Polypharmacy Patterns in Multimorbid Older People with Cardiovascular Disease: Longitudinal Study.

Area of Science:

• Gerontology
• Cardiology
• Clinical Pharmacy

Background:

• Cardiovascular disease (CVD) significantly increases mortality in older adults.
• The interplay between multimorbidity and polypharmacy in CVD patients is complex and requires characterization.
• Older populations often present with multiple chronic conditions and concurrent medication use.

Purpose of the Study:

• To characterize the evolution of combined multimorbidity and polypharmacy patterns in older adults with cardiovascular disease.
• To identify distinct patient profiles based on disease and medication combinations.
• To analyze the stability and transitions between these patterns over time.

Main Methods:

• Longitudinal study using data from the Information System for Research in Primary Care.
• Analysis of 114,516 individuals aged 65-99 years with cardiovascular multimorbidity.
• Application of fuzzy c-means clustering and hidden Markov models to identify combined patterns.

Main Results:

• Eight distinct multimorbidity and polypharmacy patterns were identified, including 'Diabetes and ischemic cardiopathy' and 'Cardiac'.
• Prevalence of overrepresented health problems and drugs remained stable, but survivors showed increased polypharmacy and multimorbidity.
• Most individuals maintained their pattern, with key transitions observed between 'Non-specific' and other complex patterns.

Conclusions:

• Eight combined multimorbidity and polypharmacy patterns, differentiated by sex, were found to be stable over follow-up in older adults with CVD.
• Understanding disease and drug behavior within these patterns is crucial for developing individualized interventions.
• These findings support tailored management strategies for complex patient cohorts.