Comprehensive Multimorbidity Patterns in Older Patients Are Associated with Quality Indicators of Medication—MoPIM Cohort Study

Marina Lleal, Marisa Baré (), Sara Ortonobes, Daniel Sevilla-Sánchez, Rosa Jordana, Susana Herranz, Maria Queralt Gorgas, Mariona Espaulella-Ferrer, Marta Arellano, Marta de Antonio, Gloria Julia Nazco, Rubén Hernández-Luis and on behalf of the MoPIM Study Group
Additional contact information
Marina Lleal: Institutional Committee for the Improvement of Clinical Practice Adequacy, Clinical Epidemiology and Cancer Screening Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
Marisa Baré: Institutional Committee for the Improvement of Clinical Practice Adequacy, Clinical Epidemiology and Cancer Screening Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
Sara Ortonobes: Pharmacy Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
Daniel Sevilla-Sánchez: Pharmacy Department, Parc Sanitari Pere Virgili, 08023 Barcelona, Catalonia, Spain
Rosa Jordana: Internal Medicine Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
Susana Herranz: Acute Care Geriatric Unit, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
Maria Queralt Gorgas: Pharmacy Department, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT), 08208 Sabadell, Catalonia, Spain
Mariona Espaulella-Ferrer: Geriatrics Department, Consorci Hospitalari de Vic, 08500 Vic, Catalonia, Spain
Marta Arellano: Geriatrics Department, Consorci Parc de Salut MAR, 08003 Barcelona, Catalonia, Spain
Marta de Antonio: Pharmacy Department, Consorci Parc de Salut MAR, 08003 Barcelona, Catalonia, Spain
Gloria Julia Nazco: Pharmacy Department, Hospital Universitario de Canarias, 38320 La Laguna, Canarias, Spain
Rubén Hernández-Luis: Internal Medicine Department, Hospital Universitario de Canarias, 38320 La Laguna, Canarias, Spain
on behalf of the MoPIM Study Group: Collaborators/Membership of the Group/Team Name is provided in the Acknowledgments.

IJERPH, 2022, vol. 19, issue 23, 1-16

Abstract: Multimorbidity is increasing and poses a challenge to the clinical management of patients with multiple conditions and drug prescriptions. The objectives of this work are to evaluate if multimorbidity patterns are associated with quality indicators of medication: potentially inappropriate prescribing (PIP) or adverse drug reactions (ADRs). A multicentre prospective cohort study was conducted including 740 older (≥65 years) patients hospitalised due to chronic pathology exacerbation. Sociodemographic, clinical and medication related variables (polypharmacy, PIP according to STOPP/START criteria, ADRs) were collected. Bivariate analyses were performed comparing previously identified multimorbidity clusters (osteoarticular, psychogeriatric, minor chronic disease, cardiorespiratory) to presence, number or specific types of PIP or ADRs. Significant associations were found in all clusters. The osteoarticular cluster presented the highest prevalence of PIP (94.9%) and ADRs (48.2%), mostly related to anxiolytics and antihypertensives, followed by the minor chronic disease cluster, associated with ADRs caused by antihypertensives and insulin. The psychogeriatric cluster presented PIP and ADRs of neuroleptics and the cardiorespiratory cluster indicators were better overall. In conclusion, the associations that were found reinforce the existence of multimorbidity patterns and support specific medication review actions according to each patient profile. Thus, determining the relationship between multimorbidity profiles and quality indicators of medication could help optimise healthcare processes. Trial registration number: NCT02830425.

Keywords: older patient; multimorbidity; cluster analysis; polypharmacy; potentially inappropriate medication; potential prescribing omission; adverse drug reaction; healthcare quality indicator (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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