Trajectories and Experiences of People With Multimorbidity in Spain (LOXO-MULTIPAP) Project: a Mixed Methods Study

Gerencia de Atención Primaria, Madrid

Status: Invitation-only

Conditions: Multimorbidity

Treatments: Other: Retrospective and prospective cohort; Other: Systematic review; Other: Focus group, semi-structured interviews and Photovoice

Study type: Observational

Funder types: Other

Identifiers

NCT06478745

PI22/01651 Francisca Leiva (Other Grant/Funding Number)

PI22/01665 Rafael Rotaeche (Other Grant/Funding Number)

PI22/00768 Isabel del Cura (Other Grant/Funding Number)

20230033

PI22/00701 Antonio Gimeno (Other Grant/Funding Number)

PI22/01684 Bernardino Oliva (Other Grant/Funding Number)

PI22/01398 Concepción Violan (Other Grant/Funding Number)

Details and patient eligibility

About

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.

Full description

• Design: Mixed-method study.

  • Quantitative study: retrospective and prospective observational study. It integrates demographic and clinical information from electronic medical records and clinical-administrative databases. It involves the harmonisation of the cohorts of users of the public health system of the 7 participating regions.
  • Qualitative study with a phenomenological and ethnographic approach using focus group techniques, semi-structured interviews and Photovoice to find out the perspective of patients and professionals in shared decision-making.
  • Systematic literature review on the effectiveness of interventions on training, multimorbidity and polypharmacy in health professionals.

• Analysis:

  • Quantitative study: Cluster, network and trajectory analysis
  • Qualitative study: Thematic content analysis that will be triangulated among the members of the research team. Meanings will be interpreted and an explanatory framework will be created with the contributions of each type of informant.

Enrollment: 3,239,950 estimated patients

Sex: All

Ages: 60+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• 60 years or older
• 2 or more chronic diseases

Exclusion criteria

• Not having used the national health system in the last year

Trial design

3,239,950 participants in 3 patient groups

Quantitative Aim

Description:

Ambispective longitudinal observational study

Treatment:

Other: Retrospective and prospective cohort

Qualitative Aim

Description:

Focus group, semi-structured interviews and Photovoice

Treatment:

Other: Focus group, semi-structured interviews and Photovoice

Systematic Review Aim

Description:

Systematic literature review on the effectiveness of interventions on training, multimorbidity and polypharmacy in health professionals.

Treatment:

Other: Systematic review