional, Rochat, Jessica, additional, Alvarez-Romero, Celia, additional, Martínez-García, Alicia, additional, Angioletti, Carmen, additional, Almada, Marta, additional, Gencturk, Mert, additional, Sinaci, A. Anil, additional, Ternero-Vega, Jara Eloisa, additional, Gaudet-Blavignac, Christophe, additional, Lovis, Christian, additional, Liperoti, Rosa, additional, Costa, Elisio, additional, Parra-Calderón, Carlos Luis, additional, Moreno-Juste, Aida, additional, Gimeno-Miguel, Antonio, additional, and Prados-Torres, Alexandra, additional

Published
2022
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31. Additional file 2 of Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial

Author

del Cura-González, Isabel, López-Rodríguez, Juan A., Leiva-Fernández, Francisca, Gimeno-Feliu, Luis A., Pico-Soler, Victoria, Bujalance-Zafra, Mª. Josefa, Domínguez-Santaella, Miguel, Polentinos-Castro, Elena, Poblador-Plou, Beatriz, Ara-Bardají, Paula, Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, Castillo-Jiménez, Marcos, Lozano-Hernández, Cristina, Gimeno-Miguel, Antonio, González-Rubio, Francisca, Medina-García, Rodrigo, González-Hevilla, Alba, Gil-Conesa, Mario, Martín-Fernández, Jesús, Valderas, José M., Marengoni, Alessandra, Muth, Christiane, Prados-Torres, J. Daniel, and Prados-Torres, Alexandra

Abstract

Additional file 2: SPIRIT Trial Modifications in Extenuating Circumstance.

Published
2022
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32. Técnicas de aprendizaje automático en estudios epidemiológicos longitudinales. Aplicación a la Cohorte EpiChron de investigación en multimorbilidad

Author

Campo León, Elena, Alcalá Nalvaiz, José Tomás, and Gimeno Miguel, Antonio

Abstract

Se presentan las técnicas de Machine Learning, clúster difuso y reglas de asociación, aplicables a estudios longitudinales de tipo cohorte, en particular se aplica a una muestra de pacientes de entre 65 y 75 años durante los años 2010 a 2019, proveniente de la Cohorte EpiChron, de investigación en multimorbilidad, que contiene información de tipo médico sobre la población usuaria del sistema de salud público de Aragón.El objetivo final será la aplicación de estas técnicas para obtener una agrupación de enfermedades en diferentes clusters y construir trayectorias de multimorbilidad entre enfermedades que aparecen con un determinado patrón frecuente, es decir, determinar la secuencia temporal más probable en el diagnóstico.

Published
2022

33. Additional file 1 of Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial

Author

del Cura-González, Isabel, López-Rodríguez, Juan A., Leiva-Fernández, Francisca, Gimeno-Feliu, Luis A., Pico-Soler, Victoria, Bujalance-Zafra, Mª. Josefa, Domínguez-Santaella, Miguel, Polentinos-Castro, Elena, Poblador-Plou, Beatriz, Ara-Bardají, Paula, Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, Castillo-Jiménez, Marcos, Lozano-Hernández, Cristina, Gimeno-Miguel, Antonio, González-Rubio, Francisca, Medina-García, Rodrigo, González-Hevilla, Alba, Gil-Conesa, Mario, Martín-Fernández, Jesús, Valderas, José M., Marengoni, Alessandra, Muth, Christiane, Prados-Torres, J. Daniel, and Prados-Torres, Alexandra

Abstract

Additional file 1: CONSERVE-SPIRIT checklist.

Published
2022
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34. Additional file 3 of Effectiveness of the MULTIPAP Plus intervention in youngest-old patients with multimorbidity and polypharmacy aimed at improving prescribing practices in primary care: study protocol of a cluster randomized trial

Author

del Cura-González, Isabel, López-Rodríguez, Juan A., Leiva-Fernández, Francisca, Gimeno-Feliu, Luis A., Pico-Soler, Victoria, Bujalance-Zafra, Mª. Josefa, Domínguez-Santaella, Miguel, Polentinos-Castro, Elena, Poblador-Plou, Beatriz, Ara-Bardají, Paula, Aza-Pascual-Salcedo, Mercedes, Rogero-Blanco, Marisa, Castillo-Jiménez, Marcos, Lozano-Hernández, Cristina, Gimeno-Miguel, Antonio, González-Rubio, Francisca, Medina-García, Rodrigo, González-Hevilla, Alba, Gil-Conesa, Mario, Martín-Fernández, Jesús, Valderas, José M., Marengoni, Alessandra, Muth, Christiane, Prados-Torres, J. Daniel, and Prados-Torres, Alexandra

Abstract

Additional file 3: TIDieR.

