Polypharmacy Patterns in Multimorbid Older People with Cardiovascular Disease : Longitudinal Study
Villén, Noemí (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i de Medicina Preventiva i Salut Pública)
Roso-Llorach, Albert (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Gallego-Moll, Carlos (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Danes-Castells, Marc (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Fernández-Bertolín, Sergio (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Troncoso-Mariño, Amelia (Institut Català de la Salut)
Monteagudo, Mònica (Institut Universitari d'Investigació en Atenció Primària Jordi Gol)
Amado, Ester (Institut Català de la Salut)
Violán, Concepció (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)

Date:	2022
Abstract:	(1) Introduction: Cardiovascular disease is associated with high mortality, especially in older people. This study aimed to characterize the evolution of combined multimorbidity and polypharmacy patterns in older people with different cardiovascular disease profiles. (2) Material and methods: This longitudinal study drew data from the Information System for Research in Primary Care in people aged 65 to 99 years with profiles of cardiovascular multimorbidity. Combined patterns of multimorbidity and polypharmacy were analysed using fuzzy c-means clustering techniques and hidden Markov models. The prevalence, observed/expected ratio, and exclusivity of chronic diseases and/or groups of these with the corresponding medication were described. (3) Results: The study included 114,516 people, mostly men (59. 6%) with a mean age of 78. 8 years and a high prevalence of polypharmacy (83. 5%). The following patterns were identified: Mental, behavioural, digestive and cerebrovascular ; Neuropathy, autoimmune and musculoskeletal ; Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological ; Non-specific ; Multisystemic ; Respiratory, cardiovascular, behavioural and genitourinary ; Diabetes and ischemic cardiopathy ; and Cardiac. The prevalence of overrepresented health problems and drugs remained stable over the years, although by study end, cohort survivors had more polypharmacy and multimorbidity. Most people followed the same pattern over time; the most frequent transitions were from Non-specific to Mental, behavioural, digestive and cerebrovascular and from Musculoskeletal, mental, behavioural, genitourinary, digestive and dermatological to Non-specific. (4) Conclusions: Eight combined multimorbidity and polypharmacy patterns, differentiated by sex, remained stable over follow-up. Understanding the behaviour of different diseases and drugs can help design individualised interventions in populations with clinical complexity.
Grants:	Ministerio de Economía y Competitividad PI16/00639 Ministerio de Economía y Competitividad RD16/0007/0001
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:	Polypharmacy ; Multimorbidity ; Elderly ; Cardiovascular disease ; Chronic disease ; Combined patterns ; Clustering ; Primary healthcare
Published in:	Geriatrics, Vol. 7 (december 2022) , ISSN 2308-3417

DOI: 10.3390/geriatrics7060141
PMID: 36547277

19 p, 842.1 KB

The record appears in these collections:
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles