AUTHOR=Guo Xueyuan , Li Mengmeng , Du Xin , Jiang Chenxi , Li Songnan , Tang Ribo , Sang Caihua , Yu Ronghui , Long Deyong , Dong Jianzeng , Ma Changsheng 

TITLE=Multimorbidity, polypharmacy and inappropriate prescribing in elderly patients with atrial fibrillation: A report from the China Atrial Fibrillation Registry Study

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 9 - 2022

YEAR=2022

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2022.988799

DOI=10.3389/fcvm.2022.988799

ISSN=2297-055X

ABSTRACT=Background: Multimorbidity, polypharmacy and inappropriate prescribing is common in elderly patients worldwide. We aimed to explore the current status of multimorbidity, polypharmacy and the appropriateness of pharmacological therapy among elderly patients with atrial fibrillation (AF) in China.
Methods: We randomly selected 500 patients aged 65 years or older from the China AF Registry study. Multimorbidity was defined as ≥ 2 comorbidities and polypharmacy was defined as ≥ 5 long-term prescribed drugs. Appropriateness of prescribing was evaluated using the STOPP/START criteria version 2. Patients’ attitudes towards polypharmacy were evaluated by the PATD questionnaire.
Results: Among the 500 patients included (mean age 75.2 ± 6.7 years, 49.0% male), 98.0% had multimorbidity and 49.4% had polypharmacy. The prevalence of potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) was 43.6% (n = 218) and 71.6% (n = 358) respectively. Traditional Chinese medicine attributed largely to PIMs. Anticoagulants were the most common PPOs. Many clinical factors increased the risk of PIMs and PPOs. However, polypharmacy increased the risk of PIMs (OR 2.70, 95%CI 1.78-4.11; p < 0.0001), but not PPOs. In addition, 73.7% patients with polypharmacy were willing to have one or more of their medications deprescribed if advised by their doctor.
Conclusions: Multimorbidity and polypharmacy were highly prevalent in elderly patients with AF in China. A high prevalence of inappropriate prescribing was also observed. Therefore, much more attention should be paid to the serious health problem in the elderly population.