Expert consensus on risk prevention and control of polypharmacy for cardiovascular disease combined with neuropsychiatric disease in the elderly

Title: Expert consensus on risk prevention and control of polypharmacy for cardiovascular disease combined with neuropsychiatric disease in the elderly
Edition: Original
Classification: Experts consensus
Field: Comprehensive guideline
Countries and regions: China
Guidelines users: Doctors, Pharmacists, Patients
Evidence classification method: Oxford University Centre for Evidence-Based Medicine Evidence Grading and Recommendations
Development unit: 中华医学会临床药学分会;上海交通大学医学院附属新华医院
Registration time: 2022-06-28
Registration number: IPGRP-2022CN367
Purpose of the guideline: China is the country with the largest aging population in the world, and it is expected to continue to grow rapidly in