1
|
López Oliva S, Morais-Moreno C, Carretero-Krug A, Samaniego-Vaesken MDL, López-Sobaler AM, Partearroyo T, Puga AM. Drug Consumption and Hydration Status: Analysis of the Associations in an Elder Population. Nutrients 2024; 16:2632. [PMID: 39203768 PMCID: PMC11357581 DOI: 10.3390/nu16162632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Revised: 07/26/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024] Open
Abstract
Hydration status plays a key role in healthy ageing, and it is potentially affected by several factors, including drug consumption. However, research on this issue to date is scarce, especially in highly vulnerable groups, such as the elderly. We aimed to study the relationship linking hydration status, analysed by means of a validated questionnaire, 24 h urine analysis, body composition assessment, and drug consumption in a sample of old adults. A total of 144 elders were included in the study. Cardiovascular drug consumption was significantly associated with a lower water intake in men (β = -0.282, p = 0.029). Moreover, urinary analysis revealed that total drug intake as well as the consumption of diuretics and cardiovascular drugs were associated with poorer hydration status, whereas genito-urinary drugs were associated with an opposite effect, and these results were confirmed in terms of body composition. Hence, total drug consumption (β = -0.205), diuretic (β = -0.408), cardiovascular (β = -0.297), and genito-urinary drugs (β = 0.298) were significantly associated (p < 0.05) with total body water. The obtained results confirmed the impact of chronic treatment with certain drugs on hydration status. Nutritional interventions may be of great interest in certain population groups in order to prevent complications due to altered hydration status.
Collapse
Affiliation(s)
- Sara López Oliva
- Grupo USP-CEU de Excelencia “Nutrición para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (S.L.O.); (C.M.-M.); (A.C.-K.); (M.d.L.S.-V.); (T.P.)
| | - Carmen Morais-Moreno
- Grupo USP-CEU de Excelencia “Nutrición para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (S.L.O.); (C.M.-M.); (A.C.-K.); (M.d.L.S.-V.); (T.P.)
| | - Alejandra Carretero-Krug
- Grupo USP-CEU de Excelencia “Nutrición para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (S.L.O.); (C.M.-M.); (A.C.-K.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - María de Lourdes Samaniego-Vaesken
- Grupo USP-CEU de Excelencia “Nutrición para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (S.L.O.); (C.M.-M.); (A.C.-K.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Ana M. López-Sobaler
- Grupo de Investigación VALORNUT, Departamento de Nutrición y Ciencia de los Alimentos, Facultad de Farmacia, Universidad Complutense de Madrid, 28040 Madrid, Spain;
- Instituto de Investigaciones Sanitarias San Carlos (IdISSC), 28040 Madrid, Spain
| | - Teresa Partearroyo
- Grupo USP-CEU de Excelencia “Nutrición para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (S.L.O.); (C.M.-M.); (A.C.-K.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| | - Ana M. Puga
- Grupo USP-CEU de Excelencia “Nutrición para la Vida (Nutrition for Life)”, Ref: E02/0720, Departamento de Ciencias Farmacéuticas y de la Salud, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain; (S.L.O.); (C.M.-M.); (A.C.-K.); (M.d.L.S.-V.); (T.P.)
