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

(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 evalu...

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Autores principales:	Núria Molist-Brunet, Daniel Sevilla-Sánchez, Emma Puigoriol-Juvanteny, Mariona Espaulella-Ferrer, Jordi Amblàs-Novellas, Joan Espaulella-Panicot
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	frailty polypharmacy inappropriate prescription multimorbidity medication review goal-oriented care Medicine R
Acceso en línea:	https://doaj.org/article/e0bbab58ba804f81affe65f19b853413
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spelling	oai:doaj.org-article:e0bbab58ba804f81affe65f19b8534132021-11-11T16:27:30ZFactors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort10.3390/ijerph1821113101660-46011661-7827https://doaj.org/article/e0bbab58ba804f81affe65f19b8534132021-10-01T00:00:00Zhttps://www.mdpi.com/1660-4601/18/21/11310https://doaj.org/toc/1661-7827https://doaj.org/toc/1660-4601(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 (<i>p</i> < 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.Núria Molist-BrunetDaniel Sevilla-SánchezEmma Puigoriol-JuvantenyMariona Espaulella-FerrerJordi Amblàs-NovellasJoan Espaulella-PanicotMDPI AGarticlefrailtypolypharmacyinappropriate prescriptionmultimorbiditymedication reviewgoal-oriented careMedicineRENInternational Journal of Environmental Research and Public Health, Vol 18, Iss 11310, p 11310 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	frailty polypharmacy inappropriate prescription multimorbidity medication review goal-oriented care Medicine R
spellingShingle	frailty polypharmacy inappropriate prescription multimorbidity medication review goal-oriented care Medicine R Núria Molist-Brunet Daniel Sevilla-Sánchez Emma Puigoriol-Juvanteny Mariona Espaulella-Ferrer Jordi Amblàs-Novellas Joan Espaulella-Panicot Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort
description	(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 (<i>p</i> < 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.
format	article
author	Núria Molist-Brunet Daniel Sevilla-Sánchez Emma Puigoriol-Juvanteny Mariona Espaulella-Ferrer Jordi Amblàs-Novellas Joan Espaulella-Panicot
author_facet	Núria Molist-Brunet Daniel Sevilla-Sánchez Emma Puigoriol-Juvanteny Mariona Espaulella-Ferrer Jordi Amblàs-Novellas Joan Espaulella-Panicot
author_sort	Núria Molist-Brunet
title	Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort
title_short	Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort
title_full	Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort
title_fullStr	Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort
title_full_unstemmed	Factors Associated with the Detection of Inappropriate Prescriptions in Older People: A Prospective Cohort
title_sort	factors associated with the detection of inappropriate prescriptions in older people: a prospective cohort
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/e0bbab58ba804f81affe65f19b853413
work_keys_str_mv	AT nuriamolistbrunet factorsassociatedwiththedetectionofinappropriateprescriptionsinolderpeopleaprospectivecohort AT danielsevillasanchez factorsassociatedwiththedetectionofinappropriateprescriptionsinolderpeopleaprospectivecohort AT emmapuigorioljuvanteny factorsassociatedwiththedetectionofinappropriateprescriptionsinolderpeopleaprospectivecohort AT marionaespaulellaferrer factorsassociatedwiththedetectionofinappropriateprescriptionsinolderpeopleaprospectivecohort AT jordiamblasnovellas factorsassociatedwiththedetectionofinappropriateprescriptionsinolderpeopleaprospectivecohort AT joanespaulellapanicot factorsassociatedwiththedetectionofinappropriateprescriptionsinolderpeopleaprospectivecohort
_version_	1718432328833826816

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

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