Understanding clusters and mechanisms of complex multimorbidity in people with common allergic conditions

了解常见过敏性疾病患者复杂多发病的集群和机制

• 批准号: MR/V005146/1
• 负责人: Sinead Langan
• 金额: $ 10.04万
• 依托单位: London School of Hygiene & Tropical Medicine
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2020
• 资助国家: 英国
• 起止时间: 2020 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=MR%2FV005146%2F1
• 关键词: Understanding; clusters; mechanisms; complex; multimorbidity

Multimorbidity is a term used to mean having two or more longterm physical or mental illnesses. Multimorbidity is important because it affects what happens to people throughout their life and how their doctors can treat them. Conditions which can be associated with allergy, such as asthma and eczema, are very common particularly in children and young adults (at least 1 in 5 children), and are known to have major effects on quality of life and costs to the NHS. Previous work has shown people with allergic diseases are at risk of lots of different mental and physical health problems (multimorbidity), possibly due to their allergic disease. We don't yet understand how these diseases group together ("cluster") and why they occur. Our work will help us understand how and why allergic diseases are associated with other mental and physical illnesses (multimorbidity) in order to work out how to treat people with allergic diseases better. In this preparatory phase (also called a consolidator grant), we will first explore how allergic diseases occur in groups together with multiple other medical and psychiatric conditions and how these "clusters" develop over time. Some of these "clusters" will include conditions we already know can be associated with allergic diseases, but we also expect that we might find new associated diseases. We will do this analysis using data collected as part of usual healthcare, which has been stripped of identifiers (e.g., names). We have data collected on large numbers of people (for example 500,000 adults with eczema) over long periods of time with information about health issues, medications, doctors' visits and whether people smoke or drink alcohol. This work will be complex, so we will need to run workshops involving different kinds of experts, such as data scientists, statisticians, doctors who treat patients with allergic diseases, and patient representatives. In this preparation phase, we will also spend time finalising the most important questions for the main body of work (focusing on working out why people with allergic diseases have other mental and physical conditions) and how we can answer those questions in the best possible way. In the main body of work (also known as a "collaborative" grant), we will use advanced statistical techniques to understand why common allergic disorders are associated with other physical and mental health problems. We will look at factors in people's environment and lifestyle, or medications that doctors use to treat allergic conditions to see if these might play a role in these "clusters". This collaborative programme will help us move away from doctors focusing on only one problem at a time, to an approach that looks at all of the problems that people have that tend to cluster together. This "joined up" thinking will help us treat people better and might help us avoid some of those health problems in future.

多病是指患有两种或两种以上的长期身体或精神疾病。多重疾病很重要，因为它会影响人们一生中发生的事情，以及医生如何治疗他们。与过敏相关的疾病，如哮喘和湿疹，在儿童和年轻人中非常常见（至少五分之一的儿童），并且已知对生活质量和NHS成本有重大影响。先前的研究表明，患有过敏性疾病的人可能由于过敏性疾病而面临许多不同的精神和身体健康问题（多重疾病）的风险。我们还不了解这些疾病是如何聚集在一起的（“群集”），以及它们发生的原因。我们的工作将帮助我们了解过敏性疾病是如何以及为什么与其他精神和身体疾病（多病）相关的，以便找出如何更好地治疗过敏性疾病患者。在这个准备阶段（也称为合并资助），我们将首先探索过敏性疾病如何与多种其他医学和精神疾病一起群体发生，以及这些“集群”如何随着时间的推移而发展。其中一些“集群”将包括我们已经知道可能与过敏性疾病相关的条件，但我们也希望我们可能会发现新的相关疾病。我们将使用作为常规医疗保健的一部分收集的数据进行此分析，这些数据已删除了标识符（例如，名称）。我们收集了大量人（例如50万患有湿疹的成年人）的长期数据，其中包括健康问题、药物、医生就诊以及人们是否吸烟或饮酒的信息。这项工作将是复杂的，因此我们将需要举办涉及不同类型专家的研讨会，例如数据科学家、统计学家、治疗过敏性疾病患者的医生和患者代表。在这个准备阶段，我们还将花时间确定工作主体中最重要的问题（重点是弄清楚为什么患有过敏性疾病的人会有其他精神和身体状况），以及我们如何以最好的方式回答这些问题。在主体工作（也称为“合作”资助）中，我们将使用先进的统计技术来理解为什么常见的过敏性疾病与其他身体和精神健康问题相关。我们将研究人们的环境和生活方式，或者医生用来治疗过敏的药物，看看这些因素是否可能在这些“集群”中发挥作用。这个合作项目将帮助我们从医生一次只关注一个问题，转向一种关注人们所有问题的方法，这些问题往往集中在一起。这种“联合”思维将帮助我们更好地对待他人，并可能帮助我们避免未来出现一些健康问题。

项目成果

Novel multimorbidity clusters in people with eczema and asthma: a population-based cluster analysis.

• DOI: 10.1038/s41598-022-26357-x
• 发表时间: 2022-12-18
• 期刊: Scientific reports
• 影响因子: 4.6

Adult atopic eczema and the risk of dementia: A population-based cohort study.

成人特应性湿疹和痴呆风险：一项基于人群的队列研究。

• DOI: 10.1016/j.jaad.2022.03.049
• 发表时间: 2022
• 期刊: Journal of the American Academy of Dermatology
• 影响因子: 13.8
• 作者: Magyari A

Association of Atopic Dermatitis and Mental Health Outcomes Across Childhood: A Longitudinal Cohort Study.

• DOI: 10.1001/jamadermatol.2021.2657
• 发表时间: 2021-10-01
• 期刊: JAMA dermatology
• 影响因子: 10.9
• 作者: Kern C;Wan J;LeWinn KZ;Ramirez FD;Lee Y;McCulloch CE;Langan SM;Abuabara K
• 通讯作者: Abuabara K

Atopic Eczema-Associated Fracture Risk and Oral Corticosteroids: A Population-Based Cohort Study.

• DOI: 10.1016/j.jaip.2021.09.026
• 发表时间: 2022-01
• 期刊: The journal of allergy and clinical immunology. In practice
• 作者: Matthewman J;Mansfield KE;Prieto-Alhambra D;Mulick AR;Smeeth L;Lowe KE;Silverwood RJ;Langan SM
• 通讯作者: Langan SM

Anxiety and Depression in People with Eczema or Psoriasis: A Comparison of Associations in UK Biobank and Linked Primary Care Data.

• DOI: 10.2147/clep.s417176
• 发表时间: 2023
• 期刊: Clinical epidemiology
• 影响因子: 3.9