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2. Primary care utilisation patterns among an urban immigrant population in the Spanish National Health System

Author

Bordonaba-Bosque Daniel, Poblador-Plou Beatriz, Macipe-Costa Rosa, Gimeno-Feliu Luis A, Calderón-Larrañaga Amaia, and Prados-Torres Alexandra

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background There is evidence suggesting that the use of health services is lower among immigrants after adjusting for age and sex. This study takes a step forward to compare primary care (PC) utilisation patterns between immigrants and the native population with regard to their morbidity burden. Methods This retrospective, observational study looked at 69,067 individuals representing the entire population assigned to three urban PC centres in the city of Zaragoza (Aragon, Spain). Poisson models were applied to determine the number of annual PC consultations per individual based on immigration status. All models were first adjusted for age and sex and then for age, sex and case mix (ACG System®). Results The age and sex adjusted mean number of total annual consultations was lower among the immigrant population (children: IRR = 0.79, p < 0.05; adults: IRR = 0.73, p < 0.05). After adjusting for morbidity burden, this difference decreased among children (IRR = 0.94, p < 0.05) and disappeared among adults (IRR = 1.00). Further analysis considering the PC health service and type of visit revealed higher usage of routine diagnostic tests among immigrant children (IRR = 1.77, p < 0.05) and a higher usage of emergency services among the immigrant adult population (IRR = 1.2, p < 0.05) after adjusting for age, sex and case mix. Conclusions Although immigrants make lower use of PC services than the native population after adjusting the consultation rate for age and sex, these differences decrease significantly when considering their morbidity burden. These results reinforce the 'healthy migration effect' and discount the existence of differences in PC utilisation patterns between the immigrant and native populations in Spain.

Published
2011
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3. Does the pharmacy expenditure of patients always correspond with their morbidity burden? Exploring new approaches in the interpretation of pharmacy expenditure

Author

Abad-Díez José, Alcalá-Nalvaiz José, López-Cabañas Anselmo, Poblador-Plou Beatriz, Calderón-Larrañaga Amaia, Bordonaba-Bosque Daniel, and Prados-Torres Alexandra

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background The computerisation of primary health care (PHC) records offers the opportunity to focus on pharmacy expenditure from the perspective of the morbidity of individuals. The objective of the present study was to analyse the behaviour of pharmacy expenditure within different morbidity groups. We paid special attention to the identification of individuals who had higher values of pharmacy expenditure than their morbidity would otherwise suggest (i.e. outliers). Methods Observational study consisting of 75,574 patients seen at PHC centres in Zaragoza, Spain, at least once in 2005. Demographic and disease variables were analysed (ACG® 8.1), together with a response variable that we termed 'total pharmacy expenditure per patient'. Outlier patients were identified based on boxplot methods, adjusted boxplot for asymmetric distributions, and by analysing standardised residuals of tobit regression models. Results The pharmacy expenditure of up to 7% of attendees in the studied PHC centres during one year exceeded expectations given their morbidity burden. This group of patients was responsible for up to 24% of the total annual pharmacy expenditure. There was a significantly higher number of outlier patients within the low-morbidity band which matched up with the higher variation coefficient observed in this group (3.2 vs. 2.0 and 1.3 in the moderate- and high-morbidity bands, respectively). Conclusions With appropriate validation, the methodologies of the present study could be incorporated in the routine monitoring of the prescribing profile of general practitioners. This could not only enable evaluation of their performance, but also target groups of outlier patients and foster analyses of the causes of unusually high pharmacy expenditures among them. This interpretation of pharmacy expenditure gives new clues for the efficiency in utilisation of healthcare resources, and could be complementary to management interventions focused on individuals with a high morbidity burden.

Published
2010
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4. Applying diagnosis and pharmacy-based risk models to predict pharmacy use in Aragon, Spain: The impact of a local calibration

Author

Weiner Jonathan P, Poblador-Plou Beatriz, Abrams Chad, Calderón-Larrañaga Amaia, and Prados-Torres Alexandra

