Abstract
The pressing problem of multimorbidity and polypharmacy is aggravated by the lack of specific care models for this population. We aimed to investigate the evolution of multimorbidity and polypharmacy patterns in a given population over a 4-year period (2011–2015). A cross-sectional, observational study among the EpiChron Cohort, including anonymized demographic, clinical and drug dispensation information of all users of the public health system ≥65 years in Aragon (Spain), was performed. An exploratory factor analysis, stratified by age and sex, using an open cohort was carried out based on the tetra-choric correlations among chronic diseases and dispensed drugs during 2011 and compared with 2015. Seven baseline patterns were identified during 2011 named as: mental health, respiratory, allergic, mechanical pain, cardiometabolic, osteometabolic, and allergic/derma. Of the epidemiological patterns identified in 2015, six were already present in 2011 but a new allergic/derma one appeared. Patterns identified in 2011 were more complex in terms of both disease and drugs. Results confirmed the existing association between age and clinical complexity. The systematic associations between diseases and drugs remain similar regarding their clinical nature over time, helping in early identification of potential interactions in multimorbid patients with a high risk of negative health outcomes due to polypharmacy.
Highlights
Polypharmacy is referred to as the concurrent use of multiple drugs, and it can be the natural consequence of multimorbidity, more often intended as the coexistence of two or more chronic diseases [1]
This study found that baseline epidemiologic patterns of multimorbidity and polypharmacy identified in the young and adult Spanish population during 2015 were already present in 2011 but with the addition of an allergic/derma pattern, which is not maintained in 2015
This study investigated the nature and complexity of a population, investigating the presence of systematic associations between diseases and drugs at two different times
Summary
Polypharmacy is referred to as the concurrent use of multiple drugs, and it can be the natural consequence of multimorbidity, more often intended as the coexistence of two or more chronic diseases [1]. Inappropriate polypharmacy increases the risk of unnecessary drug use, potential drug–drug and drug–disease interactions, and adverse drug reactions (ADRs) [2,3], representing an economic and public health issue related to 4.0/).
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