Medication‐related problems in older people in Catalonia: A real‐world data study. Issue 2 (26th November 2020)

• Record Type: Journal Article
• Authors: Troncoso‐Mariño, Amelia; López‐Jiménez, Tomás; Roso‐Llorach, Albert; Villén, Noemí; Amado‐Guirado, Ester; Guisado‐Clavero, Marina; Fernández‐Bertolin, Sergio; Pons Vigues, Mariona; Foguet‐Boreu, Quintí; Violán, Concepción
• Is Part Of: Pharmacoepidemiology and drug safety. Volume 30:Issue 2(2021)
• Page Start: 220
• Page End: 228
• Publication Date: 2020-11-26
• Subjects: contraindicated drugs -- drug interactions -- duplicate therapy -- inappropriate prescribing -- multimorbidity -- older people -- pharmacoepidemiology; Pharmacoepidemiology -- Periodicals; Chemotherapy -- Periodicals; Epidemiology -- Periodicals; 615.705
• DOI: 10.1002/pds.5149
• Languages: English
• ISSNs: 1053-8569

Abstract

Abstract: Purpose: The aim of this study was to determine medication‐related problems (MRPs) in primary care patients over 65 years of age. Methods: Cross‐sectional study based on the electronic health records of patients (65‐99 years of age) visited in 284 primary health care centers during 2012 in Catalonia. Variables: age, sex, sociodemographic variables, number of drugs, kidney and liver function and MRPs (duplicate therapy, drug‐drug interactions, potentially inappropriate medications [PIMs] and drugs contraindicated in chronic kidney disease and in liver diseases). Unconditional logistic regression models were used to identify the factors associated with MRPs in patients with multimorbidity. Results: 916 619 older people were included and 853 085 of them met the criteria for multimorbidity. Median age was 75 years and 57.7% of them were women. High percentages of MRPs were observed: PIMs (62.8%), contraindicated drugs in chronic kidney disease (12.1%), duplicate therapy (11.1%), contraindicated drugs in liver diseases (4.2%), and drug‐drug interactions (1.0%). These numbers were higher in the subgroup of patients with ≥10 diseases. The most common PIMs were connected to drugs that increase the risk of fall (66.8%), antiulcer agents without criteria for gastroprotection (40.6%), and the combination of drugs with anticholinergic effects (39.7%). In the multivariate analysis, the variables associated with all MRPs among the patients with multimorbidity were the number of drugs and the number of visits. Conclusions: The coexistence of multimorbidity and polypharmacy is associated with an elevated risk of MRPs in older people. Medication safety for older patients constitutes a pressing concern for health services.