Getting to grips with multimorbidity and polypharmacy for older people

Dr Kevin Mc Namara is a Senior Research Fellow at Deakin University’s School of Medicine and Centre for Population Health Research. He has a particularly interest in the implementation of models for chronic disease prevention and management, including the management of multimorbidity. His paper, Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia, has been published in Age and Ageing journal.

Researchers from Australia offer some valuable insights about effective multidisciplinary care for older people who often have multiple health conditions (multimorbidity) and take multiple medications (polypharmacy). In ageing populations across the developed world, multimorbidity and polypharmacy pose unique and growing challenges for health professionals and systems. Treatments and goals for different health conditions are often not compatible, guideline recommendations may not be feasible, the evidence often lacking for older adults, and health systems are not designed to coordinate the activities of multiple health professionals often involved with care.

Through 26 interviews with a diverse range of health professionals, this research explored the challenges of caring for elderly patients with multimorbidity and polypharmacy. Results suggest that strategies to optimise care for these individuals may not be regularly implemented in practice by most health professionals. Pressure of workload, clinical specialisation and lack of familiarity with appropriate strategies for managing multimorbidity appeared to promote a focus by individual professionals on acute presentations over complex issues relating to multimorbidity.

At a health system level the absence of adequate resources and incentives, accountability for care coordination, or systems to ensure timely and accurate communication of information between health professionals seem to exacerbate the challenges of managing these patients. Researchers highlight the need for better evidence about models of care for multimorbidity, and the need for system-level reforms to incentivise effective management and care coordination.

Read the full Age & Ageing article ‘Health professional perspectives on the management of multimorbidity and polypharmacy for older patients in Australia‘