Sex Differences in Multimorbidity, Inappropriate Medication and Adverse Outcomes of Inpatient Care: MoPIM Cohort...

Area of Science:

• Gerontology and Geriatric Medicine
• Clinical Pharmacy and Pharmacology
• Public Health and Epidemiology

Background:

• Limited research exists on sex-based differences in multimorbidity, prescribing, and adverse outcomes in older hospitalized patients.
• Understanding these disparities is crucial for personalized geriatric care during chronic disease exacerbations.

Purpose of the Study:

• To investigate sex-specific differences in multimorbidity, potentially inappropriate prescribing (PIP), and adverse outcomes among older patients hospitalized for chronic disease exacerbation.
• To identify associations between chronic conditions (CCs), geriatric syndromes (GSs), and sociodemographic factors stratified by sex.

Main Methods:

• A multicenter, prospective cohort study included 740 hospitalized patients aged 65 years and older.
• Data collected included sociodemographics, frailty, Barthel index, CCs, GSs, polypharmacy, PIP (STOPP/START criteria), and adverse drug reactions (ADRs).
• Statistical analyses included bivariate comparisons between sexes and network graph creation for CC and GS associations.

Main Results:

• Women (53.2%) showed higher prevalence of frailty, lived more in nursing homes or alone, and had higher rates of PIP, particularly with anxiolytics and pain management drugs.
• Significant associations were observed between CCs (e.g., asthma, thyroid diseases, osteoarticular diseases) and GSs (e.g., chronic pain, anxiety/depression) in women.
• No significant differences in immediate adverse outcomes, such as length of stay, discharge destination, or in-hospital mortality, were found between men and women during the exacerbation episode.

Conclusions:

• While older women exhibit distinct patterns of frailty and potentially inappropriate prescribing, immediate adverse care outcomes during acute exacerbations appear similar between sexes.
• These findings highlight the need for sex-tailored approaches in managing geriatric patients, focusing on frailty and medication review, even when immediate outcomes are comparable.