Multi-Morbidity in the Older Person: An Examination of Polypharmacy and Socioeconomic Status

Nwadiugwu, Martin C

doi:10.3389/fpubh.2020.582234

Cited by 12 publications

(10 citation statements)

References 43 publications

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“…General trends have shown that patients with lower socioeconomic status and older-age patients often have multiple comorbidities which may affect their length of stay. However, the general trends that we see in our study have also been shown to be true in other studies analyzing different medical conditions [27].…”

Section: Discussionsupporting

confidence: 89%

An Analysis of Epidemiological Factors in Heart Failure Outcomes

Patel¹,

Taneja²,

Mohamed³

et al. 2022

Cureus

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BackgroundVarious socioeconomic and demographic factors play a role in determining treatment outcomes across numerous conditions. Different studies have shown that certain demographic factors, such as income status, directly correlate with treatment outcomes. In this study, we analyze the effect of some of these variables, namely, insurance and age, on various endpoints, including length of stay and discharge status, among heart failure patients. MethodologyThe data used in this project were retrieved from the HealthCare Utilization Project. We sorted the data by insurance, age, length of stay, and discharge status. To compare discharge status between different insurance types and age groups, we used Stata to compute odds ratios and 95% confidence intervals. To compare the length of stay among different age groups and insurance types, we conducted an unpaired twotailed Student's t-test. ResultsAcross all age groups, we found that younger patients with heart failure are more likely to discharge against medical advice compared to older patients. The average length of stay for heart failure patients was the same across all age groups except those 85 and older. Moreover, patients with a lower socioeconomic status, as determined by insurance type, were more likely to discharge against medical advice and less likely to die within hospitals. ConclusionsOur results speak to the socioeconomic inequalities seen in medicine today. Studies have shown that those with a lower socioeconomic status tend to have worse outcomes across various conditions. Our analysis shows this phenomenon holds true for heart failure as well. In addition, our study helps to determine which groups are at higher risk of making medical decisions, such as discharging against medical advice, that will negatively affect their condition. Identifying these high-risk groups is a key first step to counteracting such behavior.

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Section: Discussionsupporting

confidence: 89%

An Analysis of Epidemiological Factors in Heart Failure Outcomes

Patel¹,

Taneja²,

Mohamed³

et al. 2022

Cureus

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“…The influence of the socioeconomic and political context on older adults with multimorbidity is an underexplored topic in the literature. 42 As for patient organizations, we strongly encourage novel collaborations and initiatives advocating for those who live with multiple chronic conditions and raising awareness of 'multimorbidity' and its impact on people and society. 38 By joining forces, the organizations can help the growing group of multimorbid patients manage their different conditions and navigate the system that will otherwise potentially drain their already limited resources.…”

Section: Discussionmentioning

confidence: 99%

Putting the pieces together: A qualitative study exploring perspectives on self-management and exercise behavior among people living with multimorbidity, healthcare professionals, relatives, and patient advocates

Jäger

Lindhardt

Pedersen

et al. 2022

Journal of Multimorbidity and Comorbidity

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Background Behavior change and exercise are considered critical for successful self-management in people with multimorbidity, however, little is known about people’s needs, experiences, and preferences. Purpose The aim of this study was to qualitatively explore the perspectives of people living with multimorbidity, healthcare professionals, relatives, and patient advocates in relation to self-management and exercise behavior. Research design Analysis was carried out by means of a hybrid inductive-deductive approach using Framework Analysis that enabled the subsequent use of the COM-B model in relation to the study of exercise behavior specifically. Study sample We conducted 17 interviews (9 focus groups; 8 key informants) with 48 informants from four groups (22 people living with multimorbidity, 17 healthcare professionals, 5 relatives, and 5 patient advocates). Data analysis Through an inductive Framework analysis, we constructed three themes: Patient education, supporting behavior change, and lack of a “burning platform.” Subsequent deductive application of the COM-B profile (applied solely to data related to exercise behavior) unveiled a variety of barriers to exercise and self-management support (pain, fatigue, breathlessness, lack of motivation, financial issues, accessibility, decreased social support). Results Overall, the four groups shared common understandings while also expressing unique challenges. Conclusions Future interventions and/or policies targeting exercise behavior in people living with multimorbidity should address some of the barriers identified in this study.

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“…When evaluating the quality of life, health is generally considered as the most relevant factor; however, there are other aspects that should be considered and that are equally important to ensure wellbeing [ 46 ].…”

Section: Ageing and The Elderlymentioning

confidence: 99%

Pharmacist Intervention in Portuguese Older Adult Care

et al. 2022

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Healthy ageing has become one of the most significant challenges in a society with an increasing life expectancy. Older adults have a greater prevalence of chronic disease, with the need for multiple medications to appropriately control these issues. In addition to their health concerns, ageing individuals are prone to loneliness, dependence, and economic issues, which may affect their quality of life. Governments and health professionals worldwide have developed various strategies to promote active and healthy ageing to improve the quality of life of older adults. Pharmacists are highly qualified health professionals, easily accessible to the population, thus playing a pivotal role in medication management. Their proximity to the patient puts them in a unique position to provide education and training to improve therapeutic adherence and identify medication-related problems. This paper aims to address the importance of Portuguese community pharmacists in the medication management of older adults, emphasising their intervention in health promotion, patient education, medication-related problems, deprescription, dose administration aids, and medication review and reconciliation. We also discuss home delivery services and medication management in long-term care facilities.

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Multi-Morbidity in the Older Person: An Examination of Polypharmacy and Socioeconomic Status

Cited by 12 publications

References 43 publications

An Analysis of Epidemiological Factors in Heart Failure Outcomes

An Analysis of Epidemiological Factors in Heart Failure Outcomes

Putting the pieces together: A qualitative study exploring perspectives on self-management and exercise behavior among people living with multimorbidity, healthcare professionals, relatives, and patient advocates

Pharmacist Intervention in Portuguese Older Adult Care

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