This review will provide an exhaustive view of medication management models that could be effective for polymedicated , home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs .
BACKGROUND Older adults with multiple chronic diseases commonly require complex medication regimes .
When combined with frailty , cognitive impairment , and changing pharmacological prescriptions , older adults ' polymedication regimes increase the risk of medication-related problems ( MRPs ) and hospitalization .
Effective , well-organized medication management could avoid MRPs and their clinical outcomes .
OBJECTIVE Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated , home-dwelling older adults .
Polypharmacy Patterns: Unravelling Systematic Associations between Prescribed Medications
Objectives The aim of this study was to demonstrate the existence of systematic associations in drug prescription that lead to the establishment of patterns of polypharmacy , and the clinical interpretation of the associations found in each pattern . Methods A cross-sectional study was conducted based on information obtained from electronic medical records and the primary care pharmacy data base in 2008 . An exploratory factor analysis of drug dispensing information regarding 79,089 adult patients was performed to identify the patterns of polypharmacy . The analysis was stratified by age and sex . Results Seven patterns of polypharmacy were identified , which may be classified depending on the type of disease they are intended to treat : cardiovascular , depression-anxiety , acute respiratory infection ( ARI ) , chronic obstructive pulmonary disease ( COPD ) , rhinitis-asthma , pain , and menopause . Some of these patterns revealed a clear clinical consistency and included drugs that are prescribed together for the same clinical indication ( i.e. , ARI and COPD patterns ) . Other patterns were more complex but also clinical ly consistent : in the cardiovascular pattern , drugs for the treatment of known risk factors — such as hypertension or dyslipidemia — were combined with other medications for the treatment of diabetes or established cardiovascular pathology ( e.g. , antiplatelet agents ) . Almost all of the patterns included drugs for preventing or treating potential side effects of other drugs in the same pattern . Conclusions The present study demonstrated the existence of non-r and om associations in drug prescription , result ing in patterns of polypharmacy that are sound from the pharmacological and clinical viewpoints and that exist in a significant proportion of the population . This finding necessitates future longitudinal studies to confirm some of the proposed causal associations . The information discovered would further the development and /or adaptation of clinical patient guidelines to patients with multimorbidity who are taking multiple drugs
This review will provide an exhaustive view of medication management models that could be effective for polymedicated , home-dwelling older adults and will allow us to analyze their impact on managing and preventing MRPs .
BACKGROUND Older adults with multiple chronic diseases commonly require complex medication regimes .
When combined with frailty , cognitive impairment , and changing pharmacological prescriptions , older adults ' polymedication regimes increase the risk of medication-related problems ( MRPs ) and hospitalization .
Effective , well-organized medication management could avoid MRPs and their clinical outcomes .
OBJECTIVE Identify medication management models and analyze their impact on managing and preventing MRPs for polymedicated , home-dwelling older adults .