Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project

Background: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-te...

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Autores: Ramos, JR, Alquézar-Arbé, A, Borrego, AJ, Putze, GB, Aguiló, S, Jacob, J, Fernández, C, Llorens, P, Espinosa, FDQ, Remartinez, SG, González, RH, Martín, MM, Aroca, SS, Knabe, AS, González, RG, Fernández, MC, Larrañaga, AA, Muñoz, MA, Cho, JUH, Berganza, MTEM, Martín, SG, Sindín, GS, Penas, MS, Gómez, BGY, Sambro, RA, del Castillo, JG, Miró, O
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:dnet:r-fisabio___::02815016c1eab4bdefcfe987b443fcae
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/20720
Access Level:acceso abierto
Palabra clave:emergency department
frailty
geriatrics
polypharmacy
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network_acronym_str ES
network_name_str España
repository_id_str
dc.title.none.fl_str_mv Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
title Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
spellingShingle Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
Ramos, JR
emergency department
frailty
geriatrics
polypharmacy
title_short Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
title_full Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
title_fullStr Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
title_full_unstemmed Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
title_sort Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project
dc.creator.none.fl_str_mv Ramos, JR
Alquézar-Arbé, A
Borrego, AJ
Putze, GB
Aguiló, S
Jacob, J
Fernández, C
Llorens, P
Espinosa, FDQ
Remartinez, SG
González, RH
Martín, MM
Aroca, SS
Knabe, AS
González, RG
Fernández, MC
Larrañaga, AA
Muñoz, MA
Cho, JUH
Berganza, MTEM
Martín, SG
Sindín, GS
Penas, MS
Gómez, BGY
Sambro, RA
del Castillo, JG
Miró, O
author Ramos, JR
author_facet Ramos, JR
Alquézar-Arbé, A
Borrego, AJ
Putze, GB
Aguiló, S
Jacob, J
Fernández, C
Llorens, P
Espinosa, FDQ
Remartinez, SG
González, RH
Martín, MM
Aroca, SS
Knabe, AS
González, RG
Fernández, MC
Larrañaga, AA
Muñoz, MA
Cho, JUH
Berganza, MTEM
Martín, SG
Sindín, GS
Penas, MS
Gómez, BGY
Sambro, RA
del Castillo, JG
Miró, O
author_role author
author2 Alquézar-Arbé, A
Borrego, AJ
Putze, GB
Aguiló, S
Jacob, J
Fernández, C
Llorens, P
Espinosa, FDQ
Remartinez, SG
González, RH
Martín, MM
Aroca, SS
Knabe, AS
González, RG
Fernández, MC
Larrañaga, AA
Muñoz, MA
Cho, JUH
Berganza, MTEM
Martín, SG
Sindín, GS
Penas, MS
Gómez, BGY
Sambro, RA
del Castillo, JG
Miró, O
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv emergency department
frailty
geriatrics
polypharmacy
topic emergency department
frailty
geriatrics
polypharmacy
description Background: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-term prognostic effect of polypharmacy in elderly patients treated in EDs. Methods: A retrospective analysis of the Emergency Department Elderly in Needs (EDEN) project's cohort was performed. This registry included all elderly patients who attended 52 Spanish EDs for any condition. Mild and severe polypharmacy was defined as the use of 5-9 drugs and >10 drugs, respectively. The assessed outcomes were ED revisits, hospital readmissions, and mortality 30 days after discharge. Crude and adjusted logistic regression analyses, including the patient's comorbidities, were performed. Results: A total of 25,557 patients were evaluated [mean age: 78 (IQR: 71-84) years]; 10,534 (41.2%) and 5678 (22.2%) patients presented with mild and severe polypharmacy, respectively. In the adjusted analysis, mild polypharmacy and severe polypharmacy were associated with an increase in ED revisits [odds ratio (OR) 1.13 (95% confidence interval (CI): 1.04-1.23) and 1.38 (95% CI: 1.24-1.51)] and hospital readmissions [OR 1.18 (95% CI: 1.04-1.35) and 1.36 (95% CI: 1.16-1.60)], respectively, compared to non-polypharmacy. Mild and severe polypharmacy were not associated with increased 30-day mortality [OR 1.05 (95% CI: 0.89-2.26) and OR 0.89 (95% CI: 0.72-1.12)], respectively. Conclusion: Polypharmacy was common among the elderly treated in EDs and associated with increased risks of ED revisits and hospital readmissions <= 30 days but not with an increased risk of 30-day mortality. Patients with polypharmacy had a higher risk of ED revisits and hospital readmissions <= 30 days after discharge. Plain language summary Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project Management elderly patients with polypharmacy is becoming a major challenge to the emergency services. The progressive aging of the population is producing a progressive increase in the number of patients treated with multiple comorbidities and chronic medications. It's well known that polypharmacy is associated with an increase in hospital admissions and health care system costs. However, the impact of polypharmacy over the risk of new visits to the emergency rooms is not well defined. Understanding the impact of polypharmacy on the frequency of new visits to the emergency room and on patient mortality is the first step to establish prevention measures for new visits, proposing improvements in chronic treatment at discharge. This study aimed to determine the prevalence and effect on short-term prognosis of polypharmacy in elderly patients treated in Emergency departments. The authors used a retrospective multipurpose registry in 52 hospitals in Spain. This study includes 25,557 patients with a mean age of 78 years. On admission, the median number of drugs was 6 (IQR: 3-9), with 10,534 (41.2%) patients taking 5-9 drugs and 5,678 (22.2%) taking >10 drugs. In these patients comorbidities were associated with an increase in the number of drugs. In the patients with severe polypharmacy (>10 drugs), diuretics were the most frequently drugs prescribed, followed by antihypertensives and statins. The results obtained indicate that polypharmacy is a frequent phenomenon among the elderly population treated in Emergency departments, being antihypertensives the most frequently used drugs in this population. Those patients who takes >10 drugs have a higher risk of new visits to the emergency room and hospital readmissions in short term period.
