Optimising treatment in older people with multiple conditions

Multimorbidity is common among older adults. Now that people are living longer, many are also living with multiple conditions. The conditions may require a range of services and treatments and, often, the patient will require a case manager to discuss their needs following an assessment, with the wider multidisciplinary team.

On assessment, a commonly found contributing factor to the patient's deteriorating level of function may be inappropriately prescribed medication or mismanagement of medications. Polypharmacy can also sometimes pose an issue. This article touches on some recent research examining the effect of the impact that a multidisciplinary team could have on drug-related hospital admissions by optimising drug treatment. The research looks specifically at older adults with multiple conditions and polypharmacy who have been admitted to hospital (Blum et al, 2021).

In a cluster randomised controlled trial, Blum et al (2021) looked at 110 clusters of inpatient wards within university-based hospitals across four European countries (Switzerland, Netherlands, Belgium and Republic of Ireland), with the attending hospital doctor defining the problem and providing the details for the study, with consent. In total, 2008 older adults (≥70 years) with multimorbidity (≥three chronic conditions) and polypharmacy (≥five drugs used long term) were analysed.