Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

Dexing Zhang; Regina Wing Shan Sit; Carmen Wong; Dan Zou; Stewart W. Mercer; Marjorie C. Johnston; Samuel Yeung Shan Wong

doi:10.1136/bmjopen-2018-027279

Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

Dexing Zhang, Regina Wing Shan Sit, Carmen Wong, Dan Zou, Stewart W. Mercer, Marjorie C. Johnston, Samuel Yeung Shan Wong^* (Corresponding Author)

^*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

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Abstract

PURPOSE: This is an ongoing prospective cohort aiming to examine the biopsychosocial health profiles and predictors of health outcomes of older patients with multimorbidity in primary care in Hong Kong. PARTICIPANTS: From April 2016 to October 2017, 1077 patients aged 60+ years with at least two chronic diseases were recruited in four public primary care clinics in the New Territories East Region of Hong Kong. FINDINGS TO DATE: After weighting, the patients had 4.1 (1.8) chronic conditions and 2.5 (1.9) medications on average; 37% forgot taking medication sometimes; 71% rated their health as fair or poor; 17% were frail; 73% reported one (21%) or two or more (52%) body pain areas; 62% were overweight/obese; 23% reported chewing difficulty, 18% reported incontinence; 36% had current stage 1/2 hypertension; 38% had handgrip strength below the cut-off; 10% screened positive in sarcopenia; 17% had mild or severer cognitive impairment; 17% had mild to severe depression; 16% had mild to severe anxiety; 50% had subthreshold to severe insomnia; 28% indicated being lonely; 12% needed help in at least one out of the five daily functions and the EuroQoL-5-Dimensions-5-Level index score was 0.81 (0.20) and its Visual Analogue Scale (VAS) score was 67.6 (14.6). In the past 12 months, 17% were hospitalised, 92% attended general outpatient clinics, 70% attended specialist outpatient clinics and 10% used elderly daycare centre services, the median out-of-pocket health cost was HK$1000 (US$150). Female and male patients showed significant differences in many biopsychosocial health aspects. FUTURE PLANS: With assessments and clinical data, the cohort can be used for understanding longitudinal trajectories of biopsychosocial health profiles of Chinese older patients with multimorbidity in primary care. We are also initially planning cohort studies on factors associated with various health outcomes, as well as quality of life and healthcare use. COHORT REGISTRATION NUMBER: ChiCTR-OIC-16008477.

Original language	English
Article number	027279
Pages (from-to)	e027279
Number of pages	17
Journal	BMJ Open
Volume	10
Issue number	2
Early online date	20 Feb 2020
DOIs	https://doi.org/10.1136/bmjopen-2018-027279
Publication status	Published - Feb 2020

Keywords

chronic conditions
comorbidities
general practice
older adults
physical, psychological and social factors
primary care
SARC-F
VALIDATION
RELIABILITY
DEPRESSIVE SYMPTOMS
GENERAL-POPULATION
CLINICAL UTILITY
HEALTH-CARE
QUESTIONNAIRE
ASSOCIATION
EPIDEMIOLOGY

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© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. http://creativecommons.org/licenses/by-nc/4.0/ This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.
Final published version, 1.25 MBLicence: CC BY-NC

