A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts

Renate Quinzler, Michael H. Freitag, Birgitt Wiese, Martin Beyer, Hermann Brenner, Anne Dahlhaus, Angela Döring, Tobias Freund, Margit Heier, Hildtraud Knopf, Melanie Luppa, Jana Prokein, Steffi G. Riedel-Heller, Ingmar Schäfer, Christa Scheidt-Nave, Martin Scherer, Ben Schöttker, Joachim Szecsenyi, Petra Thürmann, Hendrik van den Bussche & 2 others Jochen Gensichen, Walter E. Haefeli

Research output: Contribution to journalArticle

Abstract

Objectives: On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients. Study Design and Setting: Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study). By assessing receiver-operating characteristics (ROC) curves, the performance of medCDS was then confirmed in independent cohorts (ESTHER, KORA-Age) of community-dwelling older patients and compared with already existing medication-based scores and a score using selected anatomical-therapeutic-chemical (ATC) codes. Results: The final medCDS score had an ROC area under the curve (AUC) of 0.73 (95% CI 0.70-0.76). In the validation cohorts, its ROC AUCs were 0.79 (0.76-0.82, KORA-Age) and 0.74 (0.71-0.78, ESTHER), which were superior to already existing medication-based scores (RxRisk, CDS) and scores based on pharmacological ATC code subgroups (ATC3) or age and sex alone (Age&Sex). Conclusions: A new medCDS, which is based on actual treatment standards, predicts mortality of older outpatients significantly better than already existing scores.

LanguageEnglish (US)
Pages112-124
Number of pages13
JournalJournal of clinical epidemiology
Volume105
DOIs
StatePublished - Jan 1 2019

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Geriatrics
Chronic Disease
Mortality
ROC Curve
Outpatients
Area Under Curve
Independent Living
Evidence-Based Medicine
Therapeutics
Cohort Studies
Pharmacology
Guidelines
Population

Keywords

  • Elderly
  • Medication-based chronic disease score
  • Mortality
  • Multimorbidity
  • Risk assessment

ASJC Scopus subject areas

  • Epidemiology

Cite this

A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts. / Quinzler, Renate; Freitag, Michael H.; Wiese, Birgitt; Beyer, Martin; Brenner, Hermann; Dahlhaus, Anne; Döring, Angela; Freund, Tobias; Heier, Margit; Knopf, Hildtraud; Luppa, Melanie; Prokein, Jana; Riedel-Heller, Steffi G.; Schäfer, Ingmar; Scheidt-Nave, Christa; Scherer, Martin; Schöttker, Ben; Szecsenyi, Joachim; Thürmann, Petra; van den Bussche, Hendrik; Gensichen, Jochen; Haefeli, Walter E.

In: Journal of clinical epidemiology, Vol. 105, 01.01.2019, p. 112-124.

Research output: Contribution to journalArticle

Quinzler, R, Freitag, MH, Wiese, B, Beyer, M, Brenner, H, Dahlhaus, A, Döring, A, Freund, T, Heier, M, Knopf, H, Luppa, M, Prokein, J, Riedel-Heller, SG, Schäfer, I, Scheidt-Nave, C, Scherer, M, Schöttker, B, Szecsenyi, J, Thürmann, P, van den Bussche, H, Gensichen, J & Haefeli, WE 2019, 'A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts' Journal of clinical epidemiology, vol. 105, pp. 112-124. https://doi.org/10.1016/j.jclinepi.2018.09.004
Quinzler, Renate ; Freitag, Michael H. ; Wiese, Birgitt ; Beyer, Martin ; Brenner, Hermann ; Dahlhaus, Anne ; Döring, Angela ; Freund, Tobias ; Heier, Margit ; Knopf, Hildtraud ; Luppa, Melanie ; Prokein, Jana ; Riedel-Heller, Steffi G. ; Schäfer, Ingmar ; Scheidt-Nave, Christa ; Scherer, Martin ; Schöttker, Ben ; Szecsenyi, Joachim ; Thürmann, Petra ; van den Bussche, Hendrik ; Gensichen, Jochen ; Haefeli, Walter E. / A novel superior medication-based chronic disease score predicted all-cause mortality in independent geriatric cohorts. In: Journal of clinical epidemiology. 2019 ; Vol. 105. pp. 112-124.
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AU - Quinzler, Renate

AU - Freitag, Michael H.

AU - Wiese, Birgitt

AU - Beyer, Martin

AU - Brenner, Hermann

AU - Dahlhaus, Anne

AU - Döring, Angela

AU - Freund, Tobias

AU - Heier, Margit

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AU - Luppa, Melanie

AU - Prokein, Jana

AU - Riedel-Heller, Steffi G.

AU - Schäfer, Ingmar

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AU - Schöttker, Ben

AU - Szecsenyi, Joachim

AU - Thürmann, Petra

AU - van den Bussche, Hendrik

AU - Gensichen, Jochen

AU - Haefeli, Walter E.

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N2 - Objectives: On the basis of current treatment guidelines, we developed and validated a medication-based chronic disease score (medCDS) and tested its association with all-cause mortality of older outpatients. Study Design and Setting: Considering the most prevalent chronic diseases in the elderly German population, we compiled a list of evidence-based medicines used to treat these disorders. Based on this list, a score (medCDS) was developed to predict mortality using data of a large longitudinal cohort of older outpatients (training sample; MultiCare Cohort Study). By assessing receiver-operating characteristics (ROC) curves, the performance of medCDS was then confirmed in independent cohorts (ESTHER, KORA-Age) of community-dwelling older patients and compared with already existing medication-based scores and a score using selected anatomical-therapeutic-chemical (ATC) codes. Results: The final medCDS score had an ROC area under the curve (AUC) of 0.73 (95% CI 0.70-0.76). In the validation cohorts, its ROC AUCs were 0.79 (0.76-0.82, KORA-Age) and 0.74 (0.71-0.78, ESTHER), which were superior to already existing medication-based scores (RxRisk, CDS) and scores based on pharmacological ATC code subgroups (ATC3) or age and sex alone (Age&Sex). Conclusions: A new medCDS, which is based on actual treatment standards, predicts mortality of older outpatients significantly better than already existing scores.

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KW - Multimorbidity

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