- Instituto CEU Alimentación y Sociedad, Facultad de Farmacia, Universidad San Pablo-CEU, CEU Universities, Urbanización Montepríncipe, 28660 Boadilla del Monte, Spain
| |
Collapse
|
2
|
Liu Y, Huang L, Hu F, Zhang X. Frailty, polypharmacy, malnutrition, chronic conditions, and quality of life in the elderly: Large population-based study. JMIR Public Health Surveill 2024. [PMID: 39145920 DOI: 10.2196/50617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/16/2024] Open
Abstract
BACKGROUND Aging, a significant public health issue, is associated with multiple concurrent chronic diseases and aging-related conditions (geriatric syndromes). OBJECTIVE To investigate the impact of age and chronic conditions on geriatric syndromes and the intercorrelations between multiple geriatric syndromes and quality of life (QoL) in the elderly (≥65 years) at the population level. METHODS A large representative sample was randomly selected from a county with 17 towns and 811,867 residents, with multiple chronic conditions, geriatric syndromes (frailty, polypharmacy, and malnutrition), and QoL assesses and compared between geriatric and nongeriatric populations and among subgroups of the elderly. Associations of demographic information and chronic conditions with geriatric conditions and QoL in the elderly were assessed using multivariable-adjusted logistic regression. Intercorrelations between age, multiple geriatric syndromes, and QoL were investigated using both correlation analysis and restricted cubic splines (RCS)-based multivariable-adjusted dose-response analysis. RESULTS Elderly people comprised 43.4% of the whole population, and prevalence of frailty, (pre-)malnutrition, polypharmacy, and impaired QoL among the elderly (median age, 73 years; male proportion, 51.0%) was 8.3%, 15.6%, 3.2%, and 10.8%, respectively. Prevalence of geriatric syndromes mostly did not significantly differ among different age subgroups of the elderly (except that frailty occurred more often with older age) or by gender. (Pre-)malnutrition was significantly associated with less often obesity and more frequent constipation, polypharmacy with more often diabetes and constipation, frailty with more frequent constipation and hernia, and impaired QoL with more often hypertension, diabetes, physical disability, and constipation. MNA-SF, GFI, and EQ-5D-5L scores and number of drugs used mostly significantly predicted the other geriatric syndromes and QoL. Impaired QoL was significantly associated with more often frailty, (pre-)malnutrition, and polypharmacy, and frailty with more frequent (pre-)malnutrition and polypharmacy. At 1.5-year follow-up, impaired QoL was significantly linked to polypharmacy and frailty at baseline; (pre-)malnutrition was significantly associated with frailty at baseline; polypharmacy was significantly linked to frailty at baseline; frailty was significantly linked to both (pre-)malnutrition and polypharmacy at baseline. Causal mediation analyses showed that frailty mediated the linkage between polypharmacy and worse QoL, and also that polypharmacy mediated the linkage between frailty and worse QoL. CONCLUSIONS In this large population-based study of the elderly with prospective follow-up, multiple chronic conditions were associated with one or more of the investigated geriatric syndromes. Geriatric syndromes were mostly significantly intercorrelated with and well predictive of each other and QoL, and there existed causal relationships between geriatric syndromes and QoL with other geriatric syndromes being mediators. The findings might be subject to some bias due to residual confounding factors not available in the dataset. It would be important to perform personalized geriatric syndromes stratified by chronic conditions, and active prevention or intervention of any syndrome might help to reduce the others and improve QoL. CLINICALTRIAL
Collapse
Affiliation(s)
- Yunmei Liu
- School of Cultural Heritage and Information Management, Shanghai University, Shanghai, CN
| | - Lei Huang
- National Key Laboratory of Immunity and Inflammation, Changhai Clinical Research Unit, The First Affiliated Hospital of Naval Medical University/Changhai Hospital, Naval Medical University, Shanghai, CN
- Department of Gastroenterology, Shanghai Institute of Pancreatic Diseases, The First Affiliated Hospital of Naval Medical University/Changhai Hospital, Naval Medical University, Shanghai, CN
| | - Fei Hu
- Department of General Surgery, Feidong People's Hospital, East District of the First Affiliated Hospital of Anhui Medical University, Cuozhen Road 20, Dianpu Town, Hefei 231600, Anhui Province, China, Hefei, CN
| | - Xiuwen Zhang
- Department of General Surgery, Feidong People's Hospital, East District of the First Affiliated Hospital of Anhui Medical University, Cuozhen Road 20, Dianpu Town, Hefei 231600, Anhui Province, China, Hefei, CN
- School of Clinical Medicine, Anhui Medical University, Hefei, CN
| |
Collapse
|
3
|
