Multimorbidity and Polypharmacy
As individuals age, the likelihood of developing more than one chronic condition increases. The presence of more than one disease, or multimorbidity, often leads to treatment with multiple medications (polypharmacy). Unfortunately, polypharmacy may predis
- PDF / 171,754 Bytes
- 13 Pages / 439.37 x 666.142 pts Page_size
- 86 Downloads / 193 Views
Abstract As individuals age, the likelihood of developing more than one chronic condition increases. The presence of more than one disease, or multimorbidity, often leads to treatment with multiple medications (polypharmacy). Unfortunately, polypharmacy may predispose older adults to a number of adverse consequences, including adverse drug reactions, potentially inappropriate prescribing/medications, nonadherence, functional status decline, geriatric syndromes, and mortality. This chapter will focus on the prevalence of multimorbidity among older adults, the epidemiology of polypharmacy in this population, and the negative clinical outcomes associated with the use of multiple medications. Keywords Older adult priate prescribing
Polypharmacy Multimorbidity Potentially inappro-
Introduction As individuals age, the likelihood of developing more than one chronic condition increases. The presence of more than one disease, or multimorbidity, often leads to treatment with multiple medications (polypharmacy). Unfortunately, polypharmacy may predispose older adults to a number of adverse consequences. This chapter will focus on the prevalence of multimorbidity among older adults, the epidemiology of polypharmacy in this population, and the negative clinical outcomes associated with the use of multiple medications.
J.G. Naples Division of Geriatrics, School of Medicine, University of Pittsburgh, 3471 Fifth Avenue, Suite 500, Kaufmann Medical Building, Pittsburgh 15213, PA, USA E.R. Hajjar (&) Jefferson College of Pharmacy, Thomas Jefferson University, 901 Walnut Street, Suite 943, Philadelphia, PA 19107, USA e-mail: [email protected] © American Association of Pharmaceutical Scientists 2016 S. Stegemann (ed.), Developing Drug Products in an Aging Society, AAPS Advances in the Pharmaceutical Sciences Series 24, DOI 10.1007/978-3-319-43099-7_25
549
550
J.G. Naples and E.R. Hajjar
Multimorbidity Among Older Adults Advances in clinical practice and new medications to treat chronic illness have increased life expectancy for the overall population. Prolonged longevity, however, often results in the development of multiple diseases associated with aging (i.e., multimorbidity) [1]. Multimorbidity is formally defined as the “multiplicity of independent chronic diseases” or the “co-occurrence of two or more chronic conditions” and is quite common among older adults [2, 3]. For example, in the United States (US), 68 % of adults using fee-for-service Medicare have at least two chronic conditions. Of these Medicare beneficiaries, 23 % have 4–5 chronic medical conditions and 14 % have 6 or more [4]. Similar patterns are seen in the United Kingdom, with 6.75 million adults having at least two chronic conditions [5–7]. Unfortunately, clinical practice guidelines often fail to consider multimorbidity and thus recommend treatment for each disease state in isolation without considering the potential to precipitate polypharmacy.
Epidemiology of Polypharmacy Definitions of Polypharmacy Polypharmacy may be defined in two ways.
Data Loading...
