Polypharmacy With Common Diseases in Hospitalized Elderly Patients

Mizokami, Fumihiro; Koide, Yumiko; Noro, Takeshi; Furuta, K.

doi:10.1016/j.amjopharm.2012.02.003

Cited by 80 publications

(78 citation statements)

References 20 publications

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“…Additionally, the improper prescription of medications is often attributed to a lack of training among doctors who prescribe medicine to geriatrics, as well as a deficiency in pharmaceutical training when attending the elderly 31 . Thus, the presence of the pharmacist in the process of pharmaceutical care for the elderly is important to ensure the rational use of medications and the reduction of prescribing or dosing errors, as well as preventing the misuse of drugs and limiting the occurrence of adverse reactions.…”

Section: Discussionmentioning

confidence: 99%

Prevalence of and factors associated with polypharmacy among elderly persons resident in the community

Almeida¹,

Reiners

Azevedo

et al. 2017

Rev. bras. geriatr. gerontol.

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Objective: to verify the prevalence of and factors associated with polypharmacy among elderly residents of the city of Cuiabá, in the state of Mato Grosso. Method: a cross-sectional study of 573 people aged 60 and over was performed. Polypharmacy was defined as the use of five or more medications. To investigate the association between polypharmacy and sociodemographic variables, health and access to medication, the Mantel Haenszel chi square test was used in bivariate analysis and Poisson regression was used in multivariate analysis. The significance level adopted was 5%. Result: the prevalence of polypharmacy was 10.30%. Statistically significant associations were found between polypharmacy and living with others, describing suffering from circulatory, endocrine, nutritional and digestive tract diseases, and referring to financial difficulties for the purchase of medicines. Conclusion: some social and health condition factors play an important role in the use of multiple medications among the elderly.

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Section: Discussionmentioning

confidence: 99%

Prevalence of and factors associated with polypharmacy among elderly persons resident in the community

Almeida¹,

Reiners

Azevedo

et al. 2017

Rev. bras. geriatr. gerontol.

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“…For instance, very elderly patients are at an increased risk of developing conduction disturbances (i.e., QT prolongation, tachycardia and bradycardia, bundle branch block, and/or atrioventricular block), especially in the presence of comorbidities such as CV diseases or chronic kidney disease (CKD). This is further enhanced in the case of pharmacological treatments with multiple concomitant drugs for the management of comorbidities, due to possible interactions among molecules [12].…”

Section: Introductionmentioning

confidence: 99%

Combination Therapy of Inhaled Indacaterol/Glycopyrronium for Chronic Obstructive Pulmonary Disease in the Very Elderly: Is It Safe? An Electrocardiographic Evaluation

et al. 2018

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Cardiovascular (CV) comorbidities in patients with chronic obstructive pulmonary disease (COPD) are associated with increased morbidity and mortality, especially in old and very old subjects. The question if long-acting beta-agonist and long-acting muscarinic antagonist could be associated with the increased prevalence of CV-related adverse effects has puzzled, particularly in the past, specialists involved in the management of respiratory diseases. The safety of these compounds has scarcely been tested in patients aged ≥ 65 years with CV comorbidities, since randomized controlled trials rarely include this subpopulation. However, the fixed combination indacaterol/glycopyrronium has shown a favorable CV safety profile in both healthy volunteers and COPD patients. Thus, we aimed to assess the CV safety pro- file of the fixed combination indacaterol/glycopyrronium 110/50 μg in a series of COPD patients aged ≥ 80 years with several comorbidities. Our results indicate that this combination is safe in the comorbid elderly, since no significant electrocardiographic abnormalities were recorded after the administration of the inhaled therapy. Only rare and nonclinically significant changes in heart rate and corrected QT interval duration were evident, mainly in females and in patients with concomitant impaired kidney function.

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“…Poor communication between patients and professionals was a common experience, exacerbated by fragmentation of health services and poor communication between healthcare providers themselves, aspects of stroke care likely to be exacerbated by multimorbidity [24][25][26]. Surprisingly, there has been limited exploration of multimorbidity or polypharmacy in people with stroke, the field being characterised by small-scale studies and a small number of conditions under examination [19,[27][28][29][30][31][32][33][34][35][36]. Those studies that have examined stroke in relation to other longterm conditions have suggested that stroke is one of the diseases most significantly associated with polypharmacy [19,33], but there is a lack of large-scale studies examining a broad range of medications and comorbidities.…”

Section: Introductionmentioning

confidence: 99%

Stroke, multimorbidity and polypharmacy in a nationally representative sample of 1,424,378 patients in Scotland: implications for treatment burden

Batty

McLean

et al. 2014

BMC Medicine

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Background: The prevalence of multimorbidity (the presence of two or more long-term conditions) is rising internationally. Multimorbidity affects patients by increasing their burden of symptoms, but is also likely to increase the self-care demands, or treatment burden, that they experience. Treatment burden refers to the effort expended in operationalising treatments, navigating healthcare systems and managing relations with healthcare providers. This is an important problem for people with chronic illness such as stroke. Polypharmacy is an important marker of both multimorbidity and burden of treatment. In this study, we examined the prevalence of multimorbidity and polypharmacy in a large, nationally representative population of primary care patients with and without stroke, adjusting for age, sex and deprivation. Methods: A cross-sectional study of 1,424,378 participants aged 18 years and over, from 314 primary care practices in Scotland that were known to be demographically representative of the Scottish adult population. Data included information on the presence of stroke and another 39 long-term conditions, plus prescriptions for regular medications. Results: In total, 35,690 people (2.5%) had a diagnosis of stroke. Of the 39 comorbidities examined, 35 were significantly more common in people with stroke. Of the people with a stroke, the proportion that had one or more additional morbidities present (94.2%) was almost twice that in the control group (48%) (odds ratio (OR) adjusted for age, sex and socioeconomic deprivation 5.18; 95% confidence interval (CI) 4.95 to 5.43). In the stroke group, 12.6% had a record of 11 or more repeat prescriptions compared with only 1.5% of the control group (OR adjusted for age, sex, deprivation and morbidity count 15.84; 95% CI 14.86 to 16.88). Limitations include the use of data collected for clinical rather than research purposes, a lack of consensus in the literature on the definition of certain long-term conditions, and the absence of statistical weighting in the measurement of multimorbidity, although the latter was deemed suitable for descriptive analyses. Conclusions: Multimorbidity and polypharmacy were strikingly more common in those with a diagnosis of stroke compared with those without. This has important implications for clinical guidelines and the design of health services.

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Polypharmacy With Common Diseases in Hospitalized Elderly Patients

Cited by 80 publications

References 20 publications

Prevalence of and factors associated with polypharmacy among elderly persons resident in the community

Prevalence of and factors associated with polypharmacy among elderly persons resident in the community

Combination Therapy of Inhaled Indacaterol/Glycopyrronium for Chronic Obstructive Pulmonary Disease in the Very Elderly: Is It Safe? An Electrocardiographic Evaluation

Stroke, multimorbidity and polypharmacy in a nationally representative sample of 1,424,378 patients in Scotland: implications for treatment burden

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