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background In the financing of a national health system, where pharmaceutical spending is one of the main cost containment targets, predicting pharmacy costs for individuals and populations is essential for budget planning and care management. Although most efforts have focused on risk adjustment applying diagnostic data, the reliability of this information source has been questioned in the primary care setting. We sought to assess the usefulness of incorporating pharmacy data into claims-based predictive models (PMs). Developed primarily for the U.S. health care setting, a secondary objective was to evaluate the benefit of a local calibration in order to adapt the PMs to the Spanish health care system. Methods The population was drawn from patients within the primary care setting of Aragon, Spain (n = 84,152). Diagnostic, medication and prior cost data were used to develop PMs based on the Johns Hopkins ACG methodology. Model performance was assessed through r-squared statistics and predictive ratios. The capacity to identify future high-cost patients was examined through c-statistic, sensitivity and specificity parameters. Results The PMs based on pharmacy data had a higher capacity to predict future pharmacy expenses and to identify potential high-cost patients than the models based on diagnostic data alone and a capacity almost as high as that of the combined diagnosis-pharmacy-based PM. PMs provided considerably better predictions when calibrated to Spanish data. Conclusion Understandably, pharmacy spending is more predictable using pharmacy-based risk markers compared with diagnosis-based risk markers. Pharmacy-based PMs can assist plan administrators and medical directors in planning the health budget and identifying high-cost-risk patients amenable to care management programs.

Published
2010
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5. Pharmaceutical cost control in primary care: opinion and contributions by healthcare professionals

Author

Oliván-Blázquez Bárbara, March-Llull Sebastià, Sicras-Mainar Antoni, Calderón-Larrañaga Amaia, and Prados-Torres Alexandra

Subjects
Public aspects of medicine, RA1-1270
Abstract

Abstract Background Strategies adopted by health administrations and directed towards drug cost control in primary care (PC) can, according to earlier studies, generate tension between health administrators and healthcare professionals. This study collects and analyzes the opinions of general practitioners (GPs) regarding current cost control measures as well as their proposals for improving the effectiveness of these measures. Methods A qualitative exploratory study was carried out using 11 focus groups composed of GPs from the Spanish regions of Aragon, Catalonia and the Balearic Islands. A semi-structured guide was applied in obtaining the GPs' opinions. The transcripts of the dialogues were analyzed by two investigators who independently considered categorical and thematic content. The results were supervised by other members of the team, with overall responsibility assigned to the team leader. Results GPs are conscious of their public responsibility with respect to pharmaceutical cost, but highlight the need to spread responsibility for cost control among the different actors of the health system. They insist on implementing measures to improve the quality of prescriptions, avoiding mere quantitative evaluations of prescription costs. They also suggest moving towards the self-management of the pharmaceutical budget by each health centre itself, as a means to design personalized incentives to improve their outcomes. These proposals need to be considered by the health administration in order to pre-empt the feelings of injustice, impotence, frustration and lack of motivation that currently exist among GPs as a result of the implemented measures. Conclusion Future investigations should be oriented toward strategies that involve GPs in the planning and management of drug cost control mechanisms. The proposals in this study may be considered by the health administration as a means to move toward the rational use of drugs while avoiding concerns about injustice and feelings of impotence on the part of the GPs, which can lead to lack of interest in and disaffection with the current measures.

Published
2009
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8. 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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9. Metadata for Data dIscoverability aNd Study rEplicability in obseRVAtional Studies (MINERVA): Development and Pilot of a Metadata List and Catalogue in Europe

