Medication-Related Problems in Older People with Multimorbidity in Catalonia

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, u...

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Detalles Bibliográficos
Autores: Troncoso-Mariño, Amelia|||0000-0002-1064-0912, Roso-Llorach, Albert|||0000-0002-9264-0405, López Jiménez, Tomàs|||0000-0001-8255-4936, Villén, Noemí, Amado, Ester, Fernández-Bertolín, Sergio|||0000-0002-0029-6564, Carrasco-Ribelles, Lucía Amalia|||0000-0001-9263-1747, Borras, Josep M.|||0000-0001-7330-6308, Violán, Concepció|||0000-0003-3309-5360
Tipo de recurso: artículo
Fecha de publicación:2021
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:255328
Acceso en línea:https://ddd.uab.cat/record/255328
https://dx.doi.org/urn:doi:10.3390/jcm10040709
Access Level:acceso abierto
Palabra clave:Multimorbidity
Polypharmacy
Drug interactions
Duplicate therapy
Contraindicated drugs
Inappropriate prescribing
Primary health care
Elderly
Descripción
Sumario: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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