Kosana P, Wu K, Tassiopoulos K, Letendre S, Ma Q, Paul R, Ellis R, Erlandson KM, Farhadian SF. Polypharmacy Is Associated With Slow Gait Speed and Recurrent Falls in Older People With HIV. Clin Infect Dis 2024; 78:1608-1616. [PMID: 38147306 PMCID: PMC11175684 DOI: 10.1093/cid/ciad782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 12/01/2023] [Accepted: 12/12/2023] [Indexed: 12/27/2023] Open
Abstract
BACKGROUND Older people with human immunodeficiency virus (HIV, PWH) are prone to using multiple medications due to higher rates of medical comorbidities and the use of antiretroviral therapy (ART). We assessed the prevalence and clinical impact of polypharmacy among PWH. METHODS We leveraged clinical data from the AIDS Clinical Trials Group A5322 study "Long-Term Follow-up of Older HIV-infected Adults: Addressing Issues of Aging, HIV Infection and Inflammation" (HAILO). We included PWH aged ≥40 years with plasma HIV RNA levels <200 copies/µL. We assessed the relationship between polypharmacy (defined as the use of 5 or more prescription medications, excluding ART) and hyperpolypharmacy (defined as the use of 10 or more prescription medications, excluding ART) with slow gait speed (less than 1 meter/second) and falls, including recurrent falls. RESULTS Excluding ART, 24% of study participants had polypharmacy and 4% had hyperpolypharmacy. Polypharmacy was more common in women (30%) than men (23%). Participants with polypharmacy had a higher risk of slow gait speed (odds ratio [OR] = 1.78; 95% confidence interval [CI] = 1.27-2.50) and increased risk of recurrent falls (OR = 2.12; 95% CI = 1.06-4.23). The risk for recurrent falls was further increased in those with hyperpolypharmacy compared with those without polypharmacy (OR = 3.46; 95% CI = 1.32-9.12). CONCLUSIONS In this large, mixed-sex cohort of PWH aged ≥40 years, polypharmacy was associated with slow gait speed and recurrent falls, even after accounting for medical comorbidities, alcohol use, substance use, and other factors. These results highlight the need for increased focus on identifying and managing polypharmacy and hyperpolypharmacy in PWH.
Collapse
Affiliation(s)
- Priya Kosana
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
| | - Kunling Wu
- Center for Biostatistics in AIDS Research, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Katherine Tassiopoulos
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Scott Letendre
- Department of Medicine, University of California San Diego, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
| | - Qing Ma
- School of Pharmacy and Pharmaceutical Sciences, University of Buffalo, Buffalo, New York, USA
| | - Robert Paul
- Department of Psychological Sciences, University of Missouri–St.Louis, St. Louis, Missouri, USA
| | - Ronald Ellis
- Department of Psychiatry, University of California San Diego, San Diego, California, USA
- Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Kristine M Erlandson
- Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA
| | - Shelli F Farhadian
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, New Haven, Connecticut, USA
- Department of Medicine, Section of Infectious Diseases, Yale School of Medicine, New Haven, Connecticut, USA
| |
Collapse
|
4
|
Vennu V. Polypharmacy Is Associated with Sociodemographic Factors and Socioeconomic Status in United States Adults. PHARMACY 2024; 12:49. [PMID: 38525729 PMCID: PMC10961768 DOI: 10.3390/pharmacy12020049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2024] [Revised: 02/12/2024] [Accepted: 02/19/2024] [Indexed: 03/26/2024] Open
Abstract
A thorough understanding of polypharmacy is required to create public health initiatives that minimize the potential for adverse outcomes. This study aimed to investigate the relationship between sociodemographic factors, socioeconomic status (SES), and polypharmacy risk in United States (US) individuals between 1999-2000 and 2017-2018. The cross-sectional National Health and Nutrition Examination Survey dataset covered ten cycles between 1999-2000 and 2017-2018. All individuals aged ≥18 years were included. The simultaneous use of at least five medications by one person is known as polypharmacy. Multivariable logistic regression showed that there was a statistically significant association between polypharmacy sociodemographic factors (such as age between 45 and 64 (odds ratio [OR] = 3.76; 95% confidence interval [CI] = 3.60-3.92; p < 0.0001) and age of 65 years or above (OR = 3.96; 95% CI = 3.79-4.13; p < 0.0001), especially women (OR = 1.09; 95% CI = 1.06-1.13; p < 0.0001), non-Hispanic blacks (OR = 1.66; 95% CI = 1.51-1.83; p < 0.0001), and veterans (OR = 1.27; 95% CI = 1.22-1.31; p < 0.0001)) and SES (such as being married (OR = 1.14; 95% CI = 1.08-1.19; p = 0.031), widowed, divorced, or separated (OR = 1.21; 95% CI = 1.15-1.26; p < 0.0001), a college graduate or above (OR = 1.21, 95% CI = 1.15-1.27, p < 0.0001), and earning > USD 55,000 per year (OR = 1.86; 95% CI = 1.79-1.93; p < 0.0001)). Individuals aged 45 years and above, women, and non-Hispanic blacks with higher educational levels and yearly incomes were more likely to experience polypharmacy in the US between 1999-2000 and 2017-2018.