Author

Infection & Immunity, Child Health, Data Science & Biostatistiek, Pajouheshnia, Romin, Gini, Rosa, Gutierrez, Lia, Swertz, Morris A, Hyde, Eleanor, Sturkenboom, Miriam, Arana, Alejandro, Franzoni, Carla, Ehrenstein, Vera, Roberto, Giuseppe, Gil, Miguel, Maciá, Miguel Angel, Schäfer, Wiebke, Haug, Ulrike, Thurin, Nicolas H, Lassalle, Régis, Droz-Perroteau, Cécile, Zaccagnino, Silvia, Busto, Maria Paula, Middelkoop, Bas, Gembert, Karin, Sanchez-Saez, Francisco, Rodriguez-Bernal, Clara, Sanfélix-Gimeno, Gabriel, Hurtado, Isabel, Acosta, Manuel Barreiro de, Poblador-Plou, Beatriz, Carmona-Pírez, Jonás, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, Schultze, Anna, Jansen, Ella, Herings, Ron, Kuiper, Josine, Locatelli, Igor, Jazbar, Janja, Žerovnik, Špela, Kos, Mitja, Smit, Steven, Lind, Sirje, Metspalu, Andres, Simou, Stefania, Hedenmalm, Karin, Cochino, Ana, Alcini, Paolo, Kurz, Xavier, Perez-Gutthann, Susana, Infection & Immunity, Child Health, Data Science & Biostatistiek, Pajouheshnia, Romin, Gini, Rosa, Gutierrez, Lia, Swertz, Morris A, Hyde, Eleanor, Sturkenboom, Miriam, Arana, Alejandro, Franzoni, Carla, Ehrenstein, Vera, Roberto, Giuseppe, Gil, Miguel, Maciá, Miguel Angel, Schäfer, Wiebke, Haug, Ulrike, Thurin, Nicolas H, Lassalle, Régis, Droz-Perroteau, Cécile, Zaccagnino, Silvia, Busto, Maria Paula, Middelkoop, Bas, Gembert, Karin, Sanchez-Saez, Francisco, Rodriguez-Bernal, Clara, Sanfélix-Gimeno, Gabriel, Hurtado, Isabel, Acosta, Manuel Barreiro de, Poblador-Plou, Beatriz, Carmona-Pírez, Jonás, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, Schultze, Anna, Jansen, Ella, Herings, Ron, Kuiper, Josine, Locatelli, Igor, Jazbar, Janja, Žerovnik, Špela, Kos, Mitja, Smit, Steven, Lind, Sirje, Metspalu, Andres, Simou, Stefania, Hedenmalm, Karin, Cochino, Ana, Alcini, Paolo, Kurz, Xavier, and Perez-Gutthann, Susana

Published
2024

10. Metadata for Data dIscoverability aNd Study rEplicability in obseRVAtional Studies (MINERVA): Lessons Learnt From the MINERVA Project in Europe

Author

Data Science & Biostatistiek, Child Health, Infection & Immunity, Gini, Rosa, Pajouheshnia, Romin, Gutierrez, Lia, Swertz, Morris A, Hyde, Eleanor, Sturkenboom, Miriam, Arana, Alejandro, Franzoni, Carla, Ehrenstein, Vera, Roberto, Giuseppe, Gil, Miguel, Maciá, Miguel Angel, Schäfer, Wiebke, Haug, Ulrike, Thurin, Nicolas H, Lassalle, Régis, Droz-Perroteau, Cécile, Zaccagnino, Silvia, Busto, Maria Paula, Middelkoop, Bas, Gembert, Karin, Sanchez-Saez, Francisco, Rodriguez-Bernal, Clara, Sanfélix-Gimeno, Gabriel, Hurtado, Isabel, Acosta, Manuel Barreiro de, Poblador-Plou, Beatriz, Carmona-Pírez, Jonás, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, Schultze, Anna, Jansen, Ella, Herings, Ron, Kuiper, Josine, Locatelli, Igor, Jazbar, Janja, Žerovnik, Špela, Kos, Mitja, Smit, Steven, Lind, Sirje, Metspalu, Andres, Simou, Stefania, Hedenmalm, Karin, Cochino, Ana, Alcini, Paolo, Kurz, Xavier, Perez-Gutthann, Susana, Data Science & Biostatistiek, Child Health, Infection & Immunity, Gini, Rosa, Pajouheshnia, Romin, Gutierrez, Lia, Swertz, Morris A, Hyde, Eleanor, Sturkenboom, Miriam, Arana, Alejandro, Franzoni, Carla, Ehrenstein, Vera, Roberto, Giuseppe, Gil, Miguel, Maciá, Miguel Angel, Schäfer, Wiebke, Haug, Ulrike, Thurin, Nicolas H, Lassalle, Régis, Droz-Perroteau, Cécile, Zaccagnino, Silvia, Busto, Maria Paula, Middelkoop, Bas, Gembert, Karin, Sanchez-Saez, Francisco, Rodriguez-Bernal, Clara, Sanfélix-Gimeno, Gabriel, Hurtado, Isabel, Acosta, Manuel Barreiro de, Poblador-Plou, Beatriz, Carmona-Pírez, Jonás, Gimeno-Miguel, Antonio, Prados-Torres, Alexandra, Schultze, Anna, Jansen, Ella, Herings, Ron, Kuiper, Josine, Locatelli, Igor, Jazbar, Janja, Žerovnik, Špela, Kos, Mitja, Smit, Steven, Lind, Sirje, Metspalu, Andres, Simou, Stefania, Hedenmalm, Karin, Cochino, Ana, Alcini, Paolo, Kurz, Xavier, and Perez-Gutthann, Susana

