Multimorbidity and polypharmacy in the elderly: Lessons from REPOSI

Pier Mannuccio Mannucci, Alessandro Nobili, Pier Mannuccio Mannucci, Alessandro Nobili, Mauro Tettamanti, Luca Pasina, Carlotta Franchi, Eleonora Sparacio, Stefania Alborghetti, Rosa Di Costanzo, Tarek Kamal Eldin, Mauro Tettamanti, Codjo Djignefa Djade, Francesco Salerno, Salvatore Corrao, Alessandra Marengoni, Maura Marcucci, Domenico Prisco, Elena Silvestri, Caterina CenciTommaso Barnini, Giuseppe Delitala, Stefano Carta, Sebastiana Atzori, Gianfranco Guarnieri, Michela Zanetti, Annalisa Spalluti, Maria Grazia Serra, Maria Antonietta Bleve, Massimo Vanoli, Giulia Grignani, Gianluca Casella, Laura Gasbarrone, Giorgio Maniscalco, Massimo Gunelli, Daniela Tirotta, Antonio Brucato, Silvia Ghidoni, Paola Di Corato, Mauro Bernardi, Silvia Li Bassi, Luca Santi, Giancarlo Agnelli, Alfonso Iorio, Maura Marcucci, Emanuela Marchesini, Elmo Mannarino, Graziana Lupattelli, Pamela Rondelli, Francesco Paciullo, Fabrizio Fabris, Michela Carlon, Francesca Turatto, Maria Cristina Baroni, Marianna Zardo, Roberto Manfredini, Christian Molino, Marco Pala, Fabio Fabbian, Ranuccio Nuti, Roberto Valenti, Martina Ruvio, Silvia Cappelli, Giuseppe Paolisso, Maria Rosaria Rizzo, Maria Teresa Laieta, Teresa Salvatore, Ferdinando Carlo Sasso, Riccardo Utili, Emanuele Durante Mangoni, Daniela Pinto, Oliviero Olivieri, Anna Maria Stanzial, Renato Fellin, Stefano Volpato, Sioulis Fotini, Mario Barbagallo, Ligia Dominguez, Lidia Plances, Daniela D’Angelo, Giovanbattista Rini, Pasquale Mansueto, Ilenia Pepe, Giuseppe Licata, Luigi Calvo, Maria Valenti, Claudio Borghi, Enrico Strocchi, Elisa Rebecca Rinaldi, Marco Zoli, Elisa Fabbri, Donatella Magalotti, Alberto Auteri, Anna Laura Pasqui, Luca Puccetti, Franco Laghi Pasini, Pier Leopoldo Capecchi, Maurizio Bicchi, Carlo Sabbà, Francesco Saverio Vella, Alessandro Marseglia, Chiara Valentina Luglio, Giuseppe Palasciano, Maria Ester Modeo, Annamaria Aquilino, Pallante Raffaele, Stefania Pugliese, Caterina Capobianco, Alfredo Postiglione, Maria Rosaria Barbella, Francesco De Stefano, Luigi Fenoglio, Chiara Brignone, Christian Bracco, Alessia Giraudo, Giuseppe Musca, Olga Cuccurullo, Luigi Cricco, Alessandra Fiorentini, Maria Domenica Cappellini, Giovanna Fabio, Sonia Seghezzi, Margherita Migone De Amicis, Silvia Fargion, Paola Bonara, Mara Bulgheroni, Rosa Lombardi, Fabio Magrini, Ferdinando Massari, Tatiana Tonella, Flora Peyvandi, Alberto Tedeschi, Raffaella Rossio, Guido Moreo, Barbara Ferrari, Luisa Roncari, Valter Monzani, Valeria Savojardo, Christian Folli, Maria Magnini, Daniela Mari, Paolo Dionigi Rossi, Sarah Damanti, Silvia Prolo, Maria Sole Lilleri, Luigi Cricco, Alessandra Fiorentini, Giuliana Micale, Mauro Podda, Carlo Selmi, Francesca Meda, Francesco Salerno, Silvia Accordino, Alessio Conca, Valentina Monti, Gino Roberto Corazza, Emanuela Miceli, Marco Vincenzo Lenti, Donatella Padula, Carlo L. Balduini, Giampiera Bertolino, Stella Provini, Federica Quaglia, Giovanni Murialdo, Marta Bovio, Franco Dallegri, Luciano Ottonello, Alessandra Quercioli, Alessandra Barreca, Maria Beatrice Secchi, Davide Ghelfi, Wu Sheng Chin, Laura Carassale, Silvia Caporotundo, Luigi Anastasio, Lucia Sofia, Maria Carbone, Giancarlo Traisci, Lucrezia De Feudis, Silvia Di Carlo, Giovanni Davì, Maria Teresa Guagnano, Simona Sestili, Elisabetta Bergami, Emanuela Rizzioli, Carlo Cagnoni, Luca Bertone, Antonio Manucra, Alberto Buratti, Tiziana Tognin, Nicola Lucio Liberato, Giordano Bernasconi, Barbara Nardo, Giovanni Battista Bianchi, Sabrina Giaquinto Ospedale, Giampiero Benetti, Michela Quagliolo, Giuseppe Riccardo Centenaro, Francesco Purrello, Antonino Di Pino, Salvatore Piro, Gerardo Mancuso, Daniela Calipari, Mosè Bartone, Francesco Gullo, Michele Cortellaro, Marina Magenta, Francesca Perego;, Maria Rachele Meroni, Marco Cicardi, Antonio Gidaro, Marina Magenta, Andrea Sacco, Antonio Bonelli, Gaetano Dentamaro, Renzo Rozzini, Lina Falanga, Alessandro Giordano, Paolo Cavallo Perin, Bartolomeo Lorenzati, Gabriella Gruden, Graziella Bruno, Giuseppe Montrucchio, Elisabetta Greco, Pietro Tizzani, Giacomo Fera, Maria Loreta Di Luca, Donatella Renna, Antonio Perciccante, Alessia Coralli, Rodolfo Tassara, Deborah Melis, Lara Rebella, Giorgio Menardo, Stefania Bottone, Elsa Sferrazzo, Claudio Ferri, Rinaldo Striuli, Rosa Scipioni, Raffaella Salmi, Piergiorgio Gaudenzi, Susanna Gamberini, Franco Ricci, Cosimo Morabito, Roberto Fava, Andrea Semplicini, Lucia Gottardo, Giuseppe Delitala, Stefano Carta, Sebastiana Atzori, Gianluigi Vendemiale, Gaetano Serviddio, Roberta Forlano, Luigi Bolondi, Leonardo Rasciti, Ilaria Serio, Cesare Masala, Antonio Mammarella, Valeria Raparelli, Filippo Rossi Fanelli, Massimo Delfino, Antonio Amoroso, Francesco Violi, Stefania Basili, Ludovica Perri, Pietro Serra, Vincenzo Fontana, Marco Falcone, Raffaele Landolfi, Antonio Grieco, Antonella Gallo, Giuseppe Zuccalà, Francesco Franceschi, Guido De Marco, Cordischi Chiara, Sabbatini Marta, Martino Bellusci, Donatella Setti, Filippo Pedrazzoli, Giuseppe Romanelli, Caterina Pirali, Claudia Amolini, Enrico Agabiti Rosei, Damiano Rizzoni, Luana Castoldi, Antonio Picardi, Umberto Vespasiani Gentilucci, Chiara Mazzarelli, Paolo Gallo, Luigina Guasti, Luana Castiglioni, Andrea Maresca, Alessandro Squizzato, Sara Contini, Marta Molaro, Giorgio Annoni, Maurizio Corsi, Sara Zazzetta, Marco Bertolotti, Chiara Mussi, Roberto Scotto, Maria Alice Ferri, Francesca Veltri, Franco Arturi, Elena Succurro, Giorgio Sesti, Umberto Gualtieri, Francesco Perticone, Angela Sciacqua, Michele Quero, Chiara Bagnato, Paola Loria, Maria Angela Becchi, Gianfranco Martucci, Alessandra Fantuzzi, Mauro Maurantonio, Roberto Corinaldesi, Roberto De Giorgio, Mauro Serra, Valentina Grasso, Eugenio Ruggeri, Lorenzo Mauro Carozza, Fabio Pignatti