Published
2022
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35. Applying the FAIR4Health Solution to Identify Multimorbidity Patterns and their Association with Mortality through a Frequent Pattern Growth Association Algorithm: Validation Study. (Preprint)

Author

Carmona-Pírez, Jonás, primary, Poblador-Plou, Beatriz, additional, Poncel-Falcó, Antonio, additional, Rochat, Jessica, additional, Alvarez-Romero, Celia, additional, Martínez-García, Alicia, additional, Angioletti, Carmen, additional, Almada, Marta, additional, Gencturk, Mert, additional, Sinaci, Anil, additional, Ternero-Vega, Jara Eloisa, additional, Gaudet-Blavignac, Christophe, additional, Lovis, Christian, additional, Liperoti, Rosa, additional, Costa, Elisio, additional, Parra-Calderón, Carlos Luis, additional, Gimeno-Miguel, Antonio, additional, and Prados-Torres, Alexandra, additional

Published
2021
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36. Baseline Drug Treatments as Indicators of Increased Risk of COVID-19 Mortality in Spain and Italy

Author

Bliek-Bueno, Kevin, primary, Mucherino, Sara, additional, Poblador-Plou, Beatriz, additional, González-Rubio, Francisca, additional, Aza-Pascual-Salcedo, Mercedes, additional, Orlando, Valentina, additional, Clerencia-Sierra, Mercedes, additional, Ioakeim-Skoufa, Ignatios, additional, Coscioni, Enrico, additional, Carmona-Pírez, Jonás, additional, Perrella, Alessandro, additional, Trama, Ugo, additional, Prados-Torres, Alexandra, additional, Menditto, Enrica, additional, and Gimeno-Miguel, Antonio, additional

Published
2021
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37. Estudio de la multimorbilidad, polifarmacia y adherencia terapéutica con datos de vida real Study of multimorbidity, polypharmacy and medication adherence using real-world data

Author

Moreno Juste, Aida, Gimeno Miguel, Antonio, Aza Pascual Salcedo, María Mercedes, and Saenz Galilea, María Ángeles

