Frequency of multimorbidity and polypharmacy among geriatric patients
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Copyright (c) 2024 Dorina Markovics, Andrea Virág, Attila Besenyei, Luca Sára Szabó, Klára Gadó

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Abstract
Hungary is characterized by an ageing society. The majority of healthcare is used by the elderly. Hospitalization is frequently required due to iatrogenesis, caused by drug toxicity and adverse interactions. Polypharmacy can augment these problems.
The purpose of my research is to assess the frequency and harmful effects of polypharmacy in an elderly inpatient care unit. In addition to the survey results, during the research, which was conducted in an inpatient department, I collected data on regularly taken medications, the established diagnoses as well as the results of kidney function test. Informed consent was obtained from each patient.
According to the research, it was proven that among geriatric patients, polypharmacy is an important contributor to their potential risk. The more diseases a person suffers from, the more medications he or she must take, so more drug interactions must be expected. Therefore, it is extremely important to regularly reconsider databases concerning drug interactions. To improve patient safety, the "unit-dose system" provides great help concerning inpatients, which also includes the automatic monitoring of interactions. With the help of all this, the development of complications, hospitalization and mortality can be reduced. Decreasing iatrogenicity not only improves the patient's quality of life but also lowers the burden on the healthcare system.
References
- Akugizibwe, R., Calderón-Larrañaga, A., Roso-Llorach, A., Onder, G., Marengoni, A., Zucchelli, A., . . . Vetrano, D. L. (2020). Multimorbidity Patterns and Unplanned Hospitalisation in a Cohort of Older Adults. J Clin Med, 9(12). doi:10.3390/jcm9124001
- Balakrishnan, S., Karmacharya, I., Ghimire, S., Mistry, S. K., Singh, D. R., Yadav, O. P., . . . Yadav, U. N. (2022). Prevalence of multimorbidity and its correlates among older adults in Eastern Nepal. BMC Geriatr, 22(1), 425. doi:10.1186/s12877-022-03115-2
- Becker, M. L., Visser, L. E., van Gelder, T., Hofman, A., & Stricker, B. H. (2008). Increasing exposure to drug-drug interactions between 1992 and 2005 in people aged > or = 55 years. Drugs Aging, 25(2), 145-152. doi:10.2165/00002512-200825020-00006
- Colley, C. A., & Lucas, L. M. (1993). Polypharmacy: the cure becomes the disease. J Gen Intern Med, 8(5), 278-283. doi:10.1007/bf02600099
- Gutiérrez-Valencia, M., Izquierdo, M., Cesari, M., Casas-Herrero, Á., Inzitari, M., & Martínez-Velilla, N. (2018). The relationship between frailty and polypharmacy in older people: A systematic review. Br J Clin Pharmacol, 84(7), 1432-1444. doi:10.1111/bcp.13590
- Hivatal, K. S. (2022). Népesség korév és nem szerint. Retrieved from https://www.ksh.hu/stadat_files/nep/hu/nep0003.html Hivatal, K. S. (2022). Születéskor várható átlagos élettartam, átlagéletkor nem, vármegye és régió szerint Retrieved from https://www.ksh.hu/stadat_files/nep/hu/nep0039.html
- Hovstadius, B., Hovstadius, K., Astrand, B., & Petersson, G. (2010). Increasing polypharmacy - an individual-based study of the Swedish population 2005-2008. BMC Clin Pharmacol, 10, 16. doi:10.1186/1472-6904-10-16