Research output: Contribution to journalArticle

Abstract

The dramatic demographic changes that are occurring in the third millennium are modifying the mission of generalist professionals such as primary care physicians and internists. Multiple chronic diseases and the related prescription of multiple medications are becoming typical problems and present many challenges. Unfortunately, the available evidence regarding the efficacy of medications has been generated by clinical trials involving patients completely different from those currently admitted to internal medicine: much younger, affected by a single disease and managed in a highly controlled research environment. Because only registries can provide information on drug effectiveness in real-life conditions, REPOSI started in 2008 with the goal of acquiring data on elderly people acutely admitted to medical or geriatric hospital wards in Italy. The main goals of the registry were to evaluate drug prescription appropriateness, the relationship between multimorbidity/polypharmacy and such cogent outcomes as hospital mortality and re-hospitalization, and the identification of disease clusters that most often concomitantly occur in the elderly. The findings of 3-yearly REPOSI runs (2008, 2010, 2012) suggest the following pertinent tasks for the internist in order to optimally handle their elderly patients: the management of multiple medications, the need to become acquainted with geriatric multidimensional tools, the promotion and implementation of a multidisciplinary team approach to patient health and care and the corresponding involvement of patients and their relatives and caregivers. There is also a need for more research, tailored to the peculiar features of the multimorbid elderly patient.

Original languageEnglish
Pages (from-to)723-734
Number of pages12
JournalInternal and Emergency Medicine
Volume9
Issue number7
DOIs
Publication statusPublished - Oct 2 2014

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Keywords

  • Adverse drug effects
  • Aging
  • Drug prescription
  • Multidimensional evaluation
  • Multimorbidity
  • Polypharmacy

ASJC Scopus subject areas

  • Emergency Medicine
  • Internal Medicine

Cite this

Mannucci, P. M., Nobili, A., Mannucci, P. M., Nobili, A., Tettamanti, M., Pasina, L., Franchi, C., Sparacio, E., Alborghetti, S., Di Costanzo, R., Eldin, T. K., Tettamanti, M., Djade, C. D., Salerno, F., Corrao, S., Marengoni, A., Marcucci, M., Prisco, D., Silvestri, E., ... Pignatti, F. (2014). Multimorbidity and polypharmacy in the elderly: Lessons from REPOSI. Internal and Emergency Medicine, 9(7), 723-734. https://doi.org/10.1007/s11739-014-1124-1