Prevalence of multimorbidity and polypharmacy among adults and older adults: a systematic review

The Lancet Healthy Longevity, Journal Year: 2024, Volume and Issue: 5(4), P. e287 - e296

Published: March 4, 2024

Multimorbidity (multiple conditions) and polypharmacy medications) are increasingly common, yet there is a need to better understand the prevalence of co-occurrence. In this systematic review, we examined multimorbidity among adults (≥18 years) older (≥65 in clinical community settings. Six electronic databases were searched, 87 studies retained after two levels screening. Most focused on 65 years done population-based Although operational definitions varied across studies, consistent cut-points (two or more conditions five used most studies. adult samples, ranged from 4·8% 93·1%, while 2·6% 86·6%. High heterogeneity between indicates for reporting specific lists medications definitions.

Language: Английский

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Chat GPT vs. Clinical Decision Support Systems in the Analysis of Drug–Drug Interactions

Clinical Pharmacology & Therapeutics, Journal Year: 2025, Volume and Issue: unknown

Published: Feb. 11, 2025

The current standard method for the analysis of potential drug–drug interactions (pDDIs) is time‐consuming and includes use multiple clinical decision support systems (CDSSs) interpretation by healthcare professionals. With emergence large language models developed with artificial intelligence, an interesting alternative arose. This retrospective study included 30 patients polypharmacy, who underwent a pDDI between October 2022 August 2023, compared performance Chat GPT established CDSSs (MediQ®, Lexicomp®, Micromedex®) in pDDIs. A multidisciplinary team interpreted obtained results decided upon relevance assigned severity grades using three categories: (i) contraindicated, (ii) severe, (iii) moderate. expert review identified total 280 clinically relevant pDDIs (3 contraindications, 13 264 moderate) CDSSs, 80 (2 5 73 GPT. almost entirely neglected risk to QTc prolongation (85 vs. 8), which could also not be sufficiently improved specific prompt. To assess consistency provided GPT, we repeated each query found inconsistent 90% cases. In contrast, acceptable comprehensible recommendations questions on side effects. identification cannot recommended currently, because were detected, there obvious errors inconsistent. However, if these limitations are addressed accordingly, it promising platform future.

Language: Английский

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Factors associated with frailty in older people: an umbrella review

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Sept. 5, 2024

Language: Английский

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The co-occurrence of multimorbidity and polypharmacy among middle-aged and older adults in Canada: A cross-sectional study using the Canadian Longitudinal Study on Aging (CLSA) and the Canadian Primary Care Sentinel Surveillance Network (CPCSSN)

PLoS ONE, Journal Year: 2025, Volume and Issue: 20(1), P. e0312873 - e0312873

Published: Jan. 15, 2025

Background There is an increasing prevalence of multiple conditions (multimorbidity) and medications (polypharmacy) across many populations. Previous literature has focused on the impact these health states separately, but there a need to better understand their co-occurrence. Methods findings This study reported multimorbidity polypharmacy among middle-aged older adults in two national datasets: Canadian Longitudinal Study Aging (CLSA) Primary Care Sentinel Surveillance Network (CPCSSN). Using consistent methodology, we conducted cross-sectional analysis CLSA participants CPCSSN patients aged 45 85 years as 2015. When was defined or more conditions, 66.7% 52.0% cohorts, respectively. The 14.9% cohort 22.6% when five medications. same cut-points, co-occurrence similar between cohorts (CLSA: 14.3%; CPCSSN: 13.5%). Approximately 20% (65 years) were living with both 21.4%; 18.3%), compared almost 10% (45 64 this 9.2%; 9.9%). Across age groups, females had consistently higher estimates multimorbidity, polypharmacy. Conclusions found that are not interchangeable understanding population needs. one polypharmacy, double proportion younger cohorts. implications for future research, well policy clinical practice, aim reduce occurrence unnecessary enhance well-being aging

Language: Английский

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How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC

European Journal of Heart Failure, Journal Year: 2025, Volume and Issue: unknown

Published: March 17, 2025

Abstract The multiplicity of coexisting comorbidities affecting patients with heart failure ( HF) , together the availability multiple treatments improving prognosis in HF reduced ejection fraction, has led to an increase number prescribed medications each patient. Polypharmacy is defined as regular use medications, and over last years become emerging aspect care, particularly older frailer who are more frequently on treatments, therefore likely exposed tolerability issues, drug–drug interactions practical difficulties management. negatively affects adherence treatment, associated a higher risk adverse drug reactions, impaired quality life, hospitalizations worse prognosis. It important adopt implement strategies for management polypharmacy from other medical disciplines, including medication reconciliation, therapeutic revision treatment prioritization. also essential develop new ‐specific strategies, primary goal avoiding redundant minimizing reactions interactions, finally adherence. This clinical consensus statement document Heart Failure Association European Society Cardiology proposes rationale, pragmatic multidisciplinary approach prescription current era multimorbidity ‘multi‐medication’ .