- Lenander, C., Bondesson, Å., Viberg, N., Beckman, A., & Midlöv, P. (2018). Effects of medication reviews on use of potentially inappropriate medications in elderly patients; a cross-sectional study in Swedish primary care. BMC Health Serv Res, 18(1), 616. doi:10.1186/s12913-018-3425-y
- Lexiq. (2020). Multimorbid. Retrieved from https://lexiq.hu/multimorbid
- Lexiq. (2020.). Polifarmácia. Retrieved from https://lexiq.hu/polifarmacia
- Lexow, M., Wernecke, K., Schmid, G. L., Sultzer, R., Bertsche, T., & Schiek, S. (2021). Considering additive effects of polypharmacy : Analysis of adverse events in geriatric patients in long-term care facilities. Wien Klin Wochenschr, 133(15-16), 816-824. doi:10.1007/s00508-020-01750-6
- Magro, L., Moretti, U., & Leone, R. (2012). Epidemiology and characteristics of adverse drug reactions caused by drug-drug interactions. Expert Opin Drug Saf, 11(1), 83-94. doi:10.1517/14740338.2012.631910
- Mallet, L., Spinewine, A., & Huang, A. (2007). The challenge of managing drug interactions in elderly people. Lancet, 370(9582), 185-191. doi:10.1016/s0140-6736(07)61092-7
- Mangoni, A. A., & Jackson, S. H. (2004). Age-Related Changes in Pharmacokinetics and Pharmacodynamics: Basic Principles and Practical Applications. Br J Clin Pharmacol, 57(1), 6-14. doi:10.1046/j.1365-2125.2003.02007.x
- Marengoni, A., Angleman, S., Melis, R., Mangialasche, F., Karp, A., Garmen, A., . . . Fratiglioni, L. (2011). Aging with multimorbidity: a systematic review of the literature. Ageing Res Rev, 10(4), 430-439. doi:10.1016/j.arr.2011.03.003
- Mjörndal, T., Boman, M. D., Hägg, S., Bäckström, M., Wiholm, B. E., Wahlin, A., & Dahlqvist, R. (2002). Adverse drug reactions as a cause for admissions to a department of internal medicine. Pharmacoepidemiology and Drug Safety, 11(1), 65-72. doi:10.1002/pds.667
- Moffat, K., & Mercer, S. W. (2015). Challenges of managing people with multimorbidity in today's healthcare systems. BMC Fam Pract, 16, 129. doi:10.1186/s12875-015-0344-4
- Patel, T. K., Patel, P. B., Bhalla, H. L., Dwivedi, P., Bajpai, V., & Kishore, S. (2023). Impact of suspected adverse drug reactions on mortality and length of hospital stay in the hospitalised patients: a meta-analysis. Eur J Clin Pharmacol, 79(1), 99-116. doi:10.1007/s00228-022-03419-7
- Rodrigues, L. P., de Oliveira Rezende, A. T., Delpino, F. M., Mendonça, C. R., Noll, M., Nunes, B. P., … Silveira, E. A. (2022). Association between multimorbidity and hospitalization in older adults: systematic review and meta-analysis. Age Ageing, 51(7). doi:10.1093/ageing/afac155
- Rodrigues, M. C., & Oliveira, C. (2016). Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review. Rev Lat Am Enfermagem, 24, e2800. doi:10.1590/1518-8345.1316.2800
- Romskaug, R., Skovlund, E., Straand, J., Molden, E., Kersten, H., Pitkala, K. H., . . . Wyller, T. B. (2020). Effect of Clinical Geriatric Assessments and Collaborative Medication Reviews by Geriatrician and Family Physician for Improving Health-Related Quality of Life in Home-Dwelling Older Patients Receiving Polypharmacy: A Cluster Randomized Clinical Trial. JAMA Intern Med, 180(2), 181-189. doi:10.1001/jamainternmed.2019.5096
- Székács, B. (2005). Az öregedés biológiai és élettani vonatkozásai. Budapest: Semmelweis kiadó.
- Tulner, L. R., Frankfort, S. V., Gijsen, G. J., van Campen, J. P., Koks, C. H., & Beijnen, J. H. (2008). Drug-drug interactions in a geriatric outpatient cohort: prevalence and relevance. Drugs Aging, 25(4), 343-355. doi:10.2165/00002512-200825040-00007
https://doi.org/10.47225/mg/16/43/15973