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Impact of Socioeconomic Inequalities in Transition Between Health, Multimorbidity and Death Amongst Older People

NCT ID: NCT02609516

Last Updated: 2015-11-20

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

UNKNOWN

Total Enrollment

1300000 participants

Study Classification

OBSERVATIONAL

Study Start Date

2015-01-31

Study Completion Date

2017-01-31

Brief Summary

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Life expectancy at age 65 in the most deprived fifth of the English population was about 4 years shorter than of the most affluent fifth in 2010. The inverse gradient between mortality and social position is well established. But how disease patterns and multimorbidity (having two or more long term conditions at the same time) impact on differential mortality rates is inconclusive: is it because disadvantaged groups acquire more or more lethal combinations of, diseases over their life course; or, simply, become ill at ages younger than more affluent groups?

Detailed Description

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The association between social inequality and cause-specific mortality and single disease morbidity has been studied extensively. However, it remains unclear whether having two or more chronic diseases concurrently (or 'multimorbidity') plays a role in contributing to the inequalities gap in survival. This is particularly relevant given an ageing population and the trend of a widening in the life expectancy gap across several European countries.

Multimorbidity incidence increases rapidly with age. Estimates of the prevalence of multimorbidity in older people range from 55% to 98%, mainly due to the selection of diseases included, population coverage (hospital, community) and data source (self-reported surveys or clinical records). However, across all studies there is a clear and consistent pattern of higher prevalence rates at older ages, with multimorbidity.

Many aspects of the patient health trajectory remain under-explored. Patient case-mixes are likely to vary across socioeconomic groups, alongside a host of prognostic factors, including the clustering of multiple risk factors, age of onset, and disease presentation, progression and management in the presence of multiple health conditions.

Conditions

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Multimorbidity

Study Design

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Observational Model Type

COHORT

Study Time Perspective

RETROSPECTIVE

Study Groups

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Healthy

Patients without any of the pre-specified chronic diseases

This is not an intervention study

Intervention Type OTHER

This study is based on the retrospective analysis of linked electronic health records.

Multimorbid

Patients having any two or more of the pre-specified chronic diseases

This is not an intervention study

Intervention Type OTHER

This study is based on the retrospective analysis of linked electronic health records.

Interventions

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This is not an intervention study

This study is based on the retrospective analysis of linked electronic health records.

Intervention Type OTHER

Eligibility Criteria

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Inclusion Criteria

* Registered with a participating practice that has agreed to data linkage
* Registered with an 'up to standard' participating general practice for at least 1 year
* Aged 45 and over on Jan 1st 2001 or who turn 45 between 1st Jan 2001 and 25th March 2010, irrespective of initial health status.

Exclusion Criteria

* Patients with a record unlinked to deprivation due to missing or incomplete postcode of residence.
Minimum Eligible Age

45 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

Yes

Sponsors

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University of Leeds

OTHER

Sponsor Role collaborator

University College, London

OTHER

Sponsor Role lead

Responsible Party

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Harry Hemingway

Professor of Epidemiology and Public Health

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Madhavi Bajekal, PhD

Role: STUDY_DIRECTOR

University College, London

Locations

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University College London

London, , United Kingdom

Site Status

Countries

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United Kingdom

Other Identifiers

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14_179

Identifier Type: -

Identifier Source: org_study_id