Evidence map›Paper›PMID 39699748›Full record

ArticleEuropean geriatric medicine2025

Frailty, comorbidity, and multimorbidity and their relation with medications adherence in primary care older adults.

Francesco Lapi, Ettore Marconi, Pierangelo Lora Aprile, Alberto Magni, Davide Liborio Vetrano, Alessandro Rossi, Alberto Pilotto, Claudio Cricelli

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Article in European geriatric medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Trial
  2. Multimorbidity and cardiovascular prevention in primary care: a cohort study in New Zealand.The British journal of general practice : the journal of the Royal College of General Practitioners · 2026
    Article
  3. Review
  4. Article
  5. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Francesco LapiHealth Search, Italian College of General Practitioners and Primary Care, Via del Sansovino 179, 50142, Florence, Italy. lapi.francesco@simg.it.ORCID http://orcid.org/0000-0002-4342-9128
Ettore MarconiHealth Search, Italian College of General Practitioners and Primary Care, Via del Sansovino 179, 50142, Florence, Italy.
Pierangelo Lora AprileItalian College of General Practitioners and Primary Care, Florence, Italy.
Alberto MagniItalian College of General Practitioners and Primary Care, Florence, Italy.
Davide Liborio VetranoAging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
Alessandro RossiItalian College of General Practitioners and Primary Care, Florence, Italy.
Alberto PilottoDepartment of Interdisciplinary Medicine, "Aldo Moro" University of Bari, Bari, Italy.
Claudio CricelliItalian College of General Practitioners and Primary Care, Florence, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTo assess and compare, through a retrospective cohort study, the relationships between frailty, comorbidity, multimorbidity, and levels of adherence to lipid-lowering drugs (LLDs), antihypertensives and antidepressants.

methodsIn a primary care database, we selected a cohort of patients aged 60 or older on December 31, 2022. The date of the first prescription of the aforementioned medications was the study index date. Patients with Variable Medication Possession Ratio (VMPR) > = 80% were classified as properly adherent. Frailty (i.e. Primary Care-Frailty Index), comorbidity (i.e. Charlson Index) and multimorbidity (i.e. disease counts) alternatively entered multivariate logistic regressions along with age and sex. Models' performances in prediction of medications adherence were compared in terms of information (AIC; BIC) and discrimination values (AUC).

resultsIncident users of LLDs, antihypertensives or antidepressants were 4310 (mean age: 67.9 (SD: 6.9); 56.0% females), 5969 (mean age: 69.1 (SD: 7.6); 58.0% females), and 3834 (mean age: 68.7 (SD: 6.9); 66.5% females), respectively. Among users of LLDs (46% adherent) and antidepressants (22% adherent), those who were moderately or severely frail showed a significant 30-32% decrease in adherence. In contrast, users of antihypertensives (46% adherent) showed a 41% increase in adherence when multimorbid. As a whole, the three multivariate models were equally effective in informing on medication adherence, as per AIC and BIC. They also displayed similar discriminatory ability, with AUC scores ranging from 53 to 58%. Regarding the workload of GPs, the number of elderly patients classified as moderately/high frail was less than those with co-morbidities or multimorbidities. For instance, there were approximately 35 users of antihypertensive medications per GP for the moderately frail group, compared to 46 and 66 for the co-morbid and multi-morbid groups, respectively.

conclusionsThese findings showed similar capacity for frailty, comorbidity, and multimorbidity in capturing medications adherence. Given the existence of a validated tool in primary care that aligns well with GPs' workload, frailty seems the most suitable measure for assessing the complexity of older adults in relation to their adherence to long-term medications.

Indexed as

Frail ElderlyFrailtyMedication AdherenceMultimorbidityPrimary Health CareAgedAged, 80 and overAntidepressive AgentsAntihypertensive AgentsComorbidityFemaleHumansHypolipidemic AgentsMaleMiddle AgedRetrospective StudiesAntidepressive AgentsAntihypertensive AgentsHypolipidemic AgentsComorbidityFrailtyMedications adherenceMultimorbidity

Identifiers

PMID39699748

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.