Subjects
medicina preventiva
Abstract

Antecedentes y objetivos La multimorbilidad, definida como la presencia de dos o más enfermedades crónicas de forma simultánea en un individuo, y la polifarmacia, es decir, la prescripción simultánea y prolongada de múltiples medicamentos en un solo individuo tienen un gran impacto en la salud de los pacientes y en el uso de los recursos sanitarios. Por ello es necesario avanzar en su caracterización, así como en el estudio de la adherencia terapéutica, ya que las consecuencias clínicas de un bajo cumplimiento terapéutico pueden comprometer la calidad de vida y morbimortalidad de los pacientes con multimorbilidad y polifarmacia.El objetivo general de esta tesis que se presenta es avanzar en el conocimiento de la multimorbilidad y polifarmacia, a través del estudio de la relación entre las diferentes enfermedades crónicas y fármacos, y su papel en la adherencia terapéutica en las enfermedades crónicas más prevalentes, utilizando datos clínicos reales procedentes de grandes bases de datos poblacionales.Las preguntas de investigación se responden en cuatro artículos publicados y vinculados a cada uno de los siguientes objetivos específicos: a) determinar la presencia de asociaciones sistemáticas entre enfermedades crónicas y fármacos en forma de patrones de multimorbilidad y polifarmacia, y valorar la presencia de interacciones medicamentosas y de cascada terapéutica; b) estudiar la influencia de la multimorbilidad y polifarmacia en la adherencia terapéutica en las enfermedades crónicas con alto riesgo cardiovascular más prevalentes; c) caracterizar el patrón de tratamiento de la diabetes mellitus en la población de Aragón, la persistencia al tratamiento y la influencia en ella de la multimorbilidad y polifarmacia; d) comparar el patrón de uso de antidiabéticos y los factores que afectan a su persistencia entre España (Aragón) e Italia (Campania).MetodologíaEl primer objetivo específico se abordó a través de la realización de un análisis factorial exploratorio enfocado a detectar asociaciones no aleatorias entre enfermedades crónicas y fármacos, permitiendo la identificación de patrones de multimorbilidad y polifarmacia.El segundo objetivo específico se llevó a cabo a través de la realización de un estudio descriptivo de la población y de la adherencia terapéutica, y de un modelo de regresión logística binaria para valorar la relación entre adherencia (variable dependiente) y las variables independientes: género, edad (estratificada en los tres grupos de edad), número de fármacos co-prescritos, número de comorbilidades crónicas, y presencia de enfermedad mental.Para el tercer y cuarto objetivos específicos, se realizó un estudio descriptivo de los patrones de prescripción de antidiabéticos, la persistencia se calculó usando el método Kaplan-Meier, y se desarrolló el modelo de regresión de Cox para estimar el riesgo de discontinuación durante un año de seguimiento.ConclusionesSe identificaron asociaciones sistemáticas entre enfermedades crónicas y fármacos en forma de 6 patrones de multimorbilidad y polifarmacia denominados: respiratorio, salud mental, cardiometabólico, endocrinológico, osteometabólico y mecánico-dolor. Las diferencias en su composición dependieron en parte del género y de la edad del paciente, y se identificó la presencia de interacciones fármaco-fármaco, cascada terapéutica y diferencias de género.Existió una adherencia terapéutica sub-óptima al tratamiento de la hipertensión arterial, dislipemia y diabetes mellitus en España.La población española diagnosticada de diabetes mellitus tipo 2 presentó una alta tasa de multimorbilidad y polifarmacia, y el patrón de prescripción de antidiabéticos fue muy similar en España e Italia siguiendo las recomendaciones de las guías de práctica clínica. En cuanto a la persistencia de estas dos poblaciones, 7 de cada 10 españoles y 8 de cada 10 italianos fueron persistentes a su tratamiento antidiabético. No se observó una relación consistente sobre el impacto de la multimorbilidad y polifarmacia en la adherencia y persistencia.

Published
2021

38. Chronic Obstructive Pulmonary Disease and Incidence of Hip Fracture: A Nested Case-Control Study in the EpiChron Cohort

Author

Díez-Manglano, Jesús, Berges Vidal, María, Martínez Barredo, Lucía, Poblador-Plou, Beatriz, Gimeno-Miguel, Antonio, Martínez Heras, Pilar, and Prados-Torres, Alexandra

Subjects
lcsh:RC705-779, Male, Hip Fractures, case-control study, Incidence, case–control study, lcsh:Diseases of the respiratory system, Comorbidity, chronic obstructive pulmonary disease, Pulmonary Disease, Chronic Obstructive, hip fracture, Risk Factors, Spain, Case-Control Studies, Humans, Female, Original Research, Aged
Abstract

