Medication-Related Problems in Older People with Multimorbidity in Catalonia : A Real-World Data Study with 5 Years' Follow-Up
Troncoso-Mariño, Amelia (Institut d'Investigació Biomèdica de Bellvitge)
Roso-Llorach, Albert (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
López Jiménez, Tomàs (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Villén, Noemí (Institut Català de la Salut)
Amado, Ester (Institut Català de la Salut)
Fernández-Bertolín, Sergio (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Carrasco-Ribelles, Lucía Amalia (Universitat Politècnica de Catalunya. Departament de Teoria del Senyal i Comunicacions)
Borras, Josep M. (Institut d'Investigació Biomèdica de Bellvitge)
Violán, Concepció (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)

Date:	2021
Abstract:	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.
Grants:	Ministerio de Economía y Competitividad PI16/00639 Agència de Gestió d'Ajuts Universitaris i de Recerca 2017/SGR-578 Generalitat de Catalunya SLT002/16/00058
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Multimorbidity ; Polypharmacy ; Drug interactions ; Duplicate therapy ; Contraindicated drugs ; Inappropriate prescribing ; Primary health care ; Elderly
Published in:	Journal of clinical medicine, Vol. 10 (february 2021) , ISSN 2077-0383

DOI: 10.3390/jcm10040709
PMID: 33670201

14 p, 839.9 KB

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