Does multimorbidity still remain a matter of the elderly: Lithuanian national data analysis

Jurevičienė, Elena; Onder, Graziano; Visockienė, Žydrūnė; Puronaitė, Roma; Petrikonytė, Dovilė; Gargalskaitė, U.; Kasiulevičius, Vytautas; Navickas, Rokas

doi:10.1016/j.healthpol.2018.03.003

Cited by 13 publications

(12 citation statements)

References 16 publications

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“… 34 In Lithuania, the risk of acquiring an additional chronic condition was found to increase exponentially from the age of 29 years and stabilise between the age of 51 years and 57 years. 35 36 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

et al. 2021

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ObjectivesPrevalence estimates for specific chronic conditions and multimorbidity (MM) in eastern Europe are scarce. This national study estimates the prevalence of MM by age group and sex in Estonia.DesignA population-based cross-sectional study, using administrative data.SettingData were collected on 55 chronic conditions from the Estonian Health Insurance Fund from 2015 to 2017. MM was defined as the coexistence of two or more conditions.ParticipantsThe Estonian Health Insurance Fund includes data for approximately 95% of the Estonian population receiving public health insurance.Primary and secondary outcome measuresPrevalence and 95% CIs for MM stratified by age group and sex.ResultsNearly half (49.1%) of the individuals (95% CI 49.0 to 49.3) had at least 1 chronic condition, and 30.1% (95% CI 30.0 to 30.2) had MM (2 or more chronic conditions). The number of conditions and the prevalence of MM increased with age, ranging from an MM prevalence of 3.5% (3.5%–3.6%) in the youngest (0–24 years) to as high as 80.4% (79.4%–81.3%) in the oldest (≥85 years) age group. Half of all individuals had MM by 60 years of age, and 75% of the population had MM by 75 years of age. Women had a higher prevalence of MM (34.9%, 95% CI 34.7 to 35.0) than men (24.4%, 95% CI 24.3 to 24.5). Hypertension was the most frequent chronic condition (24.5%), followed by chronic pain (12.4%) and arthritis (7.7%).ConclusionsHypertension is an important chronic condition amenable to treatment with lifestyle and therapeutic interventions. Given the established correlation between uncontrolled hypertension and exacerbation of other cardiovascular conditions as well as acute illnesses, this most common condition within the context of MM may be suitable for targeted public health interventions.

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Section: Discussionmentioning

confidence: 99%

Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

et al. 2021

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“…Increased life expectancy and steadily improving healthcare contribute to a growing subpopulation of multimorbid patients, commonly defined as having a minimum of two conditions. [1][2][3] The prevalence of multimorbidity is reported to be 20%-30% in the general population, 55%-98% in the elderly and 22%-65% in hospitalised patients. [4][5][6] Multimorbidity is associated with the use of multiple drugs, increased use of healthcare services and reduced life expectancy.…”

Section: Introductionmentioning

confidence: 99%

Effect of medicines management versus standard care on readmissions in multimorbid patients: a randomised controlled trial

Lea¹,

Mowé

Molden

et al. 2020

BMJ Open

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ObjectiveTo investigate the effect of pharmacist-led medicines management in multimorbid, hospitalised patients on long-term hospital readmissions and survival.DesignParallel-group, randomised controlled trial.SettingRecruitment from an internal medicine hospital ward in Oslo, Norway. Patients were enrolled consecutively from August 2014 to the predetermined target number of 400 patients. The last participant was enrolled March 2016. Follow-up until 31 December 2017, that is, 21–40 months.ParticipantsAcutely admitted multimorbid patients ≥18 years, using minimum four regular drugs from minimum two therapeutic classes. 399 patients were randomly assigned, 1:1, to the intervention or control group. After excluding 11 patients dying in-hospital and 2 erroneously included, the primary analysis comprised 386 patients (193 in each group) with median age 79 years (range 23–96) and number of diseases 7 (range 2–17).InterventionIntervention patients received pharmacist-led medicines management comprising medicines reconciliation at admission, repeated medicines reviews throughout the stay and medicines reconciliation and tailored information at discharge, according to the integrated medicines management model. Control patients received standard care.Primary and secondary outcome measuresThe primary endpoint was difference in time to readmission or death within 12 months. Overall survival was a priori the clinically most important secondary endpoint.ResultsPharmacist-led medicines management had no significant effect on the primary endpoint time to readmission or death within 12 months (median 116 vs 184 days, HR 0.82, 95% CI 0.64 to 1.04, p=0.106). A statistically significantly increased overall survival was observed during 21–40 months follow-up (HR 0.66, 95% CI 0.48 to 0.90, p=0.008).ConclusionsPharmacist-led medicines management had no statistically significant effect on time until readmission or death. A statistically significant increased overall survival was seen. Further studies should be conducted to investigate the effect of such an intervention on a larger scale.Trial registration numberNCT02336113.

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“…This is a heterogeneous patient group, but a common feature is increased health care utilization, including frequent hospitalizations, and multiple drug treatments [19–23]. The population of multimorbid patients is growing due to steadily improving health care and increasing life expectancy [24, 25]. These patients are often admitted to internal medicine wards due to the complex nature of their disease state.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and risk factors of drug-related hospitalizations in multimorbid patients admitted to an internal medicine ward

Lea¹,

Mowé

Mathiesen

et al. 2019

PLoS ONE

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Background Knowledge of risk factors for drug-related hospitalizations (DRHs) is limited. Aim To examine the prevalence of DRHs and the relationships between DRHs and various variables in multimorbid patients admitted to an internal medicine ward. Methods Multimorbid patients ≥ 18 years, using minimum of four regular drugs from minimum two therapeutic classes, were included from the Internal Medicine ward, Oslo University Hospital, Norway, from August 2014 to March 2016. Clinical pharmacists prospectively conducted medicines reconciliations and reviews to reveal drug-related problems (DRPs). Blinded for identified DRPs, an interdisciplinary group retrospectively made comprehensive, clinical assessments of each patient case to classify hospitalizations as drug-related (DRH) or non-drug-related (non-DRH). Age, sex distribution, Charlson Comorbidity Index (CCI), renal function, aberrant genotype frequencies, body-mass index, number of drugs, proportion of patients which received assistance for drug administration from the home care service, and/or through multidose-dispensed drugs, and occurrence of specific DRP subgroups, were compared separately between patients with DRHs versus non-DRHs, followed by multiple logistic regression analysis. Results Hospitalizations were classified as drug-related in 155 of the 404 included patients (38%). Factors significantly associated with DRHs were occurrence of adverse effect DRPs (adjusted odds ratio (OR) 3.3, 95% confidence interval (CI) 1.4–8.0), adherence issues (OR 2.9, 1.1–7.2), home care (OR 1.9, 1.1–3.5), drug monitoring DRPs (OR 1.9, 1.2–3.0), and CCI score ≥6 (OR 0.33, 0.14–0.77). Frequencies of aberrant genotypes did not differ between the patient groups, but in 41 patients with DRHs (26.5%), gene-drug interactions influenced the assessments of DRHs. Conclusion DRHs are prevalent in multimorbid patients with adverse effect DRPs and adherence issues as the most important risk factors.

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Does multimorbidity still remain a matter of the elderly: Lithuanian national data analysis

Cited by 13 publications

References 16 publications

Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

Prevalence of chronic conditions and multimorbidity in Estonia: a population-based cross-sectional study

Effect of medicines management versus standard care on readmissions in multimorbid patients: a randomised controlled trial

Prevalence and risk factors of drug-related hospitalizations in multimorbid patients admitted to an internal medicine ward

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