OBJECTIVE: To estimate the association between guideline recommended drugs and @entity204 in older adults with multiple chronic conditions. DESIGN: Population based cohort study. SETTING: Medicare Current Beneficiary Survey cohort, a nationally representative sample of Americans aged 65 years or more. @entity1 : 8578 older adults with two or more study chronic conditions ( @entity955 , @entity453 , @entity308 , @entity6 , @entity712 , @entity407 , @entity101 , and @entity1031 ), followed through 2011. EXPOSURES: Drugs included b blockers, @entity460 channel blockers, @entity1397 , @entity2449 , renin-angiotensin system (RAS) blockers; selective @entity750 reuptake inhibitors (SSRIs) and serotonin @entity1063 reuptake inhibitors (SNRIs); statins; @entity7206 ; and @entity1229 . MAIN OUTCOME MEASURE: Adjusted hazard ratios for @entity204 among @entity1 with a condition and taking a guideline recommended drug relative to @entity1 with the condition not taking the drug and among @entity1 with the most common combinations of four conditions. RESULTS: Over 50% of @entity1 with each condition received the recommended drugs regardless of coexisting conditions; 1287/8578 (15%) @entity1 died during the three years of follow-up. Among cardiovascular drugs, b blockers, @entity460 channel blockers, RAS blockers, and @entity6817 were associated with reduced mortality for indicated conditions. For example, the adjusted hazard ratio for b blockers was 0.59 (95% confidence interval 0.48 to 0.72) for @entity1 with @entity955 and 0.68 (0.57 to 0.81) for those with @entity712 . The adjusted hazard ratios for cardiovascular drugs were similar to those with common combinations of four coexisting conditions, with trends toward variable effects for b blockers. None of @entity1397 , @entity2449 , or SSRIs/SNRIs was associated with reduced mortality. @entity1229 was associated with a reduced risk of @entity204 among those with @entity955 (adjusted hazard ratio 0.69, 95% confidence interval 0.56 to 0.85) and @entity1031 (0.44, 0.30 to 0.62). Attenuation in the association with reduced risk of @entity204 was found with @entity1229 in @entity1 with some combinations of coexisting conditions. CONCLUSIONS: Average effects on survival, particularly for cardiovascular study drugs, were comparable to those reported in randomized controlled trials but varied for some drugs according to coexisting conditions. Determining treatment effects in combinations of conditions may guide prescribing in @entity1 with multiple chronic conditions.

Association between guideline recommended drugs and XXXX in older adults with multiple chronic conditions: population based cohort study.

@entity1 :: ('9606', 'Species') :: ['PARTICIPANTS', 'participants', 'people'] @entity407 :: ('MESH:D006949', 'Disease') :: ['hyperlipidemia'] @entity308 :: ('MESH:D003866', 'Disease') :: ['depression'] @entity712 :: ('MESH:D006333', 'Disease') :: ['heart failure'] @entity101 :: ('MESH:D006973', 'Disease') :: ['hypertension'] @entity6 :: ('MESH:D003920', 'Disease') :: ['diabetes'] @entity1063 :: ('MESH:D009638', 'Chemical') :: ['norepinephrine'] @entity1397 :: ('MESH:C055162', 'Chemical') :: ['clopidogrel'] @entity1031 :: ('MESH:D013923', 'Disease') :: ['thromboembolic disease'] @entity7206 :: ('MESH:D049971', 'Chemical') :: ['thiazides'] @entity955 :: ('MESH:D001281', 'Disease') :: ['atrial fibrillation'] @entity460 :: ('MESH:D002118', 'Chemical') :: ['calcium'] @entity750 :: ('MESH:D012701', 'Chemical') :: ['serotonin'] @entity453 :: ('MESH:D003324', 'Disease') :: ['coronary artery disease, chronic kidney disease'] @entity204 :: ('MESH:D003643', 'Disease') :: ['death'] @entity6817 :: ('D019821', 'Chemical') :: ['statins'] @entity1229 :: ('MESH:D014859', 'Chemical') :: ['warfarin', 'Warfarin'] @entity2449 :: ('MESH:D008687', 'Chemical') :: ['metformin']
@entity204 :: (MESH:D003643,Disease) :: ['death']
