Multimorbidity and polypharmacy in the elderly: lessons from REPOSI

Area of Science:

• Geriatrics
• Internal Medicine
• Clinical Pharmacy

Background:

• Demographic shifts in the 21st century present challenges for generalist physicians, particularly internists.
• Managing elderly patients with multiple chronic diseases and polypharmacy requires approaches beyond traditional clinical trials.
• Real-world data is crucial for understanding drug effectiveness in diverse patient populations.

Purpose of the Study:

• To collect data on elderly patients admitted to Italian hospitals via the REPOSI registry.
• To assess drug prescription appropriateness in the elderly.
• To analyze the impact of multimorbidity and polypharmacy on mortality and re-hospitalization, and identify common disease clusters.

Main Methods:

• Established the REPOSI registry in 2008 to gather data on acutely admitted elderly patients.
• Conducted 3-yearly data collection runs (2008, 2010, 2012).
• Focused on drug appropriateness, multimorbidity, polypharmacy, mortality, re-hospitalization, and disease clustering.

Main Results:

• Findings indicate key tasks for internists: managing multiple medications and utilizing geriatric assessment tools.
• Emphasizes the importance of a multidisciplinary team approach, involving patients and caregivers.
• Identified a need for research specifically addressing the complexities of multimorbid elderly patients.

Conclusions:

• Internists must adapt their practice to effectively manage elderly patients with complex health needs.
• Integration of geriatric principles and multidisciplinary care is essential for optimizing outcomes.
• Further research tailored to the unique characteristics of the multimorbid elderly population is warranted.