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Article ; Online: Emerging trends and future research on the role of socioeconomic status in chronic illness and multimorbidity.

Mair, Frances S / Jani, Bhautesh Dinesh

The Lancet. Public health

2020 Volume 5, Issue 3, Page(s) e128–e129

MeSH term(s)	Biomedical Research/trends ; Chronic Disease/epidemiology ; Forecasting ; Health Status Disparities ; Humans ; Multimorbidity ; Social Class
Language	English
Publishing date	2020-01-31
Publishing country	England
Document type	Journal Article
ISSN	2468-2667
ISSN (online)	2468-2667
DOI	10.1016/S2468-2667(20)30001-3
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Emerging trends and future research on the role of socioeconomic status in chronic illness and multimorbidity

Frances S Mair / Bhautesh Dinesh Jani

The Lancet Public Health, Vol 5, Iss 3, Pp e128-e

2020 Volume 129

Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2020-03-01T00:00:00Z
Publisher	Elsevier
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Long-term conditions, multimorbidity and colorectal cancer risk in the UK Biobank cohort.

Corcoran, Neave Me / Mair, Frances S / Nicholl, Barbara / Macdonald, Sara / Jani, Bhautesh Dinesh

Journal of multimorbidity and comorbidity

2022 Volume 12, Page(s) 26335565221110123

Abstract: Purpose: Early identification of colorectal cancer (CRC) is an international priority. Multimorbidity (presence of ≥2 long-term conditions (LTCs)) is increasing and the relationship between CRC and LTCs is little-understood. This study explores the ... ...

Abstract	Purpose: Early identification of colorectal cancer (CRC) is an international priority. Multimorbidity (presence of ≥2 long-term conditions (LTCs)) is increasing and the relationship between CRC and LTCs is little-understood. This study explores the relationship between individual LTCs, multimorbidity and CRC incidence and mortality. Methods: Longitudinal analysis of the UK Biobank cohort, participants recruited 2006-2010; Results: Participants' age range: 37-73 (mean age 56.5; 54.5% female). CRC was diagnosed in 3669 (0.73%) participants, and 916 (0.18%) died from CRC during follow-up (median follow-up 7 years). CRC incidence was higher in the presence of heart failure (Hazard Ratio (HR) 1.96, 95% Confidence Interval (CI) 1.13-3.40), diabetes (HR 1.15, CI 1.01-1.32), glaucoma (HR 1.36, CI 1.06-1.74), male cancers (HR 1.44, CI 1.01-2.08). CRC mortality was higher in presence of epilepsy (HR 1.83, CI 1.03-3.26), diabetes (HR 1.32, CI 1.02-1.72), osteoporosis (HR 1.67, CI 1.12-2.58). No significant association was found between multimorbidity (≥2 LTCs) and CRC outcomes. Conclusions: The associations of certain LTCs with CRC incidence and mortality has implications for clinical practice: presence of certain LTCs in patients presenting with CRC symptoms could trigger early investigation and diagnosis. Future research should explore causative mechanisms and patient perspectives.
Language	English
Publishing date	2022-09-15
Publishing country	England
Document type	Journal Article
ISSN	2633-5565
ISSN (online)	2633-5565
DOI	10.1177/26335565221110123
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Article ; Online: Epidemiology of multimorbidity in low-income countries of sub-Saharan Africa

Alison J. Price / Modou Jobe / Isaac Sekitoleko / Amelia C. Crampin / Andrew M. Prentice / Janet Seeley / Edith F. Chikumbu / Joseph Mugisha / Ronald Makanga / Albert Dube / Frances S. Mair / Bhautesh Dinesh Jani

PLOS Global Public Health, Vol 3, Iss

Findings from four population cohorts

2023 Volume 12

Keywords	Public aspects of medicine ; RA1-1270
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Personalised lung cancer risk stratification and lung cancer screening: do general practice electronic medical records have a role?