Published
2024

15. Antidepressant use in Denmark, Germany, Spain, and Sweden between 2009 and 2014: Incidence and comorbidities of antidepressant initiators

Author

Forns, Joan, Pottegård, Anton, Reinders, Tammo, Poblador-Plou, Beatriz, Morros, Rosa, Brandt, Lena, Cainzos-Achirica, Miguel, Hellfritzsch, Maja, Schink, Tania, Prados-Torres, Alexandra, Giner-Soriano, Maria, Hägg, David, Hallas, Jesper, Cortés, Jordi, Jacquot, Emmanuelle, Deltour, Nicolas, Perez-Gutthann, Susana, Pladevall, Manel, and Reutfors, Johan

Published
2019
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17. Multimorbidity care model: Recommendations from the consensus meeting of the Joint Action on Chronic Diseases and Promoting Healthy Ageing across the Life Cycle (JA-CHRODIS)

Author

Palmer, Katie, Marengoni, Alessandra, Forjaz, Maria João, Jureviciene, Elena, Laatikainen, Tiina, Mammarella, Federica, Muth, Christiane, Navickas, Rokas, Prados-Torres, Alexandra, Rijken, Mieke, Rothe, Ulrike, Souchet, Laurène, Valderas, Jose, Vontetsianos, Theodore, Zaletel, Jelka, and Onder, Graziano

Published
2018
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20. Risk of Acute Liver Injury in Agomelatine and Other Antidepressant Users in Four European Countries: A Cohort and Nested Case–Control Study Using Automated Health Data Sources

Author

Pladevall-Vila, Manel, Pottegård, Anton, Schink, Tania, Reutfors, Johan, Morros, Rosa, Poblador-Plou, Beatriz, Timmer, Antje, Forns, Joan, Hellfritzsch, Maja, Reinders, Tammo, Hägg, David, Giner-Soriano, Maria, Prados-Torres, Alexandra, Cainzos-Achirica, Miguel, Hallas, Jesper, Brandt, Lena, Cortés, Jordi, Aguado, Jaume, Perlemuter, Gabriel, Falissard, Bruno, Castellsagué, Jordi, Jacquot, Emmanuelle, Deltour, Nicolas, and Perez-Gutthann, Susana

Published
2019
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23. 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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31. 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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39. 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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40. 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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41. Sex differences in social support perceived by polymedicated older adults with multimorbidity. MULTIPAP study

Author

Lozano-Hernández, Cristina M., López-Rodríguez, Juan Antonio, Rico-Blázquez, Milagros, Calderón-Larrañaga, Amaia, Leiva-Fernández, Francisca, Prados-Torres, Alexandra, del Cura-González, Isabel, Lozano-Hernández, Cristina M., López-Rodríguez, Juan Antonio, Rico-Blázquez, Milagros, Calderón-Larrañaga, Amaia, Leiva-Fernández, Francisca, Prados-Torres, Alexandra, and del Cura-González, Isabel

Abstract

The beneficial effects of social support on morbidity, mortality, and quality of life are well known. Using the baseline data of the MULTIPAP study (n = 593), an observational, descriptive, cross-sectional study was carried out that analyzed the sex differences in the social support perceived by polymedicated adults aged 65 to 74 years with multimorbidity. The main outcome variable was social support measured through the Duke–UNC-11 Functional Social Support (DUFSS) questionnaire in its two dimensions (confident support and affective support). For both sexes, the perception of functional social support was correlated with being married or partnered and having a higher health-related quality of life utility index. In women, it was correlated with a higher level of education, living alone, and treatment adherence, and in men with higher monthly income, prescribed drugs and fewer diagnosed diseases.

Published
2022
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42. 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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43. 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

44. 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

45. 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

46. Assessing and Measuring Chronic Multimorbidity in the Older Population: A Proposal for Its Operationalization

Author

Calderón-Larrañaga, Amaia, Vetrano, Davide L, Onder, Graziano, Gimeno-Feliu, Luis A, Coscollar-Santaliestra, Carlos, Carfí, Angelo, Pisciotta, Maria S, Angleman, Sara, Melis, René J F, Santoni, Giola, Mangialasche, Francesca, Rizzuto, Debora, Welmer, Anna-Karin, Bernabei, Roberto, Prados-Torres, Alexandra, Marengoni, Alessandra, and Fratiglioni, Laura

Published
2017
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49. 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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50. 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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