Polypharmacy in the elderly : data, models, and strategies
Abstract
The demographic shift toward an aging population is increasing the burden of public health. On average, a person of 70 years can combine the intake of up to seven medications. The administration of multiple drugs at the same time is known as polypharmacy. The often unnecessary use of more drugs that would be strictly necessary is the cause of many problems for the patient such as drug interactions, serious side effects, and lack of adherence to treatment. The increasing use of polypharmacy leads to an increase in morbidity and mortality. The national health agencies are clearly interested in the reduction of polypharmacy, given the enormous cost of associated side effects and consequent hospitalizations. To try to deepen some of the most important aspects associated with the practice of polypharmacy, this thesis focused on three main lines of research: on the one hand, the identification, extraction and storage of relevant data in polypharmacy, which led to to the construction of two databases, Drug Metabolites database (DMdb) and Drug-Drug Interactions database (DDIdb); on the other hand, the exploitation of the collected data for the development of models that allow to anticipate possible secondary effects; and finally, the analysis and review of the different polypharmacy approach strategies in various countries as an approach to a coordinated strategy proposal in the face of this increasingly important challenge for the health management of aging populations.
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