title: Polypathology, polypharmacy, medication regimen complexity and drug therapy appropriateness.
abstract: Polypathological patients are usually elderly and take numerous drugs. Polypharmacy affects 85% of these individuals and is not associated with greater survival. On the contrary, polypharmacy exposes these individuals to more adverse effects, such as weight loss, falls, functional and cognitive impairment and hospitalisations. The complexity of a drug regimen covers more aspects than the simple number of drugs consumed. The galenic form, the dosage and the method for preparing the drug can impede the understanding of and compliance with prescriptions. Both polypharmacy and therapeutic complexity are associated with poorer adherence by patients. To prevent polypharmacy, reduce complexity and improve adherence, the appropriate use of drugs is needed. Proper prescribing consists of selecting drugs that have clear evidence for their use in the indication, which are appropriate for the patient's circumstances, are well tolerated and cost-effective and whose benefits outweigh the risks. To improve the drug prescription, periodic reviews of the drugs need to be conducted, especially when the patient changes doctor and during healthcare transitions. The Beers and STOPP/START (Screening Tool of Older Person's potentially inappropriate Prescriptions/Screening Tool to Alert doctors to the Right Treatment) criteria are effective tools for this improvement. Deprescription for polymedicated polypathological patients that considers their clinical circumstances, prognosis and preferences can contribute to a more appropriate use of drugs.
authors.affiliation: Servicio de Medicina Interna, Hospital Ernest Lluch, Calatayud, España; Grupo de Investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España.
authors.forename: N
authors.initials: N
authors.lastname: Gómez Aguirre
authors.affiliation: Servicio de Medicina Interna, Hospital Ernest Lluch, Calatayud, España; Grupo de Investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España.
authors.forename: A
authors.initials: A
authors.lastname: Caudevilla Martínez
authors.affiliation: Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España.
authors.forename: L
authors.initials: L
authors.lastname: Bellostas Muñoz
authors.affiliation: Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: M
authors.initials: M
authors.lastname: Crespo Avellana
authors.affiliation: Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España; Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España.
authors.forename: J
authors.initials: J
authors.lastname: Velilla Marco
authors.affiliation: Grupo de Investigación en Comorbilidad y Pluripatología de Aragón, Instituto Aragonés de Ciencias de la Salud, Zaragoza, España; Departamento de Medicina, Dermatología y Psiquiatría, Universidad de Zaragoza, Zaragoza, España; Servicio de Medicina Interna, Hospital Universitario Miguel Servet, Zaragoza, España. Electronic address: jdiez@aragon.es.
authors.forename: J
authors.initials: J
authors.lastname: Díez-Manglano
keywords: Complejidad terapéutica; Drug prescription; Pluripatología; Polifarmacia; Polypathology; Polypharmacy; Prescripción de medicamentos; Therapeutic complexity