Geriatrician-led multidisciplinary team management improving polypharmacy among older inpatients in China

Frontiers in Pharmacology

Pharmacology

Ying Liu¹  Lihua Chen¹  Lisha Hou¹  Li Mo¹  Li Cao¹  Xin Xia¹  Jinhui Wu¹  Yi Song² 

[1] The Center of Gerontology and Geriatrics, National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China;The Center of Gerontology and Geriatrics, National Clinical Research Center of Geriatrics, West China Hospital, Sichuan University, Chengdu, Sichuan, China;West China School of Nursing, Sichuan University, Chengdu, Sichuan, China;

关键词: polypharmacy;    medication therapy management;    multidisciplinary communication;    aged;    inpatients;   

DOI  :  10.3389/fphar.2023.1167306

 received in 2023-02-16, accepted in 2023-04-19,  发布年份 2023

来源: Frontiers

【 摘 要 】

Background/Aim: Polypharmacy is prevalent among older inpatients and associated with adverse outcomes. To determine whether a geriatrician-led multidisciplinary team (MDT) management mode could reduce medications use among older inpatients.Methods: A retrospective cohort study was conducted in a geriatric department of a tertiary hospital in China with 369 older inpatients, including 190 patients received MDT management (MDT cohort), and 179 patients received usual treatment (non-MDT cohort). The primary outcome was to compare the changes of the amount of medications before and after hospitalization in two cohorts.Results: We reported that MDT management significantly reduced the number of medications used in older inpatients at discharge (at home: n = 7 [IQR: 4, 11] vs at discharge: n = 6 [IQR: 4, 8], p < 0.05). Hospitalization with the MDT management had a significant effect on the change in the amount of medications (F = 7.813, partial-η2 = 0.011, p = 0.005). The discontinuance of medications was associated with polypharmacy at home (OR: 96.52 [95% CI: 12.53-743.48], p < 0.001), and the addition of medications was associated with a diagnosis of chronic obstructive pulmonary disease (COPD) (OR: 2.36 [95% CI: 1.02-5.49], p = 0.046).Conclusion: The results indicated that the geriatrician-led MDT mode during hospitalization could reduce the number of medications used by older patients. The patients with polypharmacy were more likely to “deprescription” after MDT management, while the patients with COPD were more likely to be under-prescription at home, polypharmacy which could be made up for after MDT management.

【 授权许可】

Unknown   
Copyright © 2023 Song, Chen, Liu, Xia, Hou, Wu, Cao and Mo.