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Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication—MoPIM Cohort Study

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Listed:
  • Marina Lleal

    (Institutional Committee for the Improvement of Clinical Practice Adequacy, Clinical Epidemiology and Cancer Screening Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
    Department of Paediatrics, Obstetrics and Gynaecology, Preventive Medicine and Public Health, Autonomous University of Barcelona (UAB), 08193 Bellaterra, Catalonia, Spain)

  • Marisa Baré

    (Institutional Committee for the Improvement of Clinical Practice Adequacy, Clinical Epidemiology and Cancer Screening Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
    Research Network on Health Services in Chronic Patients (REDISSEC), ISCIII, 28029 Madrid, Spain
    Research Network on Chronicity, Primary Care and Health Promotion (RICAPPS), ISCIII, 28029 Madrid, Spain)

  • Sara Ortonobes

    (Pharmacy Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain)

  • Daniel Sevilla-Sánchez

    (Pharmacy Department, Parc Sanitari Pere Virgili, 08023 Barcelona, Catalonia, Spain)

  • Rosa Jordana

    (Internal Medicine Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain)

  • Susana Herranz

    (Acute Care Geriatric Unit, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain)

  • Maria Queralt Gorgas

    (Pharmacy Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain)

  • Mariona Espaulella-Ferrer

    (Geriatrics Department, Consorci Hospitalari de Vic, 08500 Vic, Catalonia, Spain)

  • Marta Arellano

    (Geriatrics Department, Consorci Parc de Salut MAR, 08003 Barcelona, Catalonia, Spain)

  • Marta de Antonio

    (Pharmacy Department, Consorci Parc de Salut MAR, 08003 Barcelona, Catalonia, Spain)

  • Gloria Julia Nazco

    (Pharmacy Department, Hospital Universitario de Canarias, 38320 La Laguna, Canarias, Spain)

  • Rubén Hernández-Luis

    (Internal Medicine Department, Hospital Universitario de Canarias, 38320 La Laguna, Canarias, Spain)

  • on behalf of the MoPIM Study Group

    (Collaborators/Membership of the Group/Team Name is provided in the Acknowledgments.)

Abstract

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.

Suggested Citation

  • Marina Lleal & Marisa Baré & Sara Ortonobes & Daniel Sevilla-Sánchez & Rosa Jordana & Susana Herranz & Maria Queralt Gorgas & Mariona Espaulella-Ferrer & Marta Arellano & Marta de Antonio & Gloria Jul, 2022. "Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication—MoPIM Cohort Study," IJERPH, MDPI, vol. 19(23), pages 1-16, November.
    • Handle: RePEc:gam:jijerp:v:19:y:2022:i:23:p:15902-:d:987587
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    References listed on IDEAS

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    1. Jonás Carmona-Pírez & Ignatios Ioakeim-Skoufa & Antonio Gimeno-Miguel & Beatriz Poblador-Plou & Francisca González-Rubio & Dolores Muñoyerro-Muñiz & Juliana Rodríguez-Herrera & Juan Antonio Goicoechea, 2022. "Multimorbidity Profiles and Infection Severity in COVID-19 Population Using Network Analysis in the Andalusian Health Population Database," IJERPH, MDPI, vol. 19(7), pages 1-13, March.
    2. Cathal A. Cadogan & Cristín Ryan & Carmel M. Hughes, 2016. "Appropriate Polypharmacy and Medicine Safety: When Many is not Too Many," Drug Safety, Springer, vol. 39(2), pages 109-116, February.
    3. Mingkwan Na Takuathung & Wannachai Sakuludomkan & Rapheephorn Khatsri & Nahathai Dukaew & Napatsorn Kraivisitkul & Balqis Ahmadmusa & Chollada Mahakkanukrauh & Kachathip Wangthaweesap & Jirakit Onin &, 2022. "Adverse Effects of Angiotensin-Converting Enzyme Inhibitors in Humans: A Systematic Review and Meta-Analysis of 378 Randomized Controlled Trials," IJERPH, MDPI, vol. 19(14), pages 1-13, July.
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