This trial is active, not recruiting.

Condition multimorbidity
Treatment this is not an intervention study
Sponsor University College, London
Collaborator University of Leeds
Start date January 2015
End date September 2015
Trial size 1300000 participants
Trial identifier NCT02609516, 14_179


Life expectancy at age 65 in the most deprived fifth of the English population was about 4 years shorter than of the most affluent fifth in 2010. The inverse gradient between mortality and social position is well established. But how disease patterns and multimorbidity (having two or more long term conditions at the same time) impact on differential mortality rates is inconclusive: is it because disadvantaged groups acquire more or more lethal combinations of, diseases over their life course; or, simply, become ill at ages younger than more affluent groups?

United States No locations recruiting
Other countries No locations recruiting

Study Design

Observational model cohort
Time perspective retrospective
Patients without any of the pre-specified chronic diseases
this is not an intervention study
This study is based on the retrospective analysis of linked electronic health records.
Patients having any two or more of the pre-specified chronic diseases
this is not an intervention study
This study is based on the retrospective analysis of linked electronic health records.

Primary Outcomes

Yearly multimorbidity incidence rate
time frame: 10 years
Yearly multimorbidity prevalence
time frame: 10 years
Yearly all-cause mortality rates
time frame: 10 years
Overall life expectancy
time frame: 10 years
Health state-specific life expectancies
time frame: 10 years

Secondary Outcomes

Yearly non-accidental mortality rates
time frame: 10 years

Eligibility Criteria

Male or female participants at least 45 years old.

Inclusion Criteria: - Registered with a participating practice that has agreed to data linkage - Registered with an 'up to standard' participating general practice for at least 1 year - Aged 45 and over on Jan 1st 2001 or who turn 45 between 1st Jan 2001 and 25th March 2010, irrespective of initial health status. Exclusion Criteria: - Patients with a record unlinked to deprivation due to missing or incomplete postcode of residence.

Additional Information

Official title What is the Impact of Socioeconomic Inequalities in the Rates of Transition Between Health, Multimorbidity and Death Amongst Older People in England?
Description The association between social inequality and cause-specific mortality and single disease morbidity has been studied extensively. However, it remains unclear whether having two or more chronic diseases concurrently (or 'multimorbidity') plays a role in contributing to the inequalities gap in survival. This is particularly relevant given an ageing population and the trend of a widening in the life expectancy gap across several European countries. Multimorbidity incidence increases rapidly with age. Estimates of the prevalence of multimorbidity in older people range from 55% to 98%, mainly due to the selection of diseases included, population coverage (hospital, community) and data source (self-reported surveys or clinical records). However, across all studies there is a clear and consistent pattern of higher prevalence rates at older ages, with multimorbidity. Many aspects of the patient health trajectory remain under-explored. Patient case-mixes are likely to vary across socioeconomic groups, alongside a host of prognostic factors, including the clustering of multiple risk factors, age of onset, and disease presentation, progression and management in the presence of multiple health conditions.
Trial information was received from ClinicalTrials.gov and was last updated in November 2015.
Information provided to ClinicalTrials.gov by University College, London.