Relation between drug therapy-based comorbidity indices, Charlson's comorbidity index, polypharmacy and mortality in three samples of older adults

Novella, Alessio; Elli, Chiara; Tettamanti, Mauro; Nobili, Alessandro; Ianes, Aladar; Mannucci, Pier Mannuccio; Pasina, Luca

doi:10.1016/j.archger.2022.104649

Cited by 8 publications

(5 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The findings support prior studies showing that a high CCI score increases the number of drugs needed. 32 We found that hypertension was the most common chronic disease in our population, consistent with national disease statistics showing that more than one-third of Indonesians are afflicted by hypertension. 33 These findings corroborate those of a previous study on elderly individuals on polypharmacy.…”

Section: Discussionsupporting

confidence: 89%

Prevalence and Predictors of Excessive Polypharmacy in Geriatric Inpatients: A Retrospective Cross-Sectional Study in Indonesia

Faisal,

Zairina,

Nathishuwan

et al. 2023

J Prim Care Community Health

View full text Add to dashboard Cite

Objectives: To investigate the prevalence and predictors of excessive polypharmacy in geriatric inpatients in Indonesia. Methods: This retrospective cross-sectional study included 1533 inpatients over the age of 60 years at Universitas Airlangga Hospital, Indonesia. Effects of a patient’s baseline characteristics on excessive polypharmacy were evaluated using logistic regression analysis. Results: Excessive polypharmacy was observed in 133 (8.67%) patients. Ulcer (OR 8.151,95% CI 2.234-29.747, P = .001), cancer (OR 5.551, 95% CI 1.602-19.237, P = .007), and renal diseases (OR 3.710, 95% CI 1.965-7.006, P < .001) were the 3 strongest predictors of excessive polypharmacy. An association between hospital stay of more than 3 days and excessive polypharmacy was identified (OR 2.382, 95% CI 1.109-5.115, P = .026). Discussion: One in 12 elderly Indonesians was found to practice excessive polypharmacy. Several chronic conditions and increased length of hospital stay were the factors associated with excessive polypharmacy.

show abstract

Section: Discussionsupporting

confidence: 89%

Prevalence and Predictors of Excessive Polypharmacy in Geriatric Inpatients: A Retrospective Cross-Sectional Study in Indonesia

Faisal,

Zairina,

Nathishuwan

et al. 2023

J Prim Care Community Health

View full text Add to dashboard Cite

show abstract

“…36–43 Other approaches include risk scores to identify patients at high risk of particular outcomes (eg, hospitalisations or adverse drug reactions) but these require further development. 44 45 Overall, strategies to identify potentially high-risk populations currently demonstrate variable validity in polypharmacy and are seldom comprehensive or holistic, as they are specific to the needs of particular groups. 2 36 46…”

Section: Resultsmentioning

confidence: 99%

Defining, identifying and addressing problematic polypharmacy within multimorbidity in primary care: a scoping review

Tsang,

Sperrin,

Blakeman

et al. 2024

BMJ Open

View full text Add to dashboard Cite

IntroductionPolypharmacy and multimorbidity pose escalating challenges. Despite numerous attempts, interventions have yet to show consistent improvements in health outcomes. A key factor may be varied approaches to targeting patients for intervention.ObjectivesTo explore how patients are targeted for intervention by examining the literature with respect to: understanding how polypharmacy is defined; identifying problematic polypharmacy in practice; and addressing problematic polypharmacy through interventions.DesignWe performed a scoping review as defined by the Joanna Briggs Institute.SettingThe focus was on primary care settings.Data sourcesMedline, Embase, Cumulative Index to Nursing and Allied Health Literature and Cochrane along with ClinicalTrials.gov, Science.gov and WorldCat.org were searched from January 2004 to February 2024.Eligibility criteriaWe included all articles that had a focus on problematic polypharmacy in multimorbidity and primary care, incorporating multiple types of evidence, such as reviews, quantitative trials, qualitative studies and policy documents. Articles focussing on a single index disease or not written in English were excluded.Extraction and analysisWe performed a narrative synthesis, comparing themes and findings across the collective evidence to draw contextualised insights and conclusions.ResultsIn total, 157 articles were included. Case-finding methods often rely on basic medication counts (often five or more) without considering medical history or whether individual medications are clinically appropriate. Other approaches highlight specific drug indicators and interactions as potentially inappropriate prescribing, failing to capture a proportion of patients not fitting criteria. Different potentially inappropriate prescribing criteria also show significant inconsistencies in determining the appropriateness of medications, often neglecting to consider multimorbidity and underprescribing. This may hinder the identification of the precise population requiring intervention.ConclusionsImproved strategies are needed to target patients with polypharmacy, which should consider patient perspectives, individual factors and clinical appropriateness. The development of a cross-cutting measure of problematic polypharmacy that consistently incorporates adjustment for multimorbidity may be a valuable next step to address frequent confounding.

