gms | German Medical Science

Background and status of (inter)national research: Elderly people (65 years and above) are more likely to have five or more co-existing chronic health problems. The increase in chronic diseases almost inevitably leads to polypharmacy. With each further medication, the risk of drug interactions and adverse drug reactions increases. Many of the adverse effects are then in turn interpreted as new diseases and again treated. To protect elderly patients, certain drugs have been classified as “potentially inappropriate medication in old age” (PIM) and compiled in the EU(7) PIM list (currently 282 substances).

A possible COVID-19 infection might bring new drugs/PIMs. The analysis of medication in elderly people is part of the project “Bavarian outpatient COVID-19 Monitor”, funded by the Bavarian State Ministry of Health and Care.

Research question and objective: The medication plans of the participants are to be compared with the EU(7) PIM list: How many drugs/PIMs do the patients receive? Which substance classes are prescribed?

Method or hypothesis: The BaCoM study follows a dynamic approach and is designed as a three-year mixed-methods registry study. The study group includes care patients with a previous COVID-19 infection. Moreover, there are two control groups: a) care patients without a positive SARS-CoV-2 PCR test and b) people aged 65 years and older with a previous COVID-19 infection without care/support needs. The impact of the pandemic on the participants of the study will be measured through six-monthly follow-up surveys. At each survey date, the participants' medication plans are collected.

A descriptive/qualitative analysis of the drugs/PIMs the patients receive will be done by reviewing the medication plans. All respondents of the BaCoM study who are 65 years and older will be included in this analysis.

Results: The study will present an overview of the treatment of elderly patients. We expect that a part of the patients will receive at least one PIM. First results will be presented at the congress.

Discussion: The analysis will present the current medication care situation of elderly people. The analysis will not provide information on the correctness of the prescription as we do not collect the patient's complete medical history. As there is currently no independent post/long COVID-19 therapy, treatment is based on symptoms. It is possible that the disease only increases existing symptoms and that patients have already taken the drugs before. In this case, a change due to the COVID-19 infection would not be visible.

Practical implications: The consequences of medical overuse particularly affect elderly patients, a vulnerable group that is also particularly affected by the pandemic. GPs, as the central providers of care for this group of patients, can be a driver of overmedicalisation. The need for action and recommendations, especially for GPs providing care, should be identified as a conclusion.

Appeal for practice (science and/or care) in one sentence: Overmedicalisation is a relevant issue for the whole of society.

Funding: Einzelförderung (BMG, DRV, BMBF, DFG, etc)