71c75d385c9851db46b813b7b16958f0 pmc_33670201.pdf 29a7a97f6ca1c0b90e585296042b584f094d44ef pmc_33670201.pdf 667e009d66071f2f744cd436015919a5ee877df22118e89e082f52c573bf2d88 pmc_33670201.pdf Title: Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up Subject: Aging, multimorbidity, and polypharmacy are associated with medication-related problems (MRPs). This study aimed to assess the association that multimorbidity and mortality have with MRPs in older people over time. We followed multimorbid, older (65–99 years) people in Catalonia from 2012 to 2016, using longitudinal data and Cox models to estimate adjusted hazard ratios (HR). We reviewed electronic health records to collect explanatory variables and MRPs (duplicate therapy, drug–drug interactions, potentially inappropriate medications (PIM), and contraindicated drugs in chronic kidney disease (CKD) or liver disease). There were 723,016 people (median age: 74 years; 58.9% women) who completed follow-up. We observed a significant (p < 0.001) increase in the proportion with at least one MRP (2012: 66.9% to 2016: 75.5%); contraindicated drugs in CKD (11.1 to 18.5%) and liver disease (3.9 to 5.3%); and PIMs (62.5 to 71.1%), especially drugs increasing fall risk (67.5%). People with 10 diseases had more MRPs (in 2016: PIMs, 89.6%; contraindicated drugs in CKD, 34.4%; and in liver disease, 9.3%). All MRPs were independently associated with mortality, from duplicate therapy (HR 1.06; 95% confidence interval (CI) 1.04–1.08) to interactions (HR 1.60; 95% CI 1.54–1.66). Ensuring safe pharmacological treatment in elderly, multimorbid patient remains a challenge for healthcare systems. Keywords: multimorbidity; polypharmacy; drug interactions; duplicate therapy; contraindicated drugs; inappropriate prescribing; primary health care; elderly Author: Amelia Troncoso-Mariño, Albert Roso-Llorach, Tomás López-Jiménez, Noemí Villen, Ester Amado-Guirado, Sergio Fernández-Bertolin, Lucía A. Carrasco-Ribelles, Josep Ma Borras and Concepción Violán Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Thu Feb 25 09:18:17 2021 CET ModDate: Thu Feb 25 09:36:27 2021 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 14 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 860080 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- JYPLJJ+VnURWPalladioL-Bold Type 1 Custom yes yes no 17 0 XNGWXG+VnURWPalladioL Type 1 Custom yes yes no 22 0 UNYIWI+URWPalladioL-Ital Type 1 Custom yes yes no 26 0 DNSXLG+URWPalladioL-Bold Type 1 Custom yes yes no 31 0 PPKNCY+URWPalladioL-Roma Type 1 Custom yes yes no 35 0 HCPSKZ+CMSY10 Type 1 Builtin yes yes no 39 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 47 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 50 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 70 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 74 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 78 0 VSLKTE+VnURWPalladioL-Italic Type 1 Custom yes yes no 95 0 PPNCPP+PalatinoLinotype TrueType WinAnsi yes yes no 112 0 JNKHLF+PalatinoLinotype-Bold CID TrueType Identity-H yes yes yes 121 0 JNKNPL+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes no 127 0 JNKHOE+PalatinoLinotype-Roman CID TrueType Identity-H yes yes yes 130 0 JNKHOF+PalatinoLinotype-Italic CID TrueType Identity-H yes yes yes 136 0 JNKHPG+PalatinoLinotype-Italic TrueType WinAnsi yes yes no 142 0 JNKIAH+PalatinoLinotype-Bold TrueType WinAnsi yes yes no 145 0 JNKIBH+PalatinoLinotype-Roman TrueType WinAnsi yes yes no 148 0 URYLRZ+URWPalladioL-BoldItal Type 1 Custom yes yes no 157 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-10-02 03:28:47 CEST RepresentationInformation: pmc_33670201.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2023-03-31 12:09:03 CEST Size: 860080 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 342 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Materials and Methods Destination: section.2 Children: Item: Title: Design, Setting, and Study Population Destination: subsection.2.1 Item: Title: Dataset Destination: subsection.2.2 Item: Title: Variables Destination: subsection.2.3 Children: Item: Title: Chronic Diseases and Multimorbidity Destination: subsubsection.2.3.1 Item: Title: Drugs Destination: subsubsection.2.3.2 Item: Title: Kidney Function Destination: subsubsection.2.3.3 Item: Title: Liver Function Destination: subsubsection.2.3.4 Item: Title: Other Variables Destination: subsubsection.2.3.5 Item: Title: Medication-Related Problems Destination: subsubsection.2.3.6 Item: Title: Ethics Destination: subsection.2.4 Item: Title: Statistical Analysis Destination: subsection.2.5 Item: Title: Results Destination: section.3 Item: Title: Discussion Destination: section.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up Author: Amelia Troncoso-Mariño, Albert Roso-Llorach, Tomás López-Jiménez, Noemí Villen, Ester Amado-Guirado, Sergio Fernández-Bertolin, Lucía A. Carrasco-Ribelles, Josep Ma Borras and Concepción Violán Subject: Aging, multimorbidity, and polypharmacy are associated with medication-related problems (MRPs). This study aimed to assess the association that multimorbidity and mortality have with MRPs in older people over time. We followed multimorbid, older (65 99 years) people in Catalonia from 2012 to 2016, using longitudinal data and Cox models to estimate adjusted hazard ratios (HR). We reviewed electronic health records to collect explanatory variables and MRPs (duplicate therapy, drug drug interactions, potentially inappropriate medications (PIM), and contraindicated drugs in chronic kidney disease (CKD) or liver disease). There were 723,016 people (median age: 74 years; 58.9% women) who completed follow-up. We observed a significant (p < 0.001) increase in the proportion with at least one MRP (2012: 66.9% to 2016: 75.5%); contraindicated drugs in CKD (11.1 to 18.5%) and liver disease (3.9 to 5.3%); and PIMs (62.5 to 71.1%), especially drugs increasing fall risk (67.5%). People with 10 diseases had more MRPs (in 2016: PIMs, 89.6%; contraindicated drugs in CKD, 34.4%; and in liver disease, 9.3%). All MRPs were independently associated with mortality, from duplicate therapy (HR 1.06; 95% confidence interval (CI) 1.04 1.08) to interactions (HR 1.60; 95% CI 1.54 1.66). Ensuring safe pharmacological treatment in elderly, multimorbid patient remains a challenge for healthcare systems. 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