Multimorbidities and polypharmacy in ageing hemophilia patients

Abstract

Aim: The aim of the study was to investigate whether multimorbidities, comorbidities, and therefore polypharmacy increase with age in hemophilia A and B patients followed in Ege University Adult Hemophilia and Thrombosis Center. Materials and Methods: Adult hemophilia A and B patients were retrospectively evaluated. Patients'demographic data, medical information about hemophilic arthropathy, viral infections hepatitis C virus (HCV), body mass index (BMI), smoking and alcohol consumption, concomitant diseases, and all medications except factor replacement therapy were analyzed. Polypharmacy was defined as ≥5 drug use. Patients were compared by dividing into two groups: ≤55 years and >55 years. Results: A total of 230 patients were evaluated (189 hemophilia A, 41 hemophilia B). There were 191 patients in ≤55 years (83%), and 39 patients in >55 years age groups (17%). The most common diseases in hemophilia patients were hypertension (19.5%), diabetes mellitus (10%), and gastroesophageal reflux disease-chronic gastritis (5.2%). The most common drugs that patients use regularly were non-steroidal anti-inflammatory drugs (14.3%), proton pump inhibitors (12.1%), and oral antidiabetics (9.5%). The number of diseases not related to hemophilia (multimorbidity) and polypharmacy in hemophilia patients aged >55 years was significantly higher than those aged <55 years (p values were 0.00 and 0.01 respectively). There was no difference between the groups in BMI, alcohol and cigarette use, and the history of HCV infection. Conclusion: Our study showed that aging hemophilia patients have more multimorbidities and use more drugs than younger patients. For this reason, the importance of the effects of additional diseases and drugs on quality of life, treatment compliance, and hemostasis is increasing.