Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies.
Prevalence of multimorbidity in community settings: A systematic review and meta-analysis of observational studies.
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DOI：
10.1177/2235042x19870934
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发表时间：
2019-01-01
影响因子：
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通讯作者：
Prina, A Matthew
中科院分区：
文献类型：
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作者：
Nguyen, Hai;Manolova, Gergana;Prina, A Matthew
背景技术背景：随着世界人口老龄化，多发病（同一个体存在两种或两种以上慢性疾病）成为公共卫生的主要问题。虽然多发性硬化症与年龄有关，但其患病率各不相同。本系统评价旨在总结和荟萃分析高、低和中等收入国家（HIC和LMICs）中多发性硬化的患病率。方法：通过检索电子数据库（Medline、Embase、PsycINFO、Global Health、Web of Science和科克伦图书馆）确定研究。术语“多发病”及其各种拼写与“患病率”或“流行病学”一起使用。质量评估采用Newcastle-Ottawa量表。根据多器官功能障碍的定义、HIC/LMIC状态、性别和年龄进行总体和分层分析。荟萃分析采用随机效应模型。结果：70个以社区为基础的研究（在18个HIC和31个LMIC中进行）被纳入最终样本。样本量从264到162，464不等。多发病的总体合并患病率为33.1%（95%置信区间（CI）：30.0-36.3%）。高收入国家和低收入国家之间的合并估计值存在相当大的差异，患病率分别为37.9%（95%CI：32.5-43.4%）和29.7%（26.4-33.0%）。总体和分层分析的研究间异质性均较高（I2> 99%）。敏感性分析表明，没有审查的研究偏斜的总体汇总estimation.CONCLUSION：一个很大的比例的全球人口，特别是那些年龄在65岁以上的，是受多morphine。为了准确估计疾病负担，有效的疾病管理和资源分配，需要标准化的多学科操作。
BACKGROUND: With ageing world populations, multimorbidity (presence of two or more chronic diseases in the same individual) becomes a major concern in public health. Although multimorbidity is associated with age, its prevalence varies. This systematic review aimed to summarise and meta-analyse the prevalence of multimorbidity in high, low- and middle-income countries (HICs and LMICs).METHODS: Studies were identified by searching electronic databases (Medline, Embase, PsycINFO, Global Health, Web of Science and Cochrane Library). The term 'multimorbidity' and its various spellings were used, alongside 'prevalence' or 'epidemiology'. Quality assessment employed the Newcastle-Ottawa scale. Overall and stratified analyses according to multimorbidity operational definitions, HICs/LMICs status, gender and age were performed. A random-effects model for meta-analysis was used.RESULTS: Seventy community-based studies (conducted in 18 HICs and 31 LMICs) were included in the final sample. Sample sizes ranged from 264 to 162,464. The overall pooled prevalence of multimorbidity was 33.1% (95% confidence interval (CI): 30.0-36.3%). There was a considerable difference in the pooled estimates between HICs and LMICs, with prevalence being 37.9% (95% CI: 32.5-43.4%) and 29.7% (26.4-33.0%), respectively. Heterogeneity across studies was high for both overall and stratified analyses (I 2 > 99%). A sensitivity analysis showed that none of the reviewed studies skewed the overall pooled estimates.CONCLUSION: A large proportion of the global population, especially those aged 65+, is affected by multimorbidity. To allow accurate estimations of disease burden, and effective disease management and resources distribution, a standardised operationalisation of multimorbidity is needed.