Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication-MoPIM Cohort Study.
Marina LlealMarisa BaréSara OrtonobesDaniel Sevilla-SanchezRosa JordanaSusana HerranzMaria Queralt GorgasMariona Espaulella-FerrerMarta ArellanoMarta de AntonioGloria Julia NazcoRubén Hernández-Luisnull On Behalf Of The MoPIM Study GroupPublished in: International journal of environmental research and public health (2022)
Multimorbidity is increasing and poses a challenge to the clinical management of patients with multiple conditions and drug prescriptions. The objectives of this work are to evaluate if multimorbidity patterns are associated with quality indicators of medication: potentially inappropriate prescribing (PIP) or adverse drug reactions (ADRs). A multicentre prospective cohort study was conducted including 740 older (≥65 years) patients hospitalised due to chronic pathology exacerbation. Sociodemographic, clinical and medication related variables (polypharmacy, PIP according to STOPP/START criteria, ADRs) were collected. Bivariate analyses were performed comparing previously identified multimorbidity clusters (osteoarticular, psychogeriatric, minor chronic disease, cardiorespiratory) to presence, number or specific types of PIP or ADRs. Significant associations were found in all clusters. The osteoarticular cluster presented the highest prevalence of PIP (94.9%) and ADRs (48.2%), mostly related to anxiolytics and antihypertensives, followed by the minor chronic disease cluster, associated with ADRs caused by antihypertensives and insulin. The psychogeriatric cluster presented PIP and ADRs of neuroleptics and the cardiorespiratory cluster indicators were better overall. In conclusion, the associations that were found reinforce the existence of multimorbidity patterns and support specific medication review actions according to each patient profile. Thus, determining the relationship between multimorbidity profiles and quality indicators of medication could help optimise healthcare processes. Trial registration number: NCT02830425.
Keyphrases
- adverse drug
- healthcare
- drug induced
- electronic health record
- emergency department
- clinical trial
- type diabetes
- study protocol
- body composition
- quality improvement
- risk factors
- end stage renal disease
- newly diagnosed
- high intensity
- prognostic factors
- primary care
- intensive care unit
- cross sectional
- phase ii
- skeletal muscle
- health insurance
- social media
- glycemic control
- affordable care act