Collapse
Affiliation(s)
- Vishal Vennu
- Department of Rehabilitation Sciences, College of Applied Medical Sciences, King Saud University, P.O. Box 10219, Riyadh 11433, Saudi Arabia
| |
Collapse
|
5
|
Anderssen-Nordahl E, Sánchez-Arcilla Rosanas M, Bosch Ferrer M, Sabaté Gallego M, Fernández-Liz E, San-José A, Barceló-Colomer ME. Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach. Front Pharmacol 2024; 15:1320490. [PMID: 38529187 PMCID: PMC10961593 DOI: 10.3389/fphar.2024.1320490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 01/29/2024] [Indexed: 03/27/2024] Open
Abstract
Background: Aging correlates with increased frailty, multi-morbidity, and chronic diseases. Furthermore, treating the aged often entails polypharmacy to achieve optimal disease management, augmenting medication-related problems (MRPs). Few guidelines and tools address the problem of polypharmacy and MRPs, mainly within the institutionalized elderly population. Routine pharmacological review is needed among institutionalized patients. This pharmacological review may improve with a multidisciplinary approach of a collaboration of multiple health professionals. This study aimed to describe institutionalized patients, systematically review their medication plans, and then give recommendations and identify MRPs. Methods: A cross-sectional study was performed using data obtained from patients living in five nursing homes in the northern area of Barcelona, Spain. The inclusion criteria comprised institutionalized patients with public health coverage provided by the Health Department of Catalonia. A detailed description of the clinical characteristics, chronic diseases, pharmacological treatments, recommendations, incomplete data, and MRPs, such as potential drug-drug interactions, therapeutic duplications, contraindications, and drugs deemed inappropriate or of doubtful efficacy, was made. The clinical pharmacologist was the medical doctor specialist who acted as the coordinator of the multidisciplinary team and actively reviewed all the prescribed medications to make recommendations and detect MRPs. Results: A total of 483 patients were included. Patients had a mean age of 86.3 (SD 8.8) years, and 72.0% were female individuals. All patients had at least three health-related problems, with a mean of 17.4 (SD 5.6). All patients, except one, had a minimum of one prescription, with a mean of 8.22 drugs prescribed (SD 3.5) per patient. Recommendations were made for 82.4% of the patients. Of these recommendations, verification of adequate use was made for 69.3% and withdrawal of a drug for 49.5%. Conclusion: This study demonstrates a high prevalence of health-related problems and several prescribed drugs in nursing homes in Catalonia. Many recommendations were made, confirming the increased proportion of polypharmacy, MRPs, and the need for standardized interventions. A multidisciplinary team approach, including general practitioners, geriatric assessments, a clinical pharmacist, and a clinical pharmacologist, should address this problem.