Language: Английский

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‘It's a job to be done’. Managing polypharmacy at home: A qualitative interview study exploring the experiences of older people living with frailty

Health Expectations, Journal Year: 2024, Volume and Issue: 27(1)

Published: Jan. 10, 2024

Many older people live with both multiple long-term conditions and frailty; thus, they manage complex medicines regimens are at heightened risk of the consequences errors. Research to enhance how has focused on adherence rather than wider skills necessary safely medicines, population living frailty managing home been under-explored. This study, therefore, examines in depth mild moderate their polypharmacy home.

Language: Английский

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From fragmented to integrated healthcare managing hypertension post-stroke: a qualitative study

Frontiers in Stroke, Journal Year: 2025, Volume and Issue: 4

Published: Jan. 30, 2025

Introduction As stroke incidence rises with an aging population, hypertension remains a critical modifiable risk factor for both primary and secondary prevention. Effective management of post-stroke requires shift from fragmented care to integrated, patient-centered approaches. This study explores the perspectives survivors healthcare professionals on evaluates acceptability innovative strategies, including 24-h ambulatory blood pressure monitoring (ABPM). Methods A qualitative using grounded theory methodology was conducted through focus group interviews in Wales Scotland between January 2019 December 2022. Participants included 48 individuals representing diverse backgrounds experiences. Data were analyzed thematically identify barriers facilitators post-stroke. Results Key findings identified four major themes: need improved cooperation among multidisciplinary teams, knowledge gaps regarding hypertension's role risk, complexities polypharmacy, potential benefits ABPM individualized care. Stroke expressed reliance clinicians management, while emphasized importance empowering patients education self-management. emerged as promising tool enhance support patient engagement, though practical challenges remain. Discussion The underscores integrating education, care, advanced techniques like into management. Strengthening communication pathways providers can foster greater engagement accountability. Addressing socio-economic barriers, improving patient-clinician communication, implementing holistic strategies are reducing recurrent risk. These emphasize systemic reforms targeted interventions bridge delivery

Language: Английский

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Inappropriate polypharmacy during the COVID-19 pandemic: impact, challenges, and solutions – a narrative review

Folia Medica, Journal Year: 2025, Volume and Issue: 67(1)

Published: Feb. 24, 2025

The COVID-19 pandemic has brought unprecedented challenges to healthcare systems worldwide, impacting various aspects of patient care. Polypharmacy, the concurrent use multiple medications by a single patient, is significant concern exacerbated pandemic. dual threat infection and polypharmacy for same vulnerable group – elderly those with pre-existing multimorbidity particularly problematic, as been shown lead suboptimal treatment outcomes in many chronic diseases. This comprehensive review explores multifaceted issues surrounding during pandemic, addressing its causes, consequences, potential solutions.

Language: Английский

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Multicomponent intervention to tailor prescriptions to patients with dementia in an intermediate care hospital: pre-post quasi experimental study

BMC Geriatrics, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 27, 2025

In persons with dementia, polypharmacy may be discordant the goals of care. It is necessary to design interventions that align treatment regimens patient's situation, prognosis and preferences. The objectives this study conducted at an intermediate care were to: i) identify inappropriate prescribing per main goal; ii) compare pharmacotherapy data pre post a medication review based on degree cognitive impairment; iii) assess implementation proposed recommendations three months after discharge. Pre-post quasi-experimental study. Patients dementia discharged from hospital between November 2021 April 2022. Demographic, clinical evaluated admission. Medication reviews interviews caregivers pharmacologic therapies overall At discharge, information was shared primary team in discharge summary. Follow up evaluate during performed months. Of 97 patients included, 94.8% had least one inappropriately prescribed medication. mean number chronic medications taken patient decreased by 29.6%, 8.05(SD 3.5) 5.67(SD 2.7) (p < 0.001); anticholinergic burden 18.6%, 1.59(SD 1.0) 1.29(SD 0.9) therapeutic complexity 28.4%, 29.23(SD 13.8) 20.94(SD 11.3) 0.001). 3 90.0%. Admission provides ideal setting for multicomponent intervention, tailoring prescriptions preferences, improving parameters related side effects, ensuring are maintained over medium term.

Language: Английский

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Community-level social capital and polypharmacy among public assistance recipients in Japan: A multilevel cross-sectional study

SSM - Population Health, Journal Year: 2025, Volume and Issue: unknown, P. 101788 - 101788

Published: March 1, 2025

•Polypharmacy is common among low socioeconomic public assistance recipients.•69.5 % of adults on had polypharmacy with ≥6 oral medications.•Higher civic participation was associated lower excessive prevalence.•Higher social cohesion higher prevalence.•Polypharmacy should be addressed based and cohesion.

Language: Английский

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