JAMDA
Volume 11, Issue 7 , Pages 475-484, September 2010

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

  • Stephen P. Fitzgerald, MB, BS, FRACP

      Affiliations

    • Internal Medicine, Royal Adelaide Hospital, Australia
    • Corresponding Author InformationAddress correspondence to Stephen P. Fitzgerald, FRACP, BSc, Internal Medicine, Royal Adelaide Hospital, SA 5000, Australia.
    • ,
  • Nigel G. Bean, BSc, PhD

      Affiliations

    • Applied Mathematics, University of Adelaide, Australia

published online 09 August 2010.

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.

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 The authors have declared they have no conflicts of interest.

PII: S1525-8610(10)00184-2

doi:10.1016/j.jamda.2010.05.008

JAMDA
Volume 11, Issue 7 , Pages 475-484, September 2010

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