GGP - Fachzeitschrift für Geriatrische und Gerontologische Pflege 2018; 02(06): 274-278
DOI: 10.1055/a-0733-0117
CNE Schwerpunkt
Polypharmazie im Alter
© Georg Thieme Verlag KG Stuttgart · New York

Multimorbidität und Polypharmakotherapie in der Geriatrie

Walter-Uwe Weitbrecht
Further Information

Publication History

Publication Date:
11 December 2018 (online)

Zusammenfassung

Komplexe Probleme Im Laufe des Alterns eines Menschen nehmen in aller Regel die Anzahl seiner (chronischen) Erkrankungen und die Pflegebedürftigkeit zu. Hieraus ergibt sich sehr oft die Verschreibung zahlreicher Medikamente. Nicht immer sind die verordneten Medikamente untereinander kompatibel. Auch hängt die Wirksamkeit der verschriebenen Medikamente vom Verständnis und von der Mitarbeit des Patienten ab. Diese Probleme werden im folgenden Artikel erörtert.

 
  • Literatur

  • 1 Statistisches Bundesamt. Ältere Menschen in Deutschland und der EU. Broschüre; 2016
  • 2 Roberts KC. et al. Prevalenz and patterns of chronic disease multimorbidity and associated determinants in Canada. In: Health Promotion and Chronic Disease Prevention in Canada 2015; 35: 85-94
  • 3 Buttery AK. et al. Changes in physical functioning among men and women aged 50–79 years in Germany: an analysis of National Health Interview and Examination Surveys, 1997–1999 and 2008–2011. In: BMC Geriatrics 2016; 16: 205-215
  • 4 Koné Pefoyo AJ. et al. The increasing burden and complexity of multimorbidity. In: BMC Public Health 2015; 15: 415-425
  • 5 Bähler C. et al. Multimorbidity, health care utilization and costs in an elderly community-dwelling population: a claims data based observational study. In: BMC Health Services Research 2015; 15: 23-34
  • 6 Barnett K. et al. Epidemiology of multimorbidity for health care, research, and medical education: a cross-sectional study. In: Lancet 2012; 380: 37-43
  • 7 van den Bussche H. et al. Which chronic deseases and disease combinations are specific to multimorbidity in the elderly? Result of a claims data based cross-sectional study in Germany. In: BMC Public Health 2011; 11: 101-109
  • 8 Doos L. et al. Multi-drug therapy in chronic condition multimorbidity: a systematic review. In: Family Practice 2014; 31: 654-663
  • 9 Moriarty F. et al. Trends and interaction of polypharmacy and potentially inappropriate prescribing in primary care over 15 years in Ireland: a repeated cross-sectional study. In: BMJ Open 2015; 5: 1-7
  • 10 Payne RA. The epidemiology of polypharmacy. In: Clinical Medicine 2016; 16: 465-469
  • 11 Charlesworth CJ. et al. Polypharmacy among adults aged 65 years and older in the United States: 1988–2010. In: J Gerontolog A Biol Sci Med Sci 2015; 70: 989-995
  • 12 Onder G. et al. Polypharmacy in nursing home in Europe: results from the SHELTER study. In: J Gerontol A Biol Sci Med Sci 2012; 67A: 698-704
  • 13 Junius-Walker U, Theile G, Hummers-Pradier E. Prevalence and predictors of polypharmacy among older primary care patients in Germany. In: Family Practice 2007; 24: 14-19
  • 14 Basak R. et al. Adherence to multiple medications prescribed for a chronic disease: a methodological investigation. In: J Manag Care Pharm 2014; 20: 815-823
  • 15 Riegel B. et al. Predictors of objectively measured medication nonadherence in adults with heart failure. In: Circ Heart Fail 2012; 5: 430-436
  • 16 Gelaw BK. et al. Nonadherence and contributing factors among ambulatory patients with antidiabetic medications in Adama Referral Hospital. In: J Diabetes Res 2014; 2014: 617041 doi: 10.1155/2014/617041. Epub 2014 Dec 3
  • 17 Thorell K. et al. Is use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort studyIs use of fall risk-increasing drugs in an elderly population associated with an increased risk of hip fracture, after adjustment for multimorbidity level: a cohort study. In: BMC Geratrics 2014; 14: 131-137
  • 18 Härstedt M. et al. Polypharmacy and adverse outcomes after hip fracture surgery. In: Journal of Orthopaedic Surgery and Research 2016; 11: 151-157
  • 19 Gong IH. et al. Relationship among total kidney volume, renal function and age. In: J Urol 2012; 187: 344-349
  • 20 Chao CT. et al. Cumulative cardiovascular polypharmacy is associated with the risk of acute kidney injury in elderly patients. In: Medicine 2015; 94: 1-8
  • 21 Gômez C. et al. Polypharmacy in the elderly: a marker of increased risk of mortality in a population-based prospective study (NEDICES). In: Gerontology 2015; 61: 301-309
  • 22 Wan-Hsuan L. et al. Effect of polypharmacy, potentially inappropriate medications and anticholinergic burden on clinical outcomes: a retrospective cohort study. In: CMAJ 2015; 187: 130-137
  • 23 Jyrkkä J. et al. Polypharmacy and nutritional status in elderly people. In: Current Opinion in Clinical Nutrition and Metabolic Care 2012; 15: 1-6
  • 24 Cooper JA. et al. Interventions to improve the appropriate use of polypharmacy in older people: a Cochrane systematic review. In: BMJ Open 2015; 5: 1-11
  • 25 Ludwig W-D, Schuler J. Reduzierung von Medikamenten – ein schwieriges Unterfangen. In: Deutsches Ärzteblatt 2018; 115: 396-397
  • 26 Messerli M. et al. Impact of a community pharmacist-led medication review on medicines use in patients on polypharmacy – a prospective randomised controlled trial. In: BMC Health Services Research 2016; 16: 145-159
  • 27 AGS Choosing Wisely Workgroup. American Geriatrics Society identifies five things that healthcare providers and patients should question. In: J Am Geriatr Soc 2013; 61: 622-631