Trajectories and Experiences of People With Multimorbidity in Spain (LOXO-MULTIPAP) Project: a Mixed Methods Study
NCT Number: NCT06478745
Acronym: LOXO
Status: ENROLLING_BY_INVITATION
Study Type: OBSERVATIONAL
Conditions: Multimorbidity
Interventions: OTHER: Retrospective and prospective cohort|OTHER: Focus group, semi-structured interviews and Photovoice|OTHER: Systematic review
Sponsor: Gerencia de Atención Primaria, Madrid
Collaborators: PI. Bernardino Oliva. Instituto Investigación Sanitaria Illes Balears|PI. Concepción Violan. Fundacion Jordi Gol i Gurina|PI Antonio Gimeno. Instituto de Investigación Sanitaria Aragón.|PI. Rafael Rotaeche. Instituto Investigación Bioguipuzcoa. Osakidetza|PI. Francisca Leiva. Instituto de Investigacion Biomedica de Malaga.|CI. Julian Librero. Navarra Biomed. Servicio Navarro de Salud|Fundación Investigacion en Innovacion Biomédica en Atención Primaria FIIBAP|Instituto de Investigación Sanitaria Gregorio Marañón|Fundacio d'Investigacio en Atencio Primaria Jordi Gol i Gurina
Sex: ALL
Age: ADULT, OLDER_ADULT
Enrollment: 3239950
Study Design: Observational Model: |Time Perspective: p
Start Date: 2024-06-30
Completion Date: 2027-07-01
Locations: Isabel del Cura González, Madrid, 28035, Spain

Summary:
The overall objective of the study is to analyze the evolution of multimorbidity, its most relevant patterns and trajectories in the Spanish National Health System population, from 2012 to 2022, and to analyze the factors that determine it, as well as the experience of professionals and patients in navigating the health system and in shared decision making.

Multimorbidity trajectories can help identify homogeneous groups of individuals with similar needs and prognoses, and help practitioners and health systems to personalize clinical interventions and preventive strategies. Capturing this dynamism is the only way to better understand the natural history of multimorbidity and shed light on hitherto unexplained findings.

Primary Outcome Measures: Multimorbidity, Presence of two or more diagnoses of any of the 60 diseases categorised by the Swedish National Study of Ageing and Care (SNAC-K20) (It is a classification, not a scale), Baseline|Death, Death and abandonment: the occurrence of this event will be measured, regardless of the cause, Start date 31/12/2012, 1 year|Drugs, 300 ATC Swedish National Study of Ageing and Care (SNAC-K20) 8It is a classification, not a scale), 1 year|Use of service, Primary Care medical/nursing visits, emergencies, referrals, admissions, 1 year|Morbidity, Defined with ICD-10, laboratory defined in the Swedish National Study of Ageing and Care (SNAC-K20). It is a classification, not a scale, Baseline/ 1 year|Frailty, EFRAIL (It consists of 5 dichotomous questions. Scoring from 0 to 5. Interpretation:

* Probable frailty: 3 to 5 points.
* Probable pre-fragility: 1 to 2 points.
* No fragility or robustness: 0 points), Baseline/ 1 year
Secondary Outcome Measures: Adherence, Morisky-Green (Patients who answer NO to all four questions are considered compliant with treatment and those who answer YES to one or more are considered non-compliant), Baseline|Social support, Dukes-Unk-11(This questionnaire consists of 11 items and a Likert-type response scale. The score range is between 11 and 55 points. A score equal to or greater than 32 indicates normal support, while a score of less than 32 indicates low perceived social support), Baseline|Functioning and disability, WHODAS (It is composed of 36 items that evaluate the following 6 dimensions. The overall score runs a scale from 0 to 100, with higher values indicating greater disability), Baseline/ 1 year|Health releated quality of life, Euroqol 5D-5L (It consists of 2 parts - The EQ-5D descriptive system and the Visual Analog Scale (VAS).

Scale (VAS). In the VAS the individual scores his or her health between two extremes, 0 and 100, the worst and the best state of health imaginable. imaginable), Baseline
Other Outcome Measures: Age, Years, Baseline|Sex, Male/Female, Baseline|Country, Country of origin, Baseline|Deprivation Index, MEDEA (Values from 1 to 5. Higher values indicate a more unfavorable socioeconomic situation), Baseline