000078174 001__ 78174
000078174 005__ 20200716101441.0
000078174 0247_ $$2doi$$a10.1371/journal.pone.0210701
000078174 0248_ $$2sideral$$a110921
000078174 037__ $$aART-2019-110921
000078174 041__ $$aeng
000078174 100__ $$aMenditto, E.
000078174 245__ $$aPatterns of multimorbidity and polypharmacy in young and adult population: Systematic associations among chronic diseases and drugs using factor analysis
000078174 260__ $$c2019
000078174 5060_ $$aAccess copy available to the general public$$fUnrestricted
000078174 5203_ $$aObjectives: The objective was to identify the systematic associations among chronic diseases and drugs in the form of patterns and to describe and clinically interpret the constituted patterns with a focus on exploring the existence of potential drug-drug and drug-disease interactions and prescribing cascades.
Methods: This observational, cross-sectional study used the demographic and clinical information from electronic medical databases and the pharmacy billing records of all users of the public health system of the Spanish region of Aragon in 2015. An exploratory factor analysis was conducted based on the tetra-choric correlations among the diagnoses of chronic diseases and the dispensed drugs in 887, 572 patients aged 65 years. The analysis was stratified by age and sex. To name the constituted patterns, assess their clinical nature, and identify potential interactions among diseases and drugs, the associations found in each pattern were independently reviewed by two pharmacists and two doctors and tested against the literature and the information reported in the technical medicinal forms.
Results: Six multimorbidity-polypharmacy patterns were found in this large-scale population study, named as respiratory, mental health, cardiometabolic, endocrinological, osteometabolic, and mechanical-pain. The nature of the patterns in terms of diseases and drugs differed by sex and age and became more complex as age advanced.
Conclusions: The six clinically sound multimorbidity-polypharmacy patterns described in this non-elderly population confirmed the existence of systematic associations among chronic diseases and medications, and revealed some unexpected associations suggesting the prescribing cascade phenomenon as a potential underlying factor. These findings may help to broaden the focus and orient the early identification of potential interactions when caring for multimorbid patients at high risk of adverse health outcomes due to polypharmacy.
000078174 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttp://creativecommons.org/licenses/by/3.0/es/
000078174 590__ $$a2.74$$b2019
000078174 592__ $$a1.023$$b2019
000078174 591__ $$aMULTIDISCIPLINARY SCIENCES$$b27 / 71 = 0.38$$c2019$$dQ2$$eT2
000078174 593__ $$aMultidisciplinary$$c2019$$dQ1
000078174 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000078174 700__ $$0(orcid)0000-0002-5440-1710$$aGimeno Miguel, A.
000078174 700__ $$aMoreno Juste, A.
000078174 700__ $$aPoblador Plou, B.
000078174 700__ $$aAza Pascual-Salcedo, M.
000078174 700__ $$aOrlando, V.
000078174 700__ $$aGonzález Rubio, F.
000078174 700__ $$0(orcid)0000-0002-5704-6056$$aPrados Torres, A.
000078174 773__ $$g14, 2 (2019), e0210701[18 pp]$$pPLoS One$$tPLoS ONE$$x1932-6203
000078174 8564_ $$s475333$$uhttps://zaguan.unizar.es/record/78174/files/texto_completo.pdf$$yVersión publicada
000078174 8564_ $$s94269$$uhttps://zaguan.unizar.es/record/78174/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000078174 909CO $$ooai:zaguan.unizar.es:78174$$particulos$$pdriver
000078174 951__ $$a2020-07-16-08:58:54
000078174 980__ $$aARTICLE