Using electronic health records to understand multimorbidity in older people: a scoping review.

IF 3.6 3区 医学 Q2 GERIATRICS & GERONTOLOGY
Lucy Smith, Glenn Simpson, Neil Singh, Lucy Wells, Hajira Dambha-Miller
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引用次数: 0

Abstract

Purpose: The increasing availability of electronic health records (EHR), encompassing routinely collected general practice, hospital, and linked national census data, presents significant opportunities to enhance our understanding of multimorbidity at scale. However, the utility and clinical impact of EHR in advancing multimorbidity research, particularly concerning older adults who are disproportionately affected, remain unclear. This study aims to synthesise the literature on the use of EHR to investigate multimorbidity in individuals aged 65 years and older.

Method: We conducted a scoping review, performing literature searches across Medline, Embase, CINAHL, and the Cochrane Central Register of Controlled Trials. Studies published from the inception of these databases until September 2024 were included if they investigated multimorbidity using EHR in individuals aged 65 years and older. The extracted data were synthesised using an iterative descriptive process.

Results: A total of 753 studies were identified, with 46 meeting the eligibility criteria for inclusion. All studies originated from high-income countries, primarily the USA and Spain. Research focused on areas such as healthcare utilisation and costs, predictive modelling based on patient disease profiles, specific clustering models, relationships between multimorbidity and particular disease categories, aetiology, polypharmacy, and the accuracy of EHR. Reporting on data completeness, sociodemographic characteristics, and the inclusion of ethnic and social diversity within EHR datasets was notably limited.

Conclusions: The use of EHR to elucidate multimorbidity is expanding and holds substantial promise. However, enhanced reporting of data completeness and sociodemographic characteristics is essential to facilitate the effective translation of findings into real-world populations. Neglecting these aspects, risks exacerbating inequality gaps for individuals 65 years and older with multimorbidity.

使用电子健康记录了解老年人多病:范围综述
目的:电子健康记录(EHR)的日益普及,包括常规收集的全科医生、医院和相关的全国人口普查数据,为加强我们对大规模多病的理解提供了重要机会。然而,电子病历在推进多病研究方面的效用和临床影响,特别是对不成比例受影响的老年人的影响,仍不清楚。本研究旨在综合使用电子病历调查65岁及以上人群多病的文献。方法:我们进行了范围综述,在Medline、Embase、CINAHL和Cochrane中央对照试验注册库中进行文献检索。从这些数据库建立之初到2024年9月发表的研究,如果使用电子病历调查65岁及以上个体的多病,则纳入其中。提取的数据使用迭代描述过程进行合成。结果:共纳入753项研究,其中46项符合纳入标准。所有的研究都来自高收入国家,主要是美国和西班牙。研究集中在医疗保健利用和成本、基于患者疾病概况的预测建模、特定聚类模型、多发病与特定疾病类别之间的关系、病因学、多药学以及电子病历的准确性等领域。关于数据完整性、社会人口学特征以及在电子病历数据集中纳入种族和社会多样性的报告明显有限。结论:电子病历用于阐明多发性疾病的应用正在扩大,并具有很大的前景。然而,加强对数据完整性和社会人口特征的报告对于促进将研究结果有效地转化为现实世界人口至关重要。忽视这些方面,可能会加剧65岁及以上多病患者的不平等差距。
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来源期刊
European Geriatric Medicine
European Geriatric Medicine GERIATRICS & GERONTOLOGY-
CiteScore
6.70
自引率
2.60%
发文量
114
审稿时长
6-12 weeks
期刊介绍: European Geriatric Medicine is the official journal of the European Geriatric Medicine Society (EUGMS). Launched in 2010, this journal aims to publish the highest quality material, both scientific and clinical, on all aspects of Geriatric Medicine. The EUGMS is interested in the promotion of Geriatric Medicine in any setting (acute or subacute care, rehabilitation, nursing homes, primary care, fall clinics, ambulatory assessment, dementia clinics..), and also in functionality in old age, comprehensive geriatric assessment, geriatric syndromes, geriatric education, old age psychiatry, models of geriatric care in health services, and quality assurance.
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