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Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up

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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Autores principales: Troncoso-Mariño, Amelia, Roso-Llorach, Albert, López-Jiménez, Tomás, Villen, Noemí, Amado-Guirado, Ester, Fernández-Bertolin, Sergio, Carrasco-Ribelles, Lucía A., Borras, Josep Ma, Violán, Concepción
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916946/
https://www.ncbi.nlm.nih.gov/pubmed/33670201
http://dx.doi.org/10.3390/jcm10040709
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author Troncoso-Mariño, Amelia
Roso-Llorach, Albert
López-Jiménez, Tomás
Villen, Noemí
Amado-Guirado, Ester
Fernández-Bertolin, Sergio
Carrasco-Ribelles, Lucía A.
Borras, Josep Ma
Violán, Concepción
author_facet Troncoso-Mariño, Amelia
Roso-Llorach, Albert
López-Jiménez, Tomás
Villen, Noemí
Amado-Guirado, Ester
Fernández-Bertolin, Sergio
Carrasco-Ribelles, Lucía A.
Borras, Josep Ma
Violán, Concepción
author_sort Troncoso-Mariño, Amelia
collection PubMed
description 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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spelling pubmed-79169462021-03-01 Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up Troncoso-Mariño, Amelia Roso-Llorach, Albert López-Jiménez, Tomás Villen, Noemí Amado-Guirado, Ester Fernández-Bertolin, Sergio Carrasco-Ribelles, Lucía A. Borras, Josep Ma Violán, Concepción J Clin Med Article 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. MDPI 2021-02-11 /pmc/articles/PMC7916946/ /pubmed/33670201 http://dx.doi.org/10.3390/jcm10040709 Text en © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Troncoso-Mariño, Amelia
Roso-Llorach, Albert
López-Jiménez, Tomás
Villen, Noemí
Amado-Guirado, Ester
Fernández-Bertolin, Sergio
Carrasco-Ribelles, Lucía A.
Borras, Josep Ma
Violán, Concepción
Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up
title Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up
title_full Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up
title_fullStr Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up
title_full_unstemmed Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up
title_short Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up
title_sort medication-related problems in older people with multimorbidity in catalonia: a real-world data study with 5 years’ follow-up
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7916946/
https://www.ncbi.nlm.nih.gov/pubmed/33670201
http://dx.doi.org/10.3390/jcm10040709
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