Jani, Bhautesh Dinesh / Sullivan, Michael K / Hanlon, Peter / Nicholl, Barbara I / Lees, Jennifer S / Brown, Lamorna / MacDonald, Sara / Mark, Patrick B / Mair, Frances S / Sullivan, Frank M

British journal of cancer

2023 Volume 129, Issue 12, Page(s) 1968–1977

Abstract: Background: In the United Kingdom (UK), cancer screening invitations are based on general practice (GP) registrations. We hypothesize that GP electronic medical records (EMR) can be utilised to calculate a lung cancer risk score with good accuracy/ ... ...

Abstract	Background: In the United Kingdom (UK), cancer screening invitations are based on general practice (GP) registrations. We hypothesize that GP electronic medical records (EMR) can be utilised to calculate a lung cancer risk score with good accuracy/clinical utility. Methods: The development cohort was Secure Anonymised Information Linkage-SAIL (2.3 million GP EMR) and the validation cohort was UK Biobank-UKB (N = 211,597 with GP-EMR availability). Fast backward method was applied for variable selection and area under the curve (AUC) evaluated discrimination. Results: Age 55-75 were included (SAIL: N = 574,196; UKB: N = 137,918). Six-year lung cancer incidence was 1.1% (6430) in SAIL and 0.48% (656) in UKB. The final model included 17/56 variables in SAIL for the EMR-derived score: age, sex, socioeconomic status, smoking status, family history, body mass index (BMI), BMI:smoking interaction, alcohol misuse, chronic obstructive pulmonary disease, coronary heart disease, dementia, hypertension, painful condition, stroke, peripheral vascular disease and history of previous cancer and previous pneumonia. The GP-EMR-derived score had AUC of 80.4% in SAIL and 74.4% in UKB and outperformed ever-smoked criteria (currently the first step in UK lung cancer screening pilots). Discussion: A GP-EMR-derived score may have a role in UK lung cancer screening by accurately targeting high-risk individuals without requiring patient contact.
MeSH term(s)	Humans ; Middle Aged ; Aged ; Electronic Health Records ; Early Detection of Cancer ; Lung Neoplasms/diagnosis ; Lung Neoplasms/epidemiology ; Risk Factors ; General Practice ; Risk Assessment
Language	English
Publishing date	2023-10-25
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	80075-2
ISSN	1532-1827 ; 0007-0920
ISSN (online)	1532-1827
ISSN	0007-0920
DOI	10.1038/s41416-023-02467-9
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Article ; Online: Potential impact of NICE guidelines on referrals from primary care to nephrology: a primary care database and prospective research study.

Sullivan, Michael K / Jani, Bhautesh Dinesh / Rutherford, Elaine / Welsh, Paul / McConnachie, Alex / Major, Rupert W / McAllister, David / Nitsch, Dorothea / Mair, Frances S / Mark, Patrick B / Lees, Jennifer S

The British journal of general practice : the journal of the Royal College of General Practitioners

2023 Volume 73, Issue 727, Page(s) e141–e147

Abstract: Background: National Institute for Health and Care Excellence 2021 guidelines on chronic kidney disease (CKD) recommend the use of the Kidney Failure Risk Equation (KFRE), which includes measurement of albuminuria. The equation to calculate estimated ... ...

