Geriatric syndromes as predictors of one-year mortality in an outpatient practice

Abstract

Introduction.– Polypharmacy is a term that describes patients who receive many medications. Unfortunately, using multiple medicationsmay cause problems such as the increased risk of inappropriate use of medications, nonadherence and adverse effects. Method.– We prospectively studied patients hospitalised at Geriatric Department during September to October 2012. Diagnoses, reason for admission, prescription before hospitalisation and after discharge were recorded. Polypharmacy was defined as the concomitant use of five or more medications and high-level polypharmacywas defined as concomitant use of ten ormoremedications. Results.–Hundred and twelve patientswere included,meanpatient age was 86.34±6.27years; 63.3% were female. Cumulative Illness Rating Scale for Geriatrics (CIRS-G): total score 9.84±7.07. Mean Charlson’s index: 2.16. The number of drugs prescribed amounted to 7.25 before hospitalisation and 8.12 at discharge. Hospitalisation led to a significant increase in numbermedications (P=0.001). Polypharmacy on admission and at discharge was observed in 83.03%and91.07% respectively, existing statistically significant difference (P=0.035). High-level polypharmacy on admission and at discharge was observed in 45.53% and 49.10% respectively. We observed a significant reduction in proton pump inhibitors and benzodiazepines. On the other hand, the laxative medication was increased at discharge (34.8 vs 53.5%, P=0.001). Conclusions.– Our study shows a high prevalence of polypharmacy in older spanish. Hospitalisation led to a significant increase in the number of medications and in the prevalence of polypharmacy. It is necessary to implement strategies to identify, and use properly drugs in elderly population.