Collapse
Affiliation(s)
- Emilie Anderssen-Nordahl
- Clinical Pharmacology Service, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Clinical Pharmacology Group, Vall d’Hebron Research Institute, Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Margarita Sánchez-Arcilla Rosanas
- Geriatric Unit, Internal Medicine Service, Vall d'Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Montserrat Bosch Ferrer
- Clinical Pharmacology Service, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Clinical Pharmacology Group, Vall d’Hebron Research Institute, Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Mònica Sabaté Gallego
- Clinical Pharmacology Service, Vall d’Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
- Clinical Pharmacology Group, Vall d’Hebron Research Institute, Barcelona, Spain
- Department of Pharmacology, Therapeutics and Toxicology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Eladio Fernández-Liz
- Primary Healthcare Barcelona, Management of Primary Care and the Community of Barcelona City, Catalan Institute of Health, Barcelona, Spain
- Foundation University Institute for Research in Primary Healthcare Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| | - Antonio San-José
- Geriatric Unit, Internal Medicine Service, Vall d'Hebron University Hospital, Vall d’Hebron Barcelona Hospital Campus, Barcelona, Spain
| | - Maria Estrella Barceló-Colomer
- Primary Healthcare Barcelona, Management of Primary Care and the Community of Barcelona City, Catalan Institute of Health, Barcelona, Spain
- Foundation University Institute for Research in Primary Healthcare Jordi Gol i Gurina (IDIAPJGol), Barcelona, Spain
| |
Collapse
|
6
|
Barrio-Cortes J, Benito-Sánchez B, Villimar-Rodriguez AI, Rujas M, Arroyo-Gallego P, Carlson J, Merino-Barbancho B, Roca-Umbert A, Castillo-Sanz A, Lupiáñez-Villanueva F, Fico G, Gómez-Gascón T. Differences in healthcare service utilization in patients with polypharmacy according to their risk level by adjusted morbidity groups: a population-based cross-sectional study. J Pharm Policy Pract 2023; 16:161. [PMID: 38017572 PMCID: PMC10683272 DOI: 10.1186/s40545-023-00665-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/15/2023] [Indexed: 11/30/2023] Open
Abstract
BACKGROUND Patients with polypharmacy suffer from complex medical conditions involving a large healthcare burden. This study aimed to describe the characteristics and utilization of primary care (PC) and hospital care (HC) and factors associated in chronic patients with polypharmacy, stratifying by adjusted morbidity groups (AMG) risk level, sex and age, and comparing with non-polypharmacy. METHODS Cross-sectional study conducted in a Spanish basic healthcare area. Studied patients were those over 18 years with chronic diseases identified by the AMG tool from Madrid electronic clinical record, which was the data source. Sociodemographic, sociofunctional, clinical and healthcare utilization variables were described and compared by risk level, sex, age and having or not polypharmacy. Factors associated with healthcare utilization in polypharmacy patients were determined by a negative binomial regression model. RESULTS In the area studied, 61.3% patients had chronic diseases, of which 16.9% had polypharmacy vs. 83.1% without polypharmacy. Patients with polypharmacy (vs. non-polypharmacy) mean age was 82.7 (vs. 52.7), 68.9% (vs. 60.7%) were women, and 22.0% (vs. 1.2%) high risk. Their average number of chronic diseases was 4.8 (vs. 2.2), and 95.6% (vs. 56.9%) had multimorbidity. Their mean number of annual healthcare contacts was 30.3 (vs. 10.5), 25.9 (vs. 8.8) with PC and 4.4 (vs. 1.7) with HC. Factors associated with a greater PC utilization in patients with polypharmacy were elevated complexity, high risk level and dysrhythmia. Variables associated with a higher HC utilization were also increased complexity and high risk, in addition to male sex, being in palliative care, having a primary caregiver, suffering from neoplasia (specifically lymphoma or leukaemia) and arthritis, whereas older age and immobilization were negatively associated. CONCLUSIONS Polypharmacy population compared to non-polypharmacy was characterized by a more advanced age, predominance of women, high-risk, complexity, numerous comorbidities, dependency and remarkable healthcare utilization. These findings could help healthcare policy makers to optimize the distribution of resources and professionals within PC and HC systems, aiming for the improvement of polypharmacy management and rational use of medicines while reducing costs attributed to healthcare utilization by these patients.
