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oai:repisalud.isciii.es:20.500.12105/232442024-11-29T01:48:39Zcom_20.500.12105_15322com_20.500.12105_2051col_20.500.12105_16967
Repisalud author Ricci-Cabello, Ignacio author Yáñez, Aina M author Fiol-deRoque, Maria Antonia author Leiva Rus, Alfonso author Llobera Cànaves, Joan author Parmentier, Fabrice BR author Valderas, Jose M 2024-09-18T06:43:35Z 2024-09-18T06:43:35Z 2021-04 Ricci-Cabello I, Yanez-Juan AM, Fiol-deRoque MA, Leiva A, Canaves JL, Parmentier FBR, et al. Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data. J Clin Med. 2021 Apr;10(8):1782. 10.3390/jcm10081782 2077-0383 Journal of Clinical Medicine https://hdl.handle.net/20.500.13003/19449 33923906 L2006985773 2-s2.0-85114082058 https://hdl.handle.net/20.500.12105/23244 644444800001 We aimed to examine the complex relationships between patient safety processes and outcomes and multimorbidity using a comprehensive set of constructs: multimorbidity, polypharmacy, discordant comorbidity (diseases not sharing either pathogenesis nor management), morbidity burden and patient complexity. We used cross-sectional data from 4782 patients in 69 primary care centres in Spain. We constructed generalized structural equation models to examine the associations between multimorbidity constructs and patient-reported patient safety (PREOS-PC questionnaire). These associations were modelled through direct and indirect (mediated by increased interactions with healthcare) pathways. For women, a consistent association between higher levels of the multimorbidity constructs and lower levels of patient safety was observed via either pathway. The findings for men replicated these observations for polypharmacy, morbidity burden and patient complexity via indirect pathways. However, direct pathways showed unexpected associations between higher levels of multimorbidity and better safety. The consistent association between multimorbidity constructs and worse patient safety among women makes it advisable to target this group for the development of interventions, with particular attention to the role of comorbidity discordance. Further research, particularly qualitative research, is needed for clarifying the complex associations among men. eng Multimorbidity Polypharmacy Patient safety Primary care Structural equation model Latent class analysis Assessing the Impact of Multi-Morbidity and Related Constructs on Patient Reported Safety in Primary Care: Generalized Structural Equation Modelling of Observational Data research article