Polypharmacy and specific comorbidities in university primary care settings.

Détails

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Etat: Public
Version: Author's accepted manuscript
ID Serval
serval:BIB_78A3158328CC
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Polypharmacy and specific comorbidities in university primary care settings.
Périodique
European journal of internal medicine
Auteur(s)
Aubert C.E., Streit S., Da Costa B.R., Collet T.H., Cornuz J., Gaspoz J.M., Bauer D., Aujesky D., Rodondi N.
ISSN
1879-0828 (Electronic)
ISSN-L
0953-6205
Statut éditorial
Publié
Date de publication
11/2016
Peer-reviewed
Oui
Volume
35
Pages
35-42
Langue
anglais
Notes
Publication types: Journal Article
Publication Status: ppublish
Résumé
Polypharmacy is associated with adverse events and multimorbidity, but data are limited on its association with specific comorbidities in primary care settings. We measured the prevalence of polypharmacy and inappropriate prescribing, and assessed the association of polypharmacy with specific comorbidities.
We did a cross-sectional analysis of 1002 patients aged 50-80years followed in Swiss university primary care settings. We defined polypharmacy as ≥5 long-term prescribed drugs and multimorbidity as ≥2 comorbidities. We used logistic mixed-effects regression to assess the association of polypharmacy with the number of comorbidities, multimorbidity, specific sets of comorbidities, potentially inappropriate prescribing (PIP) and potential prescribing omission (PPO). We used multilevel mixed-effects Poisson regression to assess the association of the number of drugs with the same parameters.
Patients (mean age 63.5years, 67.5% ≥2 comorbidities, 37.0% ≥5 drugs) had a mean of 3.9 (range 0-17) drugs. Age, BMI, multimorbidity, hypertension, diabetes mellitus, chronic kidney disease, and cardiovascular diseases were independently associated with polypharmacy. The association was particularly strong for hypertension (OR 8.49, 95%CI 5.25-13.73), multimorbidity (OR 6.14, 95%CI 4.16-9.08), and oldest age (75-80years: OR 4.73, 95%CI 2.46-9.10 vs.50-54years). The prevalence of PPO was 32.2% and PIP was more frequent among participants with polypharmacy (9.3% vs. 3.2%, p<0.006).
Polypharmacy is common in university primary care settings, is strongly associated with hypertension, diabetes mellitus, chronic kidney disease and cardiovascular diseases, and increases potentially inappropriate prescribing. Multimorbid patients should be included in further trials for developing adapted guidelines and avoiding inappropriate prescribing.

Mots-clé
Aged, Aged, 80 and over, Cardiovascular Diseases/drug therapy, Comorbidity, Cross-Sectional Studies, Databases, Factual, Diabetes Mellitus/drug therapy, Female, Hospitals, University, Humans, Hypertension/drug therapy, Inappropriate Prescribing/statistics & numerical data, Logistic Models, Male, Middle Aged, Multivariate Analysis, Polypharmacy, Primary Health Care, Renal Insufficiency, Chronic/drug therapy, Switzerland, Comorbidities, Inappropriate prescribing, Multimorbidity, Pharmacoepidemiology
Pubmed
Web of science
Création de la notice
18/06/2016 16:47
Dernière modification de la notice
20/08/2019 14:35
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