Collapse
Affiliation(s)
- Jaime Barrio-Cortes
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Ave. Reina Victoria, 21, 6Th Floor, 28003, Madrid, Spain
- Faculty of Health, Camilo José Cela University, Madrid, Spain
- Gregorio Marañón Health Research Institute, Madrid, Spain
- Research Network On Chronicity, Primary Care and Prevention and Health Promotion, Carlos III Health Institute, Madrid, Spain
| | - Beatriz Benito-Sánchez
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Ave. Reina Victoria, 21, 6Th Floor, 28003, Madrid, Spain.
| | | | - Miguel Rujas
- Technical University of Madrid (UPM), Madrid, Spain
| | | | | | | | | | | | | | | | - Tomás Gómez-Gascón
- Foundation for Biosanitary Research and Innovation in Primary Care (FIIBAP), Ave. Reina Victoria, 21, 6Th Floor, 28003, Madrid, Spain
- Research Network On Chronicity, Primary Care and Prevention and Health Promotion, Carlos III Health Institute, Madrid, Spain
- Research Institute Hospital, 12 de Octubre (imas12), Primary Care Management, Madrid, Spain
- Faculty of Medicine, Complutense University of Madrid, Madrid, Spain
| |
Collapse
|
7
|
AlAbdulKader A, Alsheikh S, Alghamdi R, AlHarkan K, AlShamlan N, Alqahtani H, Awad FA, Alotaibi R. Association Between Multi-Morbidities and Polypharmacy Among Older Adults at an Academic Medical Center in Saudi Arabia. Med Arch 2023; 77:471-476. [PMID: 38313108 PMCID: PMC10834046 DOI: 10.5455/medarh.2023.77.471-476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024] Open
Abstract
Background Polypharmacy, or the routine use of five or more medications, can result in impacting patients' quality of life. Objective to examine the association between multi-morbidities and polypharmacy, and to examine prescription practices in the elderly. Methods This is a retrospective cross-sectional study. Data were gathered from electronic medical records (EMR) at King Fahad University Hospital (KFHU) and the Family & Community Medicine Center (FCMC) of Imam Abdulrahman bin Faisal University (IAU), between January 1, 2019, and December 31, 2020. We included individuals aged 60 and above with at least one dispensed prescription in 2019 and 2020. Of the 76,216 patient records reviewed, 5,060 met the inclusion criteria. Polypharmacy was defined as a monthly average of five or more prescribed medications. The prevalence of polypharmacy was calculated by year, sex, and age group, and findings were summarized using mean medication numbers and standard deviations for each stratum. An app using R programming language was developed to help visualize patients' medication histories through interactive plots. Results Polypharmacy prevalence was 46% in 2019 and 44.6% in 2020. The mean and standard deviation of medications per person was 5.17 (3.42) in 2019 and 5.04 (3.37) in 2020. Females had a higher average number of medications than males, 5.17 (3.47) vs 5.04 (3.32). The age group of 80-85 had the highest number of medications at 5.6 (3.6), while those aged 90 and above had the lowest number at 4.48 (2.64). The presence of comorbidities was positively associated with the mean monthly medication count (P value < 0.01). Conclusion Our study revealed a high prevalence of polypharmacy among elderly patients at KFHU/FCMC, and a positive association with multi-morbidities. Consequently, measures must be taken to mitigate this globally emerging issue's impact and rapid progression.
Collapse
Affiliation(s)
- Assim AlAbdulKader
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Shahad Alsheikh
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Rizam Alghamdi
- College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khalid AlHarkan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Nouf AlShamlan
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hatem Alqahtani
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Feras Al Awad
- Department of Psychiatry, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Raed Alotaibi
- Department of Family and Community Medicine, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| |
Collapse
|