Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy.

Tamargo, J; Kjeldsen, K P; Delpón, E; Semb, A G; Cerbai, E; Dobrev, D; Savarese, G; Sulzgruber, P; Rosano, G; Borghi, C; Wassman, S; Torp-Pedersen, C T; Agewall, S; Drexel, H; Baumgartner, I; Lewis, B S; Ceconi, C; Kaski, J C; Niessner, A (2022). Facing the challenge of polypharmacy when prescribing for older people with cardiovascular disease. A review by the European Society of Cardiology Working Group on Cardiovascular Pharmacotherapy. European heart journal. Cardiovascular pharmacotherapy, 8(4), pp. 406-419. Oxford University Press 10.1093/ehjcvp/pvac005

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Population ageing has resulted in an increasing number of older people living with chronic diseases (multimorbidity) requiring five or more medications daily (polypharmacy). Ageing produces important changes in the cardiovascular system and represents the most potent single cardiovascular risk factor. Cardiovascular diseases (CVD) constitute the greatest burden for older people, their caregivers, and healthcare systems. Cardiovascular pharmacotherapy in older people is complex because age-related changes in body composition, organ function, homeostatic mechanisms and comorbidities modify the pharmacokinetic and pharmacodynamic properties of many commonly used cardiovascular and non-cardiovascular drugs. Additionally, polypharmacy increases the risk of adverse drug reactions and drug-interactions, which in turn can lead to increased morbi-mortality and healthcare costs. Unfortunately, evidence of drug efficacy and safety in older people with multimorbidity and polypharmacy is limited because these individuals are frequently under-represented/excluded from clinical trials. Moreover, clinical guidelines are largely written with a single-disease focus and only occasionally address the issue of coordination of care, when and how to discontinue treatments, if required, or how to prioritize recommendations for patients with multimorbidity and polypharmacy. This review analyses the main challenges confronting healthcare professionals when prescribing in older people with CVD, multimorbidity and polypharmacy. Our goal is to provide information that can contribute to improve drug prescribing, efficacy, and safety, as well as drug adherence and clinical outcomes.

Item Type:

Journal Article (Review Article)

Division/Institute:

04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Angiology

UniBE Contributor:

Baumgartner, Iris

Subjects:

600 Technology > 610 Medicine & health

ISSN:

2055-6845

Publisher:

Oxford University Press

Language:

English

Submitter:

Claudine Andres

Date Deposited:

17 Mar 2022 08:29

Last Modified:

10 Jun 2022 00:13

Publisher DOI:

10.1093/ehjcvp/pvac005

PubMed ID:

35092425

Uncontrolled Keywords:

adverse drug reactions drug-drug and drug-disease interactions inappropriate prescribing older people pharmacokinetic and pharmacodynamic changes polypharmacy

BORIS DOI:

10.48350/167418

URI:

https://boris.unibe.ch/id/eprint/167418

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