Applying resolved and remission codes reduced prevalence of multimorbidity in an urban multi-ethnic population

J Clin Epidemiol. 2021 Dec:140:135-148. doi: 10.1016/j.jclinepi.2021.09.005. Epub 2021 Sep 11.

Abstract

Objective: To estimate the prevalence and determinants of multimorbidity in an urban, multi-ethnic area over 15-years and investigate the effect of applying resolved/remission codes on prevalence estimates.

Study design and setting: This is a population-based retrospective cross-sectional study using electronic health records of adults registered between 2005 -2020 in general practices in one inner London borough (n = 826,936). Classification of resolved/remission was based on clinical coding defined by the patient's general practitioner.

Results: The crude and age-adjusted prevalence of multimorbidity over the study period were 21.2% (95% CI: 21.1 -21.3) and 30.8% (30.6 -31.0), respectively. Applying resolved/remission codes decreased the crude and age-adjusted prevalence estimates to 18.0% (95% CI: 17.9 -18.1) and 27.5% (27.4 -27.7). Asthma (53.2%) and depression (20.2%) were responsible for most resolved and remission codes. Substance use (Adjusted Odds Ratio 10.62 [95% CI: 10.30 -10.95]), high cholesterol (2.48 [2.44 -2.53]), and moderate obesity (2.19 [2.15 -2.23]) were the strongest risk factor determinants of multimorbidity outside of advanced age.

Conclusion: Our study highlights the importance of applying resolved/remission codes to obtain an accurate prevalence and the increased burden of multimorbidity in a young, urban, and multi-ethnic population. Understanding modifiable risk factors for multimorbidity can assist policymakers in designing effective interventions to reduce progression to multimorbidity.

Keywords: Chronic disease; Multimorbidity; Prevalence; Primary care.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age Factors
  • Aged
  • Aged, 80 and over
  • Asthma / epidemiology
  • Clinical Coding* / statistics & numerical data
  • Cross-Sectional Studies
  • Depression / epidemiology
  • Electronic Health Records / statistics & numerical data
  • Female
  • Humans
  • London / epidemiology
  • Male
  • Middle Aged
  • Multimorbidity*
  • Prevalence
  • Racial Groups / statistics & numerical data*
  • Retrospective Studies
  • Risk Factors
  • Sex Factors
  • Urban Population / statistics & numerical data*
  • Young Adult