show abstract

“…El tratamiento inicial se definió como cualquier medicamento prescrito antes de que el paciente fuera diagnosticado con una infección por SARS-CoV-2 y no tuviera fecha final. Se definió "polimedicado" como el uso de cinco o más medicamentos basales por persona 13 . Los datos identificativos de las personas que viven en una residencia de ancianos se obtuvieron del Departamento Vasco de Salud.…”

Section: Métodounclassified

Nonadverse COVID-19 evolution predictors: the CoNAE scale

Pulido-Herrero,

Larrea,

García-Gutiérrez

et al. 2024

Emergencias

View full text Add to dashboard Cite

Objetivos. Faltan herramientas para identificar a los pacientes con COVID-19 moderado o leve. El objetivo de este estudio fue identificar variables asociadas a la evolución no adversa y diseñar un modelo predictivo de evolución favorable en pacientes atendidos en servicios de urgencias hospitalarios (SUH) por infección por SARS-CoV-2. Métodos. Estudio de cohorte retrospectivo de pacientes con infección por SARS-CoV-2 que acudieron a alguno de los SUH de hospitales públicos de una área por una infección por COVID-19 entre el 1 de julio de 2020 y el 31 de julio de 2021. Los datos recogidos para este estudio incluyeron información sociodemográfica, comorbilidades basales y tratamientos, otros datos de antecedentes y registro de los signos vitales a la llegada (triaje) al SUH. Se utilizaron modelos de regresión logística multivariable multinivel para desarrollar los modelos predictivos. Resultados. Las personas que tuvieron resultados no adversos eran más jóvenes, mujeres, habían recibido dos dosis de la vacuna COVID-19 en el momento del estudio, tenían signos vitales (frecuencia cardiaca-presión diastólica/sistólica, temperatura y saturación de oxígeno) dentro de un rango normal al llegar al triaje del SUH, y no tenían ninguna de las siguientes comorbilidades: insuficiencia cardiaca, enfermedad coronaria, hipertensión arterial, diabetes, enfermedad hepática, demencia, antecedentes de tumores malignos o prescripción de corticosteroides orales sistémicos o inmunosupresores como medicación basal. El modelo tenía un área bajo la curva (ABC) de 0,8404 (IC 95%: 0,8342-0,8466). Conclusiones. Se ha desarrollado una escala de predicción de resultados no adversos que pueden ser útil como herramienta de triaje, así como para determinar el alta segura y para adaptar el nivel de atención que el paciente requiere, no sólo en el SUH, sino también a nivel de atención de emergencia primaria o extrahospitalaria.

show abstract

Relation between drug therapy-based comorbidity indices, Charlson's comorbidity index, polypharmacy and mortality in three samples of older adults

Cited by 8 publications

References 25 publications

Prevalence and Predictors of Excessive Polypharmacy in Geriatric Inpatients: A Retrospective Cross-Sectional Study in Indonesia

Prevalence and Predictors of Excessive Polypharmacy in Geriatric Inpatients: A Retrospective Cross-Sectional Study in Indonesia

Defining, identifying and addressing problematic polypharmacy within multimorbidity in primary care: a scoping review

Nonadverse COVID-19 evolution predictors: the CoNAE scale

Contact Info

Product

Resources

About