Abstract	Background: National Institute for Health and Care Excellence 2021 guidelines on chronic kidney disease (CKD) recommend the use of the Kidney Failure Risk Equation (KFRE), which includes measurement of albuminuria. The equation to calculate estimated glomerular filtration rate (eGFR) has also been updated. Aim: To investigate the impact of the use of KFRE and the updated eGFR equation on CKD diagnosis (eGFR <60 mL/min/1.73 m Design and setting: Primary care database (Secure Anonymised Information Linkage Databank [SAIL]) and prospective cohort study (UK Biobank) using data available between 2013 and 2020. Method: CKD diagnosis rates were assessed when using the updated eGFR equation. Among people with eGFR 30-59 mL/min/1.73 m Results: Using the updated eGFR equation resulted in a 1.2-fold fall in new CKD diagnoses in the predominantly White population in SAIL, whereas CKD prevalence rose by 1.9-fold among Black participants in UK Biobank. Rates of albuminuria testing have been consistently below 30% since 2015. In 2019, using KFRE >5% identified 182/61 721 (0.3%) patients at high risk of CKD progression before their eGFR declined and 361/61 721 (0.6%) low-risk patients who were no longer eligible for referral. Ethnic groups 'Asian' and 'other' had disproportionately raised KFREs. Conclusion: Application of KFRE criteria in primary care will lead to referral of more patients at elevated risk of kidney failure (particularly among minority ethnic groups) and fewer low-risk patients. Albuminuria testing needs to be expanded to enable wider KFRE implementation.
MeSH term(s)	Humans ; Prospective Studies ; Nephrology ; Albuminuria/diagnosis ; Albuminuria/epidemiology ; Disease Progression ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/epidemiology ; Glomerular Filtration Rate ; Renal Insufficiency ; Referral and Consultation ; Primary Health Care
Language	English
Publishing date	2023-01-26
Publishing country	England
Document type	Journal Article
ZDB-ID	1043148-2
ISSN	1478-5242 ; 0035-8797 ; 0960-1643
ISSN (online)	1478-5242
ISSN	0035-8797 ; 0960-1643
DOI	10.3399/BJGP.2022.0145
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Article ; Online: A Population-Based Cross-Sectional Investigation of COVID-19 Hospitalizations and Mortality Among Autistic People

Nijhof, Dewy / Sosenko, Filip / MacKay, Daniel / Fleming, Michael / Jani, Bhautesh Dinesh / Pell, Jill / Hatton, Chris / Cairns, Deborah / Henderson, Angela / Ward, Laura McKernan / Rydzewska, Ewelina / Gardani, Maria / Millington, Elliot / Melville, Craig

medRxiv

Abstract: Background: Current evidence suggests the possibility that autistic people may be at more risk of COVID-19 infection, hospitalisation, and mortality than the general population. Previous studies, however, are either limited in scale or do not investigate ...

Abstract	Background: Current evidence suggests the possibility that autistic people may be at more risk of COVID-19 infection, hospitalisation, and mortality than the general population. Previous studies, however, are either limited in scale or do not investigate potential risk factors. Whilst many risk factors have been speculated to be responsible for severe COVID-19, this research has focused on general population samples. Methods: Using data-linkage and a whole-country population, this study modelled associations between autism and COVID-19 hospitalisation and mortality risk in adults, investigating a multitude of clinical and demographic risk factors. Results: Autistic adults had higher rates of hospitalisation, Standardised Incident Ratio 1.6 in 2020 and 1.3 in 2021, and mortality, Standardised Mortality Ratio 1.52 in 2020 and 1.34 in 2021, due to COVID-19 than the general population. In both populations, age, complex multimorbidity and vaccination status were the most significant predictors of COVID-19 hospitalisation and mortality. Effects of psychotropic medication varied by class. Conclusions: Although similar factors exhibited a positive association with heightened risk of severe COVID-19 in both the autistic and general populations, with comparable effect sizes, mortality rates were elevated among the autistic population as compared to the general population. Specifically, the presence of complex multimorbidity and classification of prescribed medications may emerge as particularly significant predictors of severe COVID-19 among individuals within the autistic population due to higher prevalence of complex multimorbidity in the autistic population and variability in the association between medication classes and severe COVID-19 between both populations, though further research is needed.
Keywords	covid19
Language	English
Publishing date	2024-02-24
Publisher	Cold Spring Harbor Laboratory Press
Document type	Article ; Online
DOI	10.1101/2024.02.23.24303274
Database	COVID19

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Article ; Online: Epidemiology of multimorbidity in low-income countries of sub-Saharan Africa

Alison J Price / Modou Jobe / Isaac Sekitoleko / Amelia C Crampin / Andrew M Prentice / Janet Seeley / Edith F Chikumbu / Joseph Mugisha / Ronald Makanga / Albert Dube / Frances S Mair / Bhautesh Dinesh Jani

PLOS Global Public Health, Vol 3, Iss 12, p e

Findings from four population cohorts.

