A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy
<p><strong>Objectives:</strong> To develop and validate a prognostic model to predict deterioration in health-related quality of life (dHRQoL) in older general practice patients with at least one chronic condition and one chronic prescription.</p> <p><strong>Stud...
| Principais autores: | , , , , , , , , , , , , , , , , , , , , |
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| Formato: | Journal article |
| Idioma: | English |
| Publicado em: |
Elsevier
2020
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| _version_ | 1826310362693107712 |
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| author | González-González, AI Meid, AD Dinh, TS Blom, JW van den Akker, M Elders, PJM Thiem, U De Gaudry, DK Swart, KMA Rudolf, H Bosch-Lenders, D Trampisch, H-J Meerpohl, JJ Gerlach, FM Flaig, B Kom, G Snell, KIE Perera, R Haefeli, WE Glasziou, PP Muth, C |
| author_facet | González-González, AI Meid, AD Dinh, TS Blom, JW van den Akker, M Elders, PJM Thiem, U De Gaudry, DK Swart, KMA Rudolf, H Bosch-Lenders, D Trampisch, H-J Meerpohl, JJ Gerlach, FM Flaig, B Kom, G Snell, KIE Perera, R Haefeli, WE Glasziou, PP Muth, C |
| author_sort | González-González, AI |
| collection | OXFORD |
| description | <p><strong>Objectives:</strong> To develop and validate a prognostic model to predict deterioration in health-related quality of life (dHRQoL) in older general practice patients with at least one chronic condition and one chronic prescription.</p>
<p><strong>Study Design and Setting:</strong> We used individual participant data from five cluster-randomized trials conducted in the Netherlands and Germany to predict dHRQoL, defined as a decrease in EQ-5D-3 L index score of ≥5% after 6-month follow-up in logistic regression models with stratified intercepts to account for between-study heterogeneity. The model was validated internally and by using internal–external cross-validation (IECV).</p>
<p><strong>Results:</strong> In 3,582 patients with complete data, of whom 1,046 (29.2%) showed deterioration in HRQoL, and 12/87 variables were selected that were related to single (chronic) conditions, inappropriate medication, medication underuse, functional status, well-being, and HRQoL. Bootstrap internal validation showed a C-statistic of 0.71 (0.69 to 0.72) and a calibration slope of 0.88 (0.78 to 0.98). In the IECV loop, the model provided a pooled C-statistic of 0.68 (0.65 to 0.70) and calibration-in-the-large of 0 (−0.13 to 0.13). HRQoL/functionality had the strongest prognostic value.</p>
<p><strong>Conclusion:</strong> The model performed well in terms of discrimination, calibration, and generalizability and might help clinicians identify older patients at high risk of dHRQoL.</p> |
| first_indexed | 2024-03-07T07:50:49Z |
| format | Journal article |
| id | oxford-uuid:fe2cfc90-df28-46cb-b19f-89d3effc0e62 |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T07:50:49Z |
| publishDate | 2020 |
| publisher | Elsevier |
| record_format | dspace |
| spelling | oxford-uuid:fe2cfc90-df28-46cb-b19f-89d3effc0e622023-07-06T11:17:12ZA prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacyJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:fe2cfc90-df28-46cb-b19f-89d3effc0e62EnglishSymplectic ElementsElsevier2020González-González, AIMeid, ADDinh, TSBlom, JWvan den Akker, MElders, PJMThiem, UDe Gaudry, DKSwart, KMARudolf, HBosch-Lenders, DTrampisch, H-JMeerpohl, JJGerlach, FMFlaig, BKom, GSnell, KIEPerera, RHaefeli, WEGlasziou, PPMuth, C<p><strong>Objectives:</strong> To develop and validate a prognostic model to predict deterioration in health-related quality of life (dHRQoL) in older general practice patients with at least one chronic condition and one chronic prescription.</p> <p><strong>Study Design and Setting:</strong> We used individual participant data from five cluster-randomized trials conducted in the Netherlands and Germany to predict dHRQoL, defined as a decrease in EQ-5D-3 L index score of ≥5% after 6-month follow-up in logistic regression models with stratified intercepts to account for between-study heterogeneity. The model was validated internally and by using internal–external cross-validation (IECV).</p> <p><strong>Results:</strong> In 3,582 patients with complete data, of whom 1,046 (29.2%) showed deterioration in HRQoL, and 12/87 variables were selected that were related to single (chronic) conditions, inappropriate medication, medication underuse, functional status, well-being, and HRQoL. Bootstrap internal validation showed a C-statistic of 0.71 (0.69 to 0.72) and a calibration slope of 0.88 (0.78 to 0.98). In the IECV loop, the model provided a pooled C-statistic of 0.68 (0.65 to 0.70) and calibration-in-the-large of 0 (−0.13 to 0.13). HRQoL/functionality had the strongest prognostic value.</p> <p><strong>Conclusion:</strong> The model performed well in terms of discrimination, calibration, and generalizability and might help clinicians identify older patients at high risk of dHRQoL.</p> |
| spellingShingle | González-González, AI Meid, AD Dinh, TS Blom, JW van den Akker, M Elders, PJM Thiem, U De Gaudry, DK Swart, KMA Rudolf, H Bosch-Lenders, D Trampisch, H-J Meerpohl, JJ Gerlach, FM Flaig, B Kom, G Snell, KIE Perera, R Haefeli, WE Glasziou, PP Muth, C A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy |
| title | A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy |
| title_full | A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy |
| title_fullStr | A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy |
| title_full_unstemmed | A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy |
| title_short | A prognostic model predicted deterioration in health-related quality of life in older patients with multimorbidity and polypharmacy |
| title_sort | prognostic model predicted deterioration in health related quality of life in older patients with multimorbidity and polypharmacy |
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