Jesús Díez-Manglano,1,2 María Berges Vidal,2 Lucía Martínez Barredo,3 Beatriz Poblador-Plou,2 Antonio Gimeno-Miguel,2 Pilar Martínez Heras,3 Alexandra Prados-Torres2 1Internal Medicine Department, Royo Villanova Hospital, Zaragoza, Spain; 2EpiChron Research Group, Aragon Health Sciences Institute, IIS Aragón, REDISSEC, Zaragoza, Spain; 3Internal Medicine Department, Miguel Servet University Hospital, Zaragoza, SpainCorrespondence: Jesús Díez-Manglano Duquesa Villahermosa nº 163, 8º D, Zaragoza 50009, SpainTel +34976466910Fax +34976466919Email jdiez@aragon.esPurpose: To determine whether chronic obstructive pulmonary disease (COPD) is a risk factor for hip fracture and identify other factors associated with hip fracture.Patients and Methods: Observational nested case–control study was conducted in Aragon, Spain in 2010. We included COPD patients aged > 40 years, in the EpiChron cohort. Each COPD patient was matched for age, sex, and number of comorbidities with a control subject without COPD. Patients with an existing diagnosis of osteoporosis and those with hip fracture before 2011 were excluded. We collected baseline demographic, comorbidity, and pharmacological treatment data. During a 5-year follow-up period, we recorded the incidence of hip fracture. A logistic regression model was constructed to identify factors associated with hip fracture.Results: The study population consisted of 26,517 COPD patients and the same number of controls (median [interquartile range] age, 74 [17] years; women, 24.7%). Smoking and heart failure were more frequent in COPD patients, and obesity, hypertension, diabetes, dyslipidemia, stroke, arthritis, and visual or hearing impairment were less frequent (all p< 0.001). Consumption of benzodiazepines (p=0.037), bronchodilators (p< 0.001), and corticosteroids (p< 0.001) was higher in the COPD group, while that of beta-blockers and thiazides was lower (both p< 0.001). During follow-up, 898 (1.7%) patients experienced hip fracture, with no differences observed between COPD and control patients. Multivariate analysis revealed that independent of COPD status, age, female sex, chronic liver disease, heart failure, and benzodiazepine use were independently associated with a higher risk of hip fracture, and obesity with a lower risk. In COPD patients, use of inhaled anticholinergics was independently associated with hip fracture (OR, 1.390; 95% CI 1.134– 1.702; p=0.001).Conclusion: COPD is not a risk factor for a hip fracture within 5 years. The association between the use of inhaled anticholinergics and risk of hip fracture warrants further study.Keywords: chronic obstructive pulmonary disease, hip fracture, case–control study, incidence

Published
2020

39. Changes in Multimorbidity and Polypharmacy Patterns in Young and Adult Population over a 4-Year Period: A 2011–2015 Comparison Using Real-World Data

Author

Mucherino, Sara, primary, Gimeno-Miguel, Antonio, additional, Carmona-Pirez, Jonas, additional, Gonzalez-Rubio, Francisca, additional, Ioakeim-Skoufa, Ignatios, additional, Moreno-Juste, Aida, additional, Orlando, Valentina, additional, Aza-Pascual-Salcedo, Mercedes, additional, Poblador-Plou, Beatriz, additional, Menditto, Enrica, additional, and Prados-Torres, Alexandra, additional

Published
2021
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41. Application of the JA-CHRODIS Integrated Multimorbidity Care Model (IMCM) to a Case Study of Diabetes and Mental Health

Author

Forjaz, Maria J., Rodriguez-Blazquez, Carmen, Guerrero Fernández de Alba, Inmaculada, Gimeno-Miguel, Antonio, Bliek-Bueno, Kevin, Prados-Torres, Alexandra, Culig, J, Jureviciene, E, Maggini, M, Maguire, P, Mammarella, F, Moor, V, Navickas, R, Onder, G, Elorriaga, KP, Rijken, M, Rothe, U, Schellevis, F, Segovia, C, and Zaletel, J

Abstract

The Integrated Multimorbidity Care Model (IMCM), developed by the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS), proposes a set of 16 multidimensional components (i.e., recommendations) to improve the care of persons with multimorbidity in Europe. This study aimed at analyzing the potential applicability of the IMCM. We followed a qualitative approach that comprised two phases: (1) The design of a case study based on empirical clinical data, which consisted of a hypothetical woman with multimorbidity, type 2 diabetes mellitus, mental health, and associated social problems, and (2) the creation of a consensus group to gather the opinions of a multidisciplinary group of experts and consider the potential applicability of the IMCM to our case study. Experts described how care should be delivered to this patient according to each model component, suggested the use of specific rating scales and tools to assess her needs in a comprehensive and regular way, and pointed our crucial health and social resources to improve her care process. Experts also highlighted patient-centered, integrated and tailored care as one of the keystones of quality healthcare. Our results suggest that the IMCM is applicable in complex patients with multimorbidity.