2023 Volume 0002677

Abstract: We investigated prevalence and demographic characteristics of adults living with multimorbidity (≥2 long-term conditions) in three low-income countries of sub-Saharan Africa, using secondary population-level data from four cohorts; Malawi (urban & rural), ...

Abstract	We investigated prevalence and demographic characteristics of adults living with multimorbidity (≥2 long-term conditions) in three low-income countries of sub-Saharan Africa, using secondary population-level data from four cohorts; Malawi (urban & rural), The Gambia (rural) and Uganda (rural). Information on; measured hypertension, diabetes and obesity was available in all cohorts; measured hypercholesterolaemia and HIV and self-reported asthma was available in two cohorts and clinically diagnosed epilepsy in one cohort. Analyses included calculation of age standardised multimorbidity prevalence and the cross-sectional associations of multimorbidity and demographic/lifestyle factors using regression modelling. Median participant age was 29 (Inter quartile range-IQR 22-38), 34 (IQR25-48), 32 (IQR 22-53) and 37 (IQR 26-51) in urban Malawi, rural Malawi, The Gambia, and Uganda, respectively. Age standardised multimorbidity prevalence was higher in urban and rural Malawi (22.5%;95% Confidence intervals-CI 21.6-23.4%) and 11.7%; 95%CI 11.1-12.3, respectively) than in The Gambia (2.9%; 95%CI 2.5-3.4%) and Uganda (8.2%; 95%CI 7.5-9%) cohorts. In multivariate models, females were at greater risk of multimorbidity than males in Malawi (Incidence rate ratio-IRR 1.97, 95% CI 1.79-2.16 urban and IRR 2.10; 95%CI 1.86-2.37 rural) and Uganda (IRR- 1.60, 95% CI 1.32-1.95), with no evidence of difference between the sexes in The Gambia (IRR 1.16, 95% CI 0.86-1.55). There was strong evidence of greater multimorbidity risk with increasing age in all populations (p-value <0.001). Higher educational attainment was associated with increased multimorbidity risk in Malawi (IRR 1.78; 95% CI 1.60-1.98 urban and IRR 2.37; 95% CI 1.74-3.23 rural) and Uganda (IRR 2.40, 95% CI 1.76-3.26), but not in The Gambia (IRR 1.48; 95% CI 0.56-3.87). Further research is needed to study multimorbidity epidemiology in sub-Saharan Africa with an emphasis on robust population-level data collection for a wide variety of long-term conditions and ...
Keywords	Public aspects of medicine ; RA1-1270
Subject code	910
Language	English
Publishing date	2023-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Epidemiology of multimorbidity in low-income countries of sub-Saharan Africa: Findings from four population cohorts.

Price, Alison J / Jobe, Modou / Sekitoleko, Isaac / Crampin, Amelia C / Prentice, Andrew M / Seeley, Janet / Chikumbu, Edith F / Mugisha, Joseph / Makanga, Ronald / Dube, Albert / Mair, Frances S / Jani, Bhautesh Dinesh

