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

Int J Environ Res Public Health. 2022 Nov 29;19(23):15902. doi: 10.3390/ijerph192315902.

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.

Keywords: adverse drug reaction; cluster analysis; healthcare quality indicator; multimorbidity; older patient; polypharmacy; potential prescribing omission; potentially inappropriate medication.

Publication types

  • Clinical Study
  • Multicenter Study

MeSH terms

  • Aged
  • Chronic Disease
  • Cohort Studies
  • Drug-Related Side Effects and Adverse Reactions* / epidemiology
  • Humans
  • Inappropriate Prescribing
  • Multimorbidity
  • Potentially Inappropriate Medication List
  • Prospective Studies
  • Quality Indicators, Health Care*

Associated data

  • ClinicalTrials.gov/NCT02830425