Published
2020

43. How to Improve Healthcare for Patients with Multimorbidity and Polypharmacy in Primary Care: A Pragmatic Cluster-Randomized Clinical Trial of the Multipap Intervention

Author

del Cura-González, Isabel, primary, Lopez-Rodriguez, Juan A., additional, Leiva-Fernández, Francisca, additional, Gimeno-Miguel, Antonio, additional, Poblador-Plou, Beatriz, additional, Lopez-Verde, Fernando, additional, Lozano-Hernández, Cristina, additional, Pico-Soler, Victoria, additional, Bujalance-Zafra, M. Josefa, additional, Gimeno-Feliu, Luis A., additional, Aza-Pascual-Salcedo, Mercedes, additional, Rogero-Blanco, Marisa, additional, Gonzalez-Rubio, Francisca, additional, Garcia-de-Blas, Francisca, additional, Polentinos-Castro, Elena, additional, Sanz-Cuesta, Teresa, additional, Castillo-Jimena, Marcos, additional, Alonso-García, Marcos, additional, Calderon-Larranaga, Amaia, additional, Valderas, Jose M., additional, Marengoni, Alessandra, additional, Muth, Christiane, additional, Prados-Torres, Juan D., additional, Prados-Torres, Alexandra, additional, and Group, MULTIPAP, additional

Published
2021
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44. Comorbidity in an Older Population with Type-2 Diabetes Mellitus: Identification of the Characteristics and Healthcare Utilization of High-Cost Patients

Author

Guerrero-Fernández de Alba, Inmaculada, primary, Orlando, Valentina, additional, Monetti, Valeria M., additional, Mucherino, Sara, additional, Gimeno-Miguel, Antonio, additional, Vaccaro, Olga, additional, Forjaz, Maria João, additional, Poblador Plou, Beatriz, additional, Prados-Torres, Alexandra, additional, Riccardi, Gabriele, additional, and Menditto, Enrica, additional

Published
2020
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47. Assessing the Pilot Implementation of the Integrated Multimorbidity Care Model in Five European Settings: Results from the Joint Action CHRODIS-PLUS

Author

Rodriguez-Blazquez, Carmen, primary, João Forjaz, Maria, additional, Gimeno-Miguel, Antonio, additional, Bliek-Bueno, Kevin, additional, Poblador-Plou, Beatriz, additional, Pilar Luengo-Broto, Sara, additional, Guerrero-Fernández de Alba, Inmaculada, additional, Maria Carriazo, Ana, additional, Lama, Carmen, additional, Rodríguez-Acuña, Rafael, additional, Cosano, Inmaculada, additional, Bedoya, Juan José, additional, Angioletti, Carmen, additional, Carfì, Angelo, additional, Di Paola, Antonella, additional, Navickas, Rokas, additional, Jureviciene, Elena, additional, Dambrauskas, Laimis, additional, Liseckiene, Ida, additional, Valius, Leonas, additional, Urbonas, Gediminas, additional, Onder, Graziano, additional, and Prados-Torres, Alexandra, additional

Published
2020
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48. Multimorbidity Patterns in the General Population: Results from the EpiChron Cohort Study

Author

Ioakeim-Skoufa, Ignatios, primary, Poblador-Plou, Beatriz, additional, Carmona-Pírez, Jonás, additional, Díez-Manglano, Jesús, additional, Navickas, Rokas, additional, Gimeno-Feliu, Luis Andrés, additional, González-Rubio, Francisca, additional, Jureviciene, Elena, additional, Dambrauskas, Laimis, additional, Prados-Torres, Alexandra, additional, and Gimeno-Miguel, Antonio, additional

Published
2020
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50. Initial Therapy, Regimen Change, and Persistence in a Spanish Cohort of Newly Treated Type 2 Diabetes Patients: A Retrospective, Observational Study Using Real-World Data

Author

Moreno-Juste, Aida, primary, Poblador-Plou, Beatriz, additional, Aza-Pascual-Salcedo, Mercedes, additional, González-Rubio, Francisca, additional, Malo, Sara, additional, Librero López, Julián, additional, Pico-Soler, Victoria, additional, Giménez Labrador, Eva, additional, Mucherino, Sara, additional, Orlando, Valentina, additional, Menditto, Enrica, additional, Prados-Torres, Alexandra, additional, and Gimeno-Miguel, Antonio, additional

Published
2020
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