PLOS global public health

2023 Volume 3, Issue 12, Page(s) e0002677

Abstract	We investigated prevalence and demographic characteristics of adults living with multimorbidity (≥2 long-term conditions) in three low-income countries of sub-Saharan Africa, using secondary population-level data from four cohorts; Malawi (urban & rural), The Gambia (rural) and Uganda (rural). Information on; measured hypertension, diabetes and obesity was available in all cohorts; measured hypercholesterolaemia and HIV and self-reported asthma was available in two cohorts and clinically diagnosed epilepsy in one cohort. Analyses included calculation of age standardised multimorbidity prevalence and the cross-sectional associations of multimorbidity and demographic/lifestyle factors using regression modelling. Median participant age was 29 (Inter quartile range-IQR 22-38), 34 (IQR25-48), 32 (IQR 22-53) and 37 (IQR 26-51) in urban Malawi, rural Malawi, The Gambia, and Uganda, respectively. Age standardised multimorbidity prevalence was higher in urban and rural Malawi (22.5%;95% Confidence intervals-CI 21.6-23.4%) and 11.7%; 95%CI 11.1-12.3, respectively) than in The Gambia (2.9%; 95%CI 2.5-3.4%) and Uganda (8.2%; 95%CI 7.5-9%) cohorts. In multivariate models, females were at greater risk of multimorbidity than males in Malawi (Incidence rate ratio-IRR 1.97, 95% CI 1.79-2.16 urban and IRR 2.10; 95%CI 1.86-2.37 rural) and Uganda (IRR- 1.60, 95% CI 1.32-1.95), with no evidence of difference between the sexes in The Gambia (IRR 1.16, 95% CI 0.86-1.55). There was strong evidence of greater multimorbidity risk with increasing age in all populations (p-value <0.001). Higher educational attainment was associated with increased multimorbidity risk in Malawi (IRR 1.78; 95% CI 1.60-1.98 urban and IRR 2.37; 95% CI 1.74-3.23 rural) and Uganda (IRR 2.40, 95% CI 1.76-3.26), but not in The Gambia (IRR 1.48; 95% CI 0.56-3.87). Further research is needed to study multimorbidity epidemiology in sub-Saharan Africa with an emphasis on robust population-level data collection for a wide variety of long-term conditions and ensuring proportionate representation from men and women, and urban and rural areas.
Language	English
Publishing date	2023-12-06
Publishing country	United States
Document type	Journal Article
ISSN	2767-3375
ISSN (online)	2767-3375
DOI	10.1371/journal.pgph.0002677
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: The presence and impact of multimorbidity clusters on adverse outcomes across the spectrum of kidney function.

Sullivan, Michael K / Carrero, Juan-Jesus / Jani, Bhautesh Dinesh / Anderson, Craig / McConnachie, Alex / Hanlon, Peter / Nitsch, Dorothea / McAllister, David A / Mair, Frances S / Mark, Patrick B / Gasparini, Alessandro

BMC medicine

2022 Volume 20, Issue 1, Page(s) 420

Abstract: Background: Multimorbidity (the presence of two or more chronic conditions) is common amongst people with chronic kidney disease, but it is unclear which conditions cluster together and if this changes as kidney function declines. We explored which ... ...

Abstract	Background: Multimorbidity (the presence of two or more chronic conditions) is common amongst people with chronic kidney disease, but it is unclear which conditions cluster together and if this changes as kidney function declines. We explored which clusters of conditions are associated with different estimated glomerular filtration rates (eGFRs) and studied associations between these clusters and adverse outcomes. Methods: Two population-based cohort studies were used: the Stockholm Creatinine Measurements project (SCREAM, Sweden, 2006-2018) and the Secure Anonymised Information Linkage Databank (SAIL, Wales, 2006-2021). We studied participants in SCREAM (404,681 adults) and SAIL (533,362) whose eGFR declined lower than thresholds (90, 75, 60, 45, 30 and 15 mL/min/1.73m Results: Chronic conditions became more common and clustered differently across lower eGFR categories. At eGFR 90, 75, and 60 mL/min/1.73m Conclusions: Patterns of multimorbidity and corresponding risk of adverse outcomes varied with declining eGFR. While diabetes and cardiovascular disease are known high-risk conditions, chronic pain and depression emerged as important conditions and associated with adverse outcomes when combined with physical conditions.
MeSH term(s)	Adult ; Humans ; Multimorbidity ; Chronic Pain ; Glomerular Filtration Rate ; Renal Insufficiency, Chronic/complications ; Atrial Fibrillation/complications ; Heart Failure/complications ; Kidney
Language	English
Publishing date	2022-11-01
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2131669-7
ISSN	1741-7015 ; 1741-7015
ISSN (online)	1741-7015
ISSN	1741-7015
DOI	10.1186/s12916-022-02628-2
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