Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort Study

Int J Environ Res Public Health. 2023 Feb 18;20(4):3639. doi: 10.3390/ijerph20043639.

Abstract

There is no published evidence on the possible differences in multimorbidity, inappropriate prescribing, and adverse outcomes of care, simultaneously, from a sex perspective in older patients. We aimed to identify those possible differences in patients hospitalized because of a chronic disease exacerbation. A multicenter, prospective cohort study of 740 older hospitalized patients (≥65 years) was designed, registering sociodemographic variables, frailty, Barthel index, chronic conditions (CCs), geriatric syndromes (GSs), polypharmacy, potentially inappropriate prescribing (PIP) according to STOPP/START criteria, and adverse drug reactions (ADRs). Outcomes were length of stay (LOS), discharge to nursing home, in-hospital mortality, cause of mortality, and existence of any ADR and its worst consequence. Bivariate analyses between sex and all variables were performed, and a network graph was created for each sex using CC and GS. A total of 740 patients were included (53.2% females, 53.5% ≥85 years old). Women presented higher prevalence of frailty, and more were living in a nursing home or alone, and had a higher percentage of PIP related to anxiolytics or pain management drugs. Moreover, they presented significant pairwise associations between CC, such as asthma, vertigo, thyroid diseases, osteoarticular diseases, and sleep disorders, and with GS, such as chronic pain, constipation, and anxiety/depression. No significant differences in immediate adverse outcomes of care were observed between men and women in the exacerbation episode.

Keywords: adverse drug reaction; in-hospital mortality; multimorbidity; network analysis; outcomes of care; potentially inappropriate medication; sex perspective.

Publication types

  • Multicenter Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Chronic Disease
  • Cohort Studies
  • Drug-Related Side Effects and Adverse Reactions*
  • Female
  • Frailty*
  • Humans
  • Inappropriate Prescribing
  • Inpatients
  • Male
  • Multimorbidity
  • Prospective Studies
  • Sex Characteristics

Grants and funding

This work was supported by grants from Instituto de Salud Carlos III, Ministry of Science and Innovation (Spain)—FEDER (PI15/00552), and by the Network for Research into Healthcare in Chronic Diseases, REDISSEC (RD16/0001/0002). These funding bodies had no role in the design of the study, nor in the collection, analysis and interpretation of data nor in writing the manuscript.