44cfaaef9ffd09b9eaad3b3c4616d294 ijerph-19-15902.pdf 65e75aa8e8568eae9fef165101381e57497f5d8e ijerph-19-15902.pdf 1a23416a310b452daa4f11b5dce9ce00c52a82b9178b549d7618044d0889e5bf ijerph-19-15902.pdf Title: Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication—MoPIM Cohort Study Subject: Multimorbidity is increasing and poses a challenge to the clinical management of patients with multiple conditions and drug prescriptions. The objectives of this work are to evaluate if multimorbidity patterns are associated with quality indicators of medication: potentially inappropriate prescribing (PIP) or adverse drug reactions (ADRs). A multicentre prospective cohort study was conducted including 740 older (65 years) patients hospitalised due to chronic pathology exacerbation. Sociodemographic, clinical and medication related variables (polypharmacy, PIP according to STOPP/START criteria, ADRs) were collected. Bivariate analyses were performed comparing previously identified multimorbidity clusters (osteoarticular, psychogeriatric, minor chronic disease, cardiorespiratory) to presence, number or specific types of PIP or ADRs. Significant associations were found in all clusters. The osteoarticular cluster presented the highest prevalence of PIP (94.9%) and ADRs (48.2%), mostly related to anxiolytics and antihypertensives, followed by the minor chronic disease cluster, associated with ADRs caused by antihypertensives and insulin. The psychogeriatric cluster presented PIP and ADRs of neuroleptics and the cardiorespiratory cluster indicators were better overall. In conclusion, the associations that were found reinforce the existence of multimorbidity patterns and support specific medication review actions according to each patient profile. Thus, determining the relationship between multimorbidity profiles and quality indicators of medication could help optimise healthcare processes. Trial registration number: NCT02830425. Keywords: older patient; multimorbidity; cluster analysis; polypharmacy; potentially inappropriate medication; potential prescribing omission; adverse drug reaction; healthcare quality indicator Author: Marina Lleal, Marisa Baré, Sara Ortonobes, Daniel Sevilla-Sánchez, Rosa Jordana, Susana Herranz, Maria Queralt Gorgas, Mariona Espaulella-Ferrer, Marta Arellano, Marta de Antonio, Gloria Julia Nazco, Rubén Hernández-Luis and on behalf of the MoPIM Study Group Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Tue Nov 29 10:07:03 2022 CET ModDate: Tue Nov 29 10:23:40 2022 CET Custom Metadata: no Metadata Stream: no Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 16 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 898109 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- VTKUEQ+URWPalladioL-Bold Type 1 Custom yes yes no 10 0 FMBKNE+URWPalladioL-Roma Type 1 Custom yes yes no 15 0 IDUCIY+URWPalladioL-Ital Type 1 Custom yes yes no 19 0 JGMOZW+CMSY10 Type 1 Builtin yes yes no 23 0 SWQFHZ+VnURWPalladioL Type 1 Custom yes yes no 27 0 GIFXFT+VnURWPalladioL-Bold Type 1 Custom yes yes no 32 0 LWQXII+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 50 0 IRWHZX+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 53 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 84 0 MGFKKP+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 105 0 MGFKLB+PalatinoLinotype TrueType WinAnsi yes yes no 108 0 MGFKLD+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 111 0 MGFKKP+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 130 0 MGFKLB+PalatinoLinotype TrueType WinAnsi yes yes no 133 0 MGFKLD+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 136 0 MGFKKP+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 155 0 MGFKLB+PalatinoLinotype TrueType WinAnsi yes yes no 158 0 MGFKLD+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 161 0 CRUZTT+VnURWPalladioL-Italic Type 1 Custom yes yes no 182 0 LWLIVD+EURM10 Type 1 Builtin yes yes no 192 0 Jhove (Rel. 1.28.0, 2023-05-18) Date: 2024-07-04 02:38:51 CEST RepresentationInformation: ijerph-19-15902.pdf ReportingModule: PDF-hul, Rel. 1.12.4 (2023-03-16) LastModified: 2024-07-03 17:59:57 CEST Size: 898109 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 376 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: section.1 Item: Title: Methodology Destination: section.2 Children: Item: Title: Design and Setting Destination: subsection.2.1 Item: Title: Data Acquisition and Variables Destination: subsection.2.2 Item: Title: Sampling and Analysis Destination: subsection.2.3 Item: Title: Results Destination: section.3 Children: Item: Title: Sociodemographic and Clinical Characteristics of the Cohort Destination: subsection.3.1 Item: Title: Relationship between Multimorbidity Clusters and Potentially Inappropriate Prescribing Destination: subsection.3.2 Item: Title: Relationship between Multimorbidity Clusters and Adverse Drug Reactions Destination: subsection.3.3 Item: Title: Discussion Destination: section.4 Children: Item: Title: Main Important Results and Novelty Destination: subsection.4.1 Item: Title: Clinical Implications Destination: subsection.4.2 Item: Title: Comparison to Other Studies Destination: subsection.4.3 Item: Title: Strengths and Limitations Destination: subsection.4.4 Item: Title: Conclusions Destination: section.5 Item: Title: References Destination: section.5 Info: Title: Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication MoPIM Cohort Study Author: Marina Lleal, Marisa Baré, Sara Ortonobes, Daniel Sevilla-Sánchez, Rosa Jordana, Susana Herranz, Maria Queralt Gorgas, Mariona Espaulella-Ferrer, Marta Arellano, Marta de Antonio, Gloria Julia Nazco, Rubén Hernández-Luis and on behalf of the MoPIM Study Group Subject: Multimorbidity is increasing and poses a challenge to the clinical management of patients with multiple conditions and drug prescriptions. The objectives of this work are to evaluate if multimorbidity patterns are associated with quality indicators of medication: potentially inappropriate prescribing (PIP) or adverse drug reactions (ADRs). A multicentre prospective cohort study was conducted including 740 older (65 years) patients hospitalised due to chronic pathology exacerbation. Sociodemographic, clinical and medication related variables (polypharmacy, PIP according to STOPP/START criteria, ADRs) were collected. Bivariate analyses were performed comparing previously identified multimorbidity clusters (osteoarticular, psychogeriatric, minor chronic disease, cardiorespiratory) to presence, number or specific types of PIP or ADRs. Significant associations were found in all clusters. The osteoarticular cluster presented the highest prevalence of PIP (94.9%) and ADRs (48.2%), mostly related to anxiolytics and antihypertensives, followed by the minor chronic disease cluster, associated with ADRs caused by antihypertensives and insulin. The psychogeriatric cluster presented PIP and ADRs of neuroleptics and the cardiorespiratory cluster indicators were better overall. In conclusion, the associations that were found reinforce the existence of multimorbidity patterns and support specific medication review actions according to each patient profile. Thus, determining the relationship between multimorbidity profiles and quality indicators of medication could help optimise healthcare processes. Trial registration number: NCT02830425. 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