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doi:10.22028/D291-38483
Titel: | 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 |
VerfasserIn: | 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 |
Sprache: | Englisch |
Titel: | European Heart Journal : Cardiovascular Pharmacotherapy |
Bandnummer: | 8 |
Heft: | 4 |
Seiten: | 406–419 |
Verlag/Plattform: | Oxford University Press |
Erscheinungsjahr: | 2022 |
Freie Schlagwörter: | Older people Pharmacokinetic and pharmacodynamic changes Polypharmacy Inappropriate prescribing Adverse drug reactions Drug–drug and drug–disease interactions |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
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 der Erstveröffentlichung: | 10.1093/ehjcvp/pvac005 |
URL der Erstveröffentlichung: | http://dx.doi.org/10.1093/ehjcvp/pvac005 |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-384835 hdl:20.500.11880/34707 http://dx.doi.org/10.22028/D291-38483 |
ISSN: | 2055-6845 2055-6837 |
Datum des Eintrags: | 9-Dez-2022 |
Bezeichnung des in Beziehung stehenden Objekts: | Supplementary material |
In Beziehung stehendes Objekt: | https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/ehjcvp/8/4/10.1093_ehjcvp_pvac005/1/pvac005_supplemental_file.doc?Expires=1673598530&Signature=hWsCPcInMOwIksd1MgaOQ5kM1q1wjI4VSrXwHFzpUfShDZu0cdmut00l4aSWzWuDzwjpNRNa4pDm1IVouzZBRx5rd5IVIWl3LwTkoaECOE1gxy4i09jBCq5Y~2MDg7f-9VrO7pkyQ5A5jHK~9e5Tlh2R~k0WbVqGfkPEB2EV7uOnJj3kqAXPMVfCjS6~55nTsmpaou8ecuV31c~IpidE0jGmOSEEw3cyAnzjvQKYUXSfJ2dw5RjMDv8HT2PDL14zI1pYun~goMlMzoy0GdFXBNRcoG3sl86DmXHiUmMhhD-5YxTT~wUnC-qHAUS5lTM8OTQTdzS6Gm3LSaur0lpkKA__&Key-Pair-Id=APKAIE5G5CRDK6RD3PGA |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Innere Medizin |
Professur: | M - Keiner Professur zugeordnet |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
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