Please use this identifier to cite or link to this item: doi:10.22028/D291-38483
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Title: 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
Author(s): Tamargo, Juan
Kjeldsen, Keld Per
Delpón, Eva
Semb, Anne Grete
Cerbai, Elisabetta
Dobrev, Dobromir
Savarese, Gianluigi
Sulzgruber, Patrick
Rosano, Giuseppe
Borghi, Claudio
Wassman, Seven
Torp-Pedersen, Christian Tobias
Agewall, Stefan
Drexel, Heinz
Baumgartner, Iris
Lewis, Basil
Ceconi, Claudio
Kaski, Juan Carlos
Niessner, Alexander
Language: English
Title: European Heart Journal : Cardiovascular Pharmacotherapy
Volume: 8
Issue: 4
Pages: 406–419
Publisher/Platform: Oxford University Press
Year of Publication: 2022
Free key words: Older people
Pharmacokinetic and pharmacodynamic changes
Inappropriate prescribing
Adverse drug reactions
Drug–drug and drug–disease interactions
DDC notations: 610 Medicine and health
Publikation type: Journal Article
Abstract: 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 (CVDs) 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 underrepresented/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 improving drug prescribing, efficacy, and safety, as well as drug adherence and clinical outcomes.
DOI of the first publication: 10.1093/ehjcvp/pvac005
URL of the first publication:
Link to this record: urn:nbn:de:bsz:291--ds-384835
ISSN: 2055-6845
Date of registration: 9-Dec-2022
Description of the related object: Supplementary material
Related object:
Faculty: M - Medizinische Fakultät
Department: M - Innere Medizin
Professorship: M - Keiner Professur zugeordnet
Collections:SciDok - Der Wissenschaftsserver der Universität des Saarlandes

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