An Analysis of the Interactions Between Individual Comorbidities and Their Treatments-Implications for Guidelines and Polypharmacy

被引：90
作者：
Fitzgerald, Stephen P. [1 ]
Bean, Nigel G. [2 ]
机构：
[1] Royal Adelaide Hosp, Adelaide, SA 5000, Australia
[2] Univ Adelaide, Adelaide, SA 5005, Australia
来源：
JOURNAL OF THE AMERICAN MEDICAL DIRECTORS ASSOCIATION | 2010年 / 11卷 / 07期
关键词：
PATIENT PREFERENCES; COST-EFFECTIVENESS; MAJOR HEMORRHAGE; OF-CARE; HYPERTENSION; PREVENTION; MANAGEMENT; THERAPY; RISK;
D O I：
10.1016/j.jamda.2010.05.008
中图分类号：
R592 [老年病学]; C [社会科学总论];
学科分类号：
03 ; 0303 ; 100203 ;
摘要：
Background: With aging there is an increase in frailty and chronic disease leading to a potential increase in medication use. Most clinical trials have excluded old, frail individuals and have failed to take into account the effects of outcome interaction. Methods and Results: In this article we provide a mathematical model demonstrating that comorbidities, including old age, interact with therapies, reducing their effectiveness. Conclusion: These findings question the validity of single disease guidelines in old persons or in persons with multiple chronic diseases. (J Am Med Dir Assoc 2010; 11: 475-484)
引用
收藏
页码：475 / 484
页数：10
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