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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| Format: | Article |
| Language: | English |
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MDPI AG
2021-02-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/4/709 |
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| author | Amelia Troncoso-Mariño Albert Roso-Llorach Tomás López-Jiménez Noemí Villen Ester Amado-Guirado Sergio Fernández-Bertolin Lucía A. Carrasco-Ribelles Josep Ma Borras Concepción Violán |
| author_facet | Amelia Troncoso-Mariño Albert Roso-Llorach Tomás López-Jiménez Noemí Villen Ester Amado-Guirado Sergio Fernández-Bertolin Lucía A. Carrasco-Ribelles Josep Ma Borras Concepción Violán |
| author_sort | Amelia Troncoso-Mariño |
| collection | DOAJ |
| 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 (<i>p</i> < 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. |
| first_indexed | 2024-03-09T04:43:40Z |
| format | Article |
| id | doaj.art-1c655761fdbb4337bdef3a8d57c97e03 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T04:43:40Z |
| publishDate | 2021-02-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-1c655761fdbb4337bdef3a8d57c97e032023-12-03T13:17:34ZengMDPI AGJournal of Clinical Medicine2077-03832021-02-0110470910.3390/jcm10040709Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-UpAmelia Troncoso-Mariño0Albert Roso-Llorach1Tomás López-Jiménez2Noemí Villen3Ester Amado-Guirado4Sergio Fernández-Bertolin5Lucía A. Carrasco-Ribelles6Josep Ma Borras7Concepción Violán8Medicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, SpainFundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, SpainFundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, SpainMedicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, SpainMedicines Area and Pharmacy Service, Barcelona Territorial Management, Institut Català de la Salut, 08015 Barcelona, SpainFundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, SpainFundació Institut Universitari per a la Recerca a l’Atenció Primària de Salut Jordi Gol i Gurina (IDIAPJGol), 08007 Barcelona, SpainDepartment of Clinical Sciences, University of Barcelona and IDIBELL, L’Hospitalet de Llobregat, 08908 Barcelona, SpainDepartament de Pediatria, Obstetricia i Ginecologia i Medicina Preventiva, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), SpainAging, 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 (<i>p</i> < 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.https://www.mdpi.com/2077-0383/10/4/709multimorbiditypolypharmacydrug interactionsduplicate therapycontraindicated drugsinappropriate prescribing |
| spellingShingle | Amelia Troncoso-Mariño Albert Roso-Llorach Tomás López-Jiménez Noemí Villen Ester Amado-Guirado Sergio Fernández-Bertolin Lucía A. Carrasco-Ribelles Josep Ma Borras Concepción Violán Medication-Related Problems in Older People with Multimorbidity in Catalonia: A Real-World Data Study with 5 Years’ Follow-Up Journal of Clinical Medicine multimorbidity polypharmacy drug interactions duplicate therapy contraindicated drugs inappropriate prescribing |
| 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 | multimorbidity polypharmacy drug interactions duplicate therapy contraindicated drugs inappropriate prescribing |
| url | https://www.mdpi.com/2077-0383/10/4/709 |
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