To cite: Guellich A, Oubaya N, Cogneau J, et al. Identifying patterns of multimorbidity, polypharmacy and frailty in the elderly: a clustering analysis of baseline data from a French, randomised, controlled trial in primary care. BMJ Open 2025;15:e083584. doi:10.1136/ bmjopen-2023-083584 ► Prepublication history and additional supplemental material for this paper are available online.
To view these files, please visit the journal online (https://doi.org/10.1136/ bmjopen-2023-083584).
Received 22 December 2023 Accepted 01 April 2025
Abstract
Objectives To identify distinct profiles among elderly patients in primary care so that general practitioners (GPs) can develop more targeted care strategies.
Design A cross-sectional analysis of baseline data from the French nationwide ‘Elderly Appropriate Treatment in Primary Care’ trial.
Setting Primary care in France: 277 GPs included patients.
Participants The study participants were aged 75 or over, living at home, and taking five or more prescription medications. Of the 2724 patients included, 2651 were analysed.
Primary and secondary outcome measures To identify specific patterns of multimorbidity, polypharmacy and frailty, we applied an unsupervised clustering analysis with self-organising maps.
Results Seven clusters were identified: cluster 1 (16% of the patients) comprised frail men and women with cardiovascular, respiratory, musculoskeletal and endocrine diseases and marked polypharmacy; cluster 2 (9.3%, mainly men) comprised frail patients with cancer and cardiovascular or urogenital/renal diseases; cluster 3 (15.5%, mainly men) comprised not-very-frail patients with cardiovascular and urogenital/renal diseases; cluster 4 (18.1%) comprised not-very-frail men and women with cardiovascular diseases; cluster 5 (13.5%, mainly women) comprised mainly lonely, very frail patients with hypertension and endocrine, musculoskeletal and neuropsychiatric disorders; cluster 6 (19.1%, mainly women) comprised frail, socially isolated patients with digestive, musculoskeletal and neuropsychiatric diseases; lastly, cluster 7 (8.6%, mainly women) comprised frail, socially isolated patients with hypertension, cancer, or musculoskeletal, psychological and digestive disorders.
Conclusion Our phenotypic classification of elderly patients might facilitate efforts to align healthcare services with the care needs that are encountered by GPs in their everyday practice.