Medication patterns in older adults with multimorbidity

Background: Older adults suffer from various chronic conditions which make them particularly vulnerable. The proper management of multiple drug use is therefore crucial. The aim of our study was to describe drug prescription and medication patterns in this population. Methods: A cross-sectional stud...

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Detalles Bibliográficos
Autores: Guisado-Clavero, Marina|||0000-0002-8448-2929, Violán, Concepció|||0000-0003-3309-5360, López-Jimenez, Tomás, Roso-Llorach, Albert|||0000-0002-9264-0405, Pons-Vigués, Mariona|||0000-0002-7929-3701, Muñoz, Miguel-Angel|||0000-0002-4083-3248, Foguet-Boreu, Quintí|||0000-0002-6069-5305
Tipo de recurso: artículo
Fecha de publicación:2019
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:inglés
OAI Identifier:oai:ddd.uab.cat:223146
Acceso en línea:https://ddd.uab.cat/record/223146
https://dx.doi.org/urn:doi:10.1186/s12875-019-0969-9
Access Level:acceso abierto
Palabra clave:Ageing
Cluster analysis
Drugs
Electronic health records
Multimorbidity
Primary health care
Descripción
Sumario:Background: Older adults suffer from various chronic conditions which make them particularly vulnerable. The proper management of multiple drug use is therefore crucial. The aim of our study was to describe drug prescription and medication patterns in this population. Methods: A cross-sectional study in Barcelona (Spain) using electronic health records from 50 primary healthcare centres. Participants were aged 65 to 94 years, presenting multimorbidity (≥2 chronic diseases), and had been prescribed at least 1 drug for 6 months or longer during 2009. We calculated the prevalence of prescribed drugs and identified medication patterns using multiple correspondence analysis and k-means clustering. Analyses were stratified by sex and age (65-79, 80-94 years). Results: We studied 164,513 patients (66.8% women) prescribed a median of 4 drugs (interquartile range [IQR] = 3-7) in the 65-79 age-group and 6 drugs (IQR = 4-8) in the 80-94 age-group. A minimum of 45.9% of patients aged 65-79 years, and 61.8% of those aged 80-94 years, were prescribed 5 or more drugs. We identified 6 medication patterns, a non-specific one and 5 encompassing 8 anatomical groups (alimentary tract and metabolism, blood, cardiovascular, dermatological, musculo-skeletal, neurological, respiratory, and sensory organ). Conclusions: Drug prescription is widespread among the elderly. Six medication patterns were identified, 5 of which were related to one or more anatomical group, with associations among drugs from different systems. Overall, guidelines do not accurately reflect the situation of the elderly multimorbid, new strategies for managing multiple drug uses are needed to optimize prescribing in these patients.