Details

Autor(en) / Beteiligte

• Gomis‐Pastor, Mar
• Roig Mingell, Eulalia
• Mirabet Perez, Sonia
• Brossa Loidi, Vicente
• Lopez Lopez, Laura
• Diaz Bassons, Alba
• Aretio Pousa, Ana
• Feliu Ribera, Anna
• Ferrero‐Gregori, Andreu
• Guirado Perich, Lluís
• Mangues Bafalluy, Mª Antonia

Titel

Multimorbidity and medication complexity: New challenges in heart transplantation

Ist Teil von

• Clinical transplantation, 2019-10, Vol.33 (10), p.e13682-n/a

Ort / Verlag

Denmark

Erscheinungsjahr

2019

Quelle

Wiley Online Library

Beschreibungen/Notizen

• Introduction Multimorbidity and therapeutic complexity are a recognized problem in the heart transplant (HTx) population. However, little is known about how best to quantify this complexity or the strategies that could reduce its burden. Methods This single‐center, observational study included adult heart transplant recipients (HTxR) >1.5 years from transplant. We assessed multimorbidity (>2 comorbidities) and the patient‐level Medication Regimen Complexity Index Spanish version (pMRCI‐S) score. We also analyzed the independent predictors of pMRCI‐S and the impact of the index score on specific clinical variables. Results We included 135 chronic‐stage HTxR. Comorbidities significantly increased after HTx (6 ± 3 vs 2 ± 2, P‐value < .001). Patients took 12 ± 3 chronic drugs/d, 58% of them to treat comorbidities. The mean total pMRCI‐S score was 42 ± 11, higher than in several other chronic diseases. The medication category drugs to treat comorbidities predicted a higher total pMRCI‐S score (OR = 3.12, 95% CI 2.8‐3.43, P‐value < .001). Therapeutic complexity after HTx had an impact on solid malignancies (OR = 1.1, 95% CI 1.02‐1.18, P‐value = .02) and renal function (OR=−0.81, 95% CI −1.21‐(−0.42), P‐value < .001). Conclusions The multimorbidity and pMRCI‐S scores obtained in HTx population were worrisomely high. The pMRCI score is a sensitive method that allows identification of the factors determining therapeutic complexity after HTx and selection of strategies to reduce pMRCI‐S values.