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dc.contributor.authorHo, Iris Szu-Szu
dc.contributor.authorAzcoaga-Lorenzo, Amaya
dc.contributor.authorAkbari, Ashley
dc.contributor.authorDavies, Jim
dc.contributor.authorHodgins, Peter
dc.contributor.authorKhunti, Kamlesh
dc.contributor.authorKadam, Umesh
dc.contributor.authorLyons, Ronan
dc.contributor.authorMcCowan, Colin
dc.contributor.authorMercer, Stewart W
dc.contributor.authorNirantharakumar, Krishnarajah
dc.contributor.authorGuthrie, Bruce
dc.identifier.citationHo , I S-S , Azcoaga-Lorenzo , A , Akbari , A , Davies , J , Hodgins , P , Khunti , K , Kadam , U , Lyons , R , McCowan , C , Mercer , S W , Nirantharakumar , K & Guthrie , B 2022 , ' Variation in the estimated prevalence of multimorbidity : systematic review and meta-analysis of 193 international studies ' , BMJ Open , vol. 12 , no. 4 , e057017 .
dc.identifier.otherPURE: 279406438
dc.identifier.otherPURE UUID: 1f0a868e-de34-47ac-a87a-571b01cc0a2b
dc.identifier.otherORCID: /0000-0002-9466-833X/work/112711535
dc.identifier.otherORCID: /0000-0003-3307-878X/work/112711612
dc.identifier.otherWOS: 000789930900020
dc.identifier.otherScopus: 85129221714
dc.descriptionFunding: This study was funded by Health Data Research UK (CFC0110).en
dc.description.abstractObjective (1) To estimate the pooled prevalence of multimorbidity in all age groups, globally. (2) To examine how measurement of multimorbidity impacted the estimated prevalence. Methods In this systematic review and meta-analysis, we conducted searches in nine bibliographic databases (PsycINFO, Embase, Global Health, Medline, Scopus, Web of Science, Cochrane Library, CINAHL and ProQuest Dissertations and Theses Global) for prevalence studies published between database inception and 21 January 2020. Studies reporting the prevalence of multimorbidity (in all age groups and in community, primary care, care home and hospital settings) were included. Studies with an index condition or those that did not include people with no long-term conditions in the denominator were excluded. Retrieved studies were independently reviewed by two reviewers, and relevant data were extracted using predesigned pro forma. We used meta-analysis to pool the estimated prevalence of multimorbidity across studies, and used random-effects meta-regression and subgroup analysis to examine the association of heterogeneous prevalence estimates with study and measure characteristics. Results 13 807 titles were screened, of which 193 met inclusion criteria for meta-analysis. The pooled prevalence of multimorbidity was 42.4% (95% CI 38.9% to 46.0%) with high heterogeneity (I2 >99%). In adjusted meta-regression models, participant mean age and the number of conditions included in a measure accounted for 47.8% of heterogeneity in effect sizes. The estimated prevalence of multimorbidity was significantly higher in studies with older adults and those that included larger numbers of conditions. There was no significant difference in estimated prevalence between low-income or middle-income countries (36.8%) and high-income countries (44.3%), or between self-report (40.0%) and administrative/clinical databases (52.7%). Conclusions The pooled prevalence of multimorbidity was significantly higher in older populations and when studies included a larger number of baseline conditions. The findings suggest that, to improve study comparability and quality of reporting, future studies should use a common core conditions set for multimorbidity measurement and report multimorbidity prevalence stratified by sociodemographics. PROSPERO registration number CRD42020172409.
dc.relation.ispartofBMJ Openen
dc.rightsCopyright © Author(s) (or their employer(s)) 2022. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.en
dc.subjectRA0421 Public health. Hygiene. Preventive Medicineen
dc.titleVariation in the estimated prevalence of multimorbidity : systematic review and meta-analysis of 193 international studiesen
dc.typeJournal articleen
dc.description.versionPublisher PDFen
dc.contributor.institutionUniversity of St Andrews. School of Medicineen
dc.contributor.institutionUniversity of St Andrews. Sir James Mackenzie Institute for Early Diagnosisen
dc.contributor.institutionUniversity of St Andrews. Population and Behavioural Science Divisionen
dc.description.statusPeer revieweden

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