publishDate 2024
dc.date.none.fl_str_mv 2024
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/20720
url https://fisabio.portalinvestigacion.com/publicaciones/20720
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv SAGE PUBLICATIONS LTD
publisher.none.fl_str_mv SAGE PUBLICATIONS LTD
dc.source.none.fl_str_mv Therapeutic Advances in Drug Safety
ISSN: 20420986
ISSNe: 20420994
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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spelling Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN projectRamos, JRAlquézar-Arbé, ABorrego, AJPutze, GBAguiló, SJacob, JFernández, CLlorens, PEspinosa, FDQRemartinez, SGGonzález, RHMartín, MMAroca, SSKnabe, ASGonzález, RGFernández, MCLarrañaga, AAMuñoz, MACho, JUHBerganza, MTEMMartín, SGSindín, GSPenas, MSGómez, BGYSambro, RAdel Castillo, JGMiró, Oemergency departmentfrailtygeriatricspolypharmacyBackground: Polypharmacy is a growing phenomenon among elderly individuals. However, there is little information about the frequency of polypharmacy among the elderly population treated in emergency departments (EDs) and its prognostic effect. This study aims to determine the prevalence and short-term prognostic effect of polypharmacy in elderly patients treated in EDs. Methods: A retrospective analysis of the Emergency Department Elderly in Needs (EDEN) project's cohort was performed. This registry included all elderly patients who attended 52 Spanish EDs for any condition. Mild and severe polypharmacy was defined as the use of 5-9 drugs and >10 drugs, respectively. The assessed outcomes were ED revisits, hospital readmissions, and mortality 30 days after discharge. Crude and adjusted logistic regression analyses, including the patient's comorbidities, were performed. Results: A total of 25,557 patients were evaluated [mean age: 78 (IQR: 71-84) years]; 10,534 (41.2%) and 5678 (22.2%) patients presented with mild and severe polypharmacy, respectively. In the adjusted analysis, mild polypharmacy and severe polypharmacy were associated with an increase in ED revisits [odds ratio (OR) 1.13 (95% confidence interval (CI): 1.04-1.23) and 1.38 (95% CI: 1.24-1.51)] and hospital readmissions [OR 1.18 (95% CI: 1.04-1.35) and 1.36 (95% CI: 1.16-1.60)], respectively, compared to non-polypharmacy. Mild and severe polypharmacy were not associated with increased 30-day mortality [OR 1.05 (95% CI: 0.89-2.26) and OR 0.89 (95% CI: 0.72-1.12)], respectively. Conclusion: Polypharmacy was common among the elderly treated in EDs and associated with increased risks of ED revisits and hospital readmissions <= 30 days but not with an increased risk of 30-day mortality. Patients with polypharmacy had a higher risk of ED revisits and hospital readmissions <= 30 days after discharge. Plain language summary Short-term prognosis of polypharmacy in elderly patients treated in emergency departments: results from the EDEN project Management elderly patients with polypharmacy is becoming a major challenge to the emergency services. The progressive aging of the population is producing a progressive increase in the number of patients treated with multiple comorbidities and chronic medications. It's well known that polypharmacy is associated with an increase in hospital admissions and health care system costs. However, the impact of polypharmacy over the risk of new visits to the emergency rooms is not well defined. Understanding the impact of polypharmacy on the frequency of new visits to the emergency room and on patient mortality is the first step to establish prevention measures for new visits, proposing improvements in chronic treatment at discharge. This study aimed to determine the prevalence and effect on short-term prognosis of polypharmacy in elderly patients treated in Emergency departments. The authors used a retrospective multipurpose registry in 52 hospitals in Spain. This study includes 25,557 patients with a mean age of 78 years. On admission, the median number of drugs was 6 (IQR: 3-9), with 10,534 (41.2%) patients taking 5-9 drugs and 5,678 (22.2%) taking >10 drugs. In these patients comorbidities were associated with an increase in the number of drugs. In the patients with severe polypharmacy (>10 drugs), diuretics were the most frequently drugs prescribed, followed by antihypertensives and statins. The results obtained indicate that polypharmacy is a frequent phenomenon among the elderly population treated in Emergency departments, being antihypertensives the most frequently used drugs in this population. Those patients who takes >10 drugs have a higher risk of new visits to the emergency room and hospital readmissions in short term period.SAGE PUBLICATIONS LTD2024info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/20720Therapeutic Advances in Drug SafetyISSN: 20420986ISSNe: 20420994reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:dnet:r-fisabio___::02815016c1eab4bdefcfe987b443fcae2026-06-11T12:45:17Z
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