ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2012
Multimorbidity, polypharmacy, referrals, and adverse drug events: are we doing things well?
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 125 papers, 10 of them syntheses that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
125 citing papers in PubMed, 10 syntheses or guidelines pooled it.
- The Relationship of Continuity of Care, Polypharmacy and Medication Appropriateness: A Systematic Review of Observational Studies.Drugs & aging · 2023Pooled it
- Total uncertainty: a systematic review and thematic synthesis of experiences of uncertainty in older people with advanced multimorbidity, their informal carers and health professionals.Age and ageing · 2022Pooled it
- Pooled it
- Prevalence of adverse drug reactions in the primary care setting: A systematic review and meta-analysis.PloS one · 2021Pooled it
- Pooled it
- Polypharmacy and health outcomes in atrial fibrillation: a systematic review and meta-analysis.Open heart · 2020Pooled it
- Multimorbidity and Patient Safety Incidents in Primary Care: A Systematic Review and Meta-Analysis.PloS one · 2015Pooled it
- Health outcomes associated with polypharmacy in community-dwelling older adults: a systematic review.Journal of the American Geriatrics Society · 2014Pooled it
- Multi-drug therapy in chronic condition multimorbidity: a systematic review.Family practice · 2014Pooled it
- The prevalence of disease clusters in older adults with multiple chronic diseases--a systematic literature review.PloS one · 2013Pooled it
- Factors associated with anticholinergic burden among older patients in long-term care hospitals in Korea.The Korean journal of internal medicine · 2022Trial
- Implementation of a complex intervention to improve hospital discharge: process evaluation of a cluster randomised controlled trial.BMJ open · 2021Trial
- Prevalence and factors associated with multimorbidity among primary care patients with decreased renal function.PloS one · 2021Trial
- Temporal Trends in Multimorbidity Patterns in Patients With Atrial Fibrillation-A Nationwide Cohort Study.European journal of clinical investigation · 2026Article
- [FASEa-C Project: Pharmacists Joining the Team in Chronic Care Monitoring].Atencion primaria · 2026Observational
- Data Resource Profile: Multimorbidity in Africa Digital Innovation, Visualisation and Application (MADIVA) research hub.International journal of epidemiology · 2026Article
- Community-based, supervised, group exercise for people living with chronic conditions and multimorbidity: a cohort study.Age and ageing · 2026Article
- The burden of multimorbidity in patients with systemic lupus erythematosus - single-centre analysis.Biomedical papers of the Medical Faculty of the University Palacky, Olomouc, Czechoslovakia · 2026Article
- Training needs and curricular priorities for managing multimorbidity in Spanish primary care: findings from a national exploratory online survey.BMC primary care · 2026Article
- The impact of an intervention by a mobile geriatrics team including a pharmacist on potentially inappropriate drug prescription: results of the PharMoG study.BMC geriatrics · 2026Article
65 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe consequences of multimorbidity include polypharmacy and repeated referrals for specialised care, which may increase the risk of adverse drug events (ADEs).
aimThe objective of this study was to analyse the influence of multimorbidity, polypharmacy, and multiple referrals on the frequency of ADEs, as an indicator of therapeutic safety, in the context of a national healthcare system. DESIGN AND
settingThis was a multicentre, retrospective, observational study of 79 089 adult patients treated during 2008 in primary care centres.
methodThe explanatory patient variables sex, age, level of multimorbidity, polypharmacy, number of primary care physician visits, and number of different specialties attended were analysed. The response variable was the occurrence of ADEs. Logistic regression models were used to identify associations among the analysed variables.
resultsThe prevalence of individuals with at least one ADE was 0.88%. Multivariate analysis identified the following variables as risk factors for the occurrence of ADE in descending order of effect size: multimorbidity level (odds ratio [OR]Veryhigh/Low = 45.26; ORHigh/Low = 17.58; ORModerate/Low = 4.25), polypharmacy (OR = 1.34), female sex (OR = 1.31), number of different specialties (OR = 1.20), and number of primary care physician visits (OR = 1.01). Age, however, did not show statistical significance (OR = 1.00; 95% confidence interval = 0.996 to 1.005).
conclusionThe results of this study demonstrate that multimorbidity is strongly related to the occurrence of ADEs, insofar as it requires the intervention of multiple specialties and the prescription of multiple medications. Further research should shed light on the causal pathway between multimorbidity and increased risk of adverse events.
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