Cite this

@article{890b8b1b2e7547a2a25e51220fe9abf7,

title = "Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong",

abstract = "PURPOSE: This is an ongoing prospective cohort aiming to examine the biopsychosocial health profiles and predictors of health outcomes of older patients with multimorbidity in primary care in Hong Kong. PARTICIPANTS: From April 2016 to October 2017, 1077 patients aged 60+ years with at least two chronic diseases were recruited in four public primary care clinics in the New Territories East Region of Hong Kong. FINDINGS TO DATE: After weighting, the patients had 4.1 (1.8) chronic conditions and 2.5 (1.9) medications on average; 37% forgot taking medication sometimes; 71% rated their health as fair or poor; 17% were frail; 73% reported one (21%) or two or more (52%) body pain areas; 62% were overweight/obese; 23% reported chewing difficulty, 18% reported incontinence; 36% had current stage 1/2 hypertension; 38% had handgrip strength below the cut-off; 10% screened positive in sarcopenia; 17% had mild or severer cognitive impairment; 17% had mild to severe depression; 16% had mild to severe anxiety; 50% had subthreshold to severe insomnia; 28% indicated being lonely; 12% needed help in at least one out of the five daily functions and the EuroQoL-5-Dimensions-5-Level index score was 0.81 (0.20) and its Visual Analogue Scale (VAS) score was 67.6 (14.6). In the past 12 months, 17% were hospitalised, 92% attended general outpatient clinics, 70% attended specialist outpatient clinics and 10% used elderly daycare centre services, the median out-of-pocket health cost was HK$1000 (US$150). Female and male patients showed significant differences in many biopsychosocial health aspects. FUTURE PLANS: With assessments and clinical data, the cohort can be used for understanding longitudinal trajectories of biopsychosocial health profiles of Chinese older patients with multimorbidity in primary care. We are also initially planning cohort studies on factors associated with various health outcomes, as well as quality of life and healthcare use. COHORT REGISTRATION NUMBER: ChiCTR-OIC-16008477.",

keywords = "chronic conditions, comorbidities, general practice, older adults, physical, psychological and social factors, primary care, SARC-F, VALIDATION, RELIABILITY, DEPRESSIVE SYMPTOMS, GENERAL-POPULATION, CLINICAL UTILITY, HEALTH-CARE, QUESTIONNAIRE, ASSOCIATION, EPIDEMIOLOGY",

author = "Dexing Zhang and Sit, {Regina Wing Shan} and Carmen Wong and Dan Zou and Mercer, {Stewart W.} and Johnston, {Marjorie C.} and Wong, {Samuel Yeung Shan}",

note = "Acknowledgments We would like to thank the General Outpatient Clinics (Lek Yuen, Ma On Shan, Shatin (Tai Wai), Yuen Chau Kok) and Shatin Rhenish Neighbourhood Elderly Centre for the support and help in recruitment. We also greatly thank all the patients who joined in the cohort. Funding The staff working on this cohort received funding from the Hong Kong Jockey Club Charities Trust. Competing interests None declared. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available on reasonable request. The authors warmly welcome collaborations for future research based on this study. For those who would like to request for the data or propose new assessments into the follow-up assessments, they can email to: (yeungshanwong@cuhk.edu.hk). For more information please see the website: http://cpcp.sphpc.cuhk.edu.hk/chi/.",

year = "2020",

month = feb,

doi = "10.1136/bmjopen-2018-027279",

language = "English",

volume = "10",

pages = "e027279",

journal = "BMJ Open",

issn = "2044-6055",

publisher = "BMJ Publishing Group",

number = "2",

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TY - JOUR

T1 - Cohort profile

T2 - The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

AU - Zhang, Dexing

AU - Sit, Regina Wing Shan

AU - Wong, Carmen

AU - Zou, Dan

AU - Mercer, Stewart W.

AU - Johnston, Marjorie C.

AU - Wong, Samuel Yeung Shan

N1 - Acknowledgments We would like to thank the General Outpatient Clinics (Lek Yuen, Ma On Shan, Shatin (Tai Wai), Yuen Chau Kok) and Shatin Rhenish Neighbourhood Elderly Centre for the support and help in recruitment. We also greatly thank all the patients who joined in the cohort. Funding The staff working on this cohort received funding from the Hong Kong Jockey Club Charities Trust. Competing interests None declared. Patient consent for publication Not required. Provenance and peer review Not commissioned; externally peer reviewed. Data availability statement Data are available on reasonable request. The authors warmly welcome collaborations for future research based on this study. For those who would like to request for the data or propose new assessments into the follow-up assessments, they can email to: (yeungshanwong@cuhk.edu.hk). For more information please see the website: http://cpcp.sphpc.cuhk.edu.hk/chi/.

