Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort

Núria Molist-Brunet, Daniel Sevilla-Sánchez, Emma Puigoriol-Juvanteny, Mariona Espaulella-Ferrer, Jordi Amblàs-Novellas and Joan Espaulella-Panicot
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Núria Molist-Brunet: Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain
Daniel Sevilla-Sánchez: Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Universitat de Vic. University of Vic-Central University of Catalonia (UVIC-UCC), 08500 Vic, Spain
Emma Puigoriol-Juvanteny: Epidemiology department. Hospital Universitari de Vic, 08500 Vic, Spain
Mariona Espaulella-Ferrer: Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain
Jordi Amblàs-Novellas: Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain
Joan Espaulella-Panicot: Hospital Universitari de la Santa Creu de Vic, 08500 Vic, Spain

IJERPH, 2021, vol. 18, issue 21, 1-17

Abstract: (1) Background: Ageing is associated with complex and dynamic changes leading to multimorbidity and, therefore, polypharmacy. The main objectives were to study an older community-dwelling cohort, to detect inappropriate prescriptions (IP) applying the Patient-Centred Prescription model, and to evaluate the most associated factors. (2) Methods: This was a prospective, descriptive, and observational study conducted from June 2019 to October 2020 on patients ? 65 years with multimorbidity who lived in the community. Demographic, clinical and pharmacological data were assessed. Variables assessed were: degree of frailty, using the Frail-VIG index; therapeutical complexity and anticholinergic and sedative burden; and the number of chronic drugs to determine polypharmacy or excessive polypharmacy. Finally, a medication review was carried out through the application of the Patient-Centred Prescription model. We used univariate and multivariate regression to identify the factors associated with IP. (3) Results: We recruited 428 patients (66.6% women; mean age 85.5, SD 7.67). A total of 50.9% of them lived in a nursing home; the mean Barthel Index was 49.93 (SD 32.14), and 73.8% of patients suffered some degree of cognitive impairment. The prevalence of frailty was 92.5%. Up to 90% of patients had at least one IP. An increase in IP prevalence was detected when the Frail-VIG index increased ( p < 0.05). With the multivariate model, the relationship of polypharmacy with IP detection stands out above all. (4) Conclusions: 90% of patients presented one IP or more, and this situation can be detected through the PCP model. Factors with higher association with IP were frailty and polypharmacy.

Keywords: frailty; polypharmacy; inappropriate prescription; multimorbidity; medication review; goal-oriented care (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
References: View complete reference list from CitEc
Citations: View citations in EconPapers (2)

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