PY - 2020/2

Y1 - 2020/2

N2 - PURPOSE: This is an ongoing prospective cohort aiming to examine the biopsychosocial health profiles and predictors of health outcomes of older patients with multimorbidity in primary care in Hong Kong. PARTICIPANTS: From April 2016 to October 2017, 1077 patients aged 60+ years with at least two chronic diseases were recruited in four public primary care clinics in the New Territories East Region of Hong Kong. FINDINGS TO DATE: After weighting, the patients had 4.1 (1.8) chronic conditions and 2.5 (1.9) medications on average; 37% forgot taking medication sometimes; 71% rated their health as fair or poor; 17% were frail; 73% reported one (21%) or two or more (52%) body pain areas; 62% were overweight/obese; 23% reported chewing difficulty, 18% reported incontinence; 36% had current stage 1/2 hypertension; 38% had handgrip strength below the cut-off; 10% screened positive in sarcopenia; 17% had mild or severer cognitive impairment; 17% had mild to severe depression; 16% had mild to severe anxiety; 50% had subthreshold to severe insomnia; 28% indicated being lonely; 12% needed help in at least one out of the five daily functions and the EuroQoL-5-Dimensions-5-Level index score was 0.81 (0.20) and its Visual Analogue Scale (VAS) score was 67.6 (14.6). In the past 12 months, 17% were hospitalised, 92% attended general outpatient clinics, 70% attended specialist outpatient clinics and 10% used elderly daycare centre services, the median out-of-pocket health cost was HK$1000 (US$150). Female and male patients showed significant differences in many biopsychosocial health aspects. FUTURE PLANS: With assessments and clinical data, the cohort can be used for understanding longitudinal trajectories of biopsychosocial health profiles of Chinese older patients with multimorbidity in primary care. We are also initially planning cohort studies on factors associated with various health outcomes, as well as quality of life and healthcare use. COHORT REGISTRATION NUMBER: ChiCTR-OIC-16008477.

AB - PURPOSE: This is an ongoing prospective cohort aiming to examine the biopsychosocial health profiles and predictors of health outcomes of older patients with multimorbidity in primary care in Hong Kong. PARTICIPANTS: From April 2016 to October 2017, 1077 patients aged 60+ years with at least two chronic diseases were recruited in four public primary care clinics in the New Territories East Region of Hong Kong. FINDINGS TO DATE: After weighting, the patients had 4.1 (1.8) chronic conditions and 2.5 (1.9) medications on average; 37% forgot taking medication sometimes; 71% rated their health as fair or poor; 17% were frail; 73% reported one (21%) or two or more (52%) body pain areas; 62% were overweight/obese; 23% reported chewing difficulty, 18% reported incontinence; 36% had current stage 1/2 hypertension; 38% had handgrip strength below the cut-off; 10% screened positive in sarcopenia; 17% had mild or severer cognitive impairment; 17% had mild to severe depression; 16% had mild to severe anxiety; 50% had subthreshold to severe insomnia; 28% indicated being lonely; 12% needed help in at least one out of the five daily functions and the EuroQoL-5-Dimensions-5-Level index score was 0.81 (0.20) and its Visual Analogue Scale (VAS) score was 67.6 (14.6). In the past 12 months, 17% were hospitalised, 92% attended general outpatient clinics, 70% attended specialist outpatient clinics and 10% used elderly daycare centre services, the median out-of-pocket health cost was HK$1000 (US$150). Female and male patients showed significant differences in many biopsychosocial health aspects. FUTURE PLANS: With assessments and clinical data, the cohort can be used for understanding longitudinal trajectories of biopsychosocial health profiles of Chinese older patients with multimorbidity in primary care. We are also initially planning cohort studies on factors associated with various health outcomes, as well as quality of life and healthcare use. COHORT REGISTRATION NUMBER: ChiCTR-OIC-16008477.

KW - chronic conditions

KW - comorbidities

KW - general practice

KW - older adults

KW - physical, psychological and social factors

KW - primary care

KW - SARC-F

KW - VALIDATION

KW - RELIABILITY

KW - DEPRESSIVE SYMPTOMS

KW - GENERAL-POPULATION

KW - CLINICAL UTILITY

KW - HEALTH-CARE

KW - QUESTIONNAIRE

KW - ASSOCIATION

KW - EPIDEMIOLOGY

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U2 - 10.1136/bmjopen-2018-027279

DO - 10.1136/bmjopen-2018-027279

M3 - Article

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AN - SCOPUS:85079735911

VL - 10

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JO - BMJ Open

JF - BMJ Open

SN - 2044-6055

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ER -

Cohort profile: The prospective study on Chinese elderly with multimorbidity in primary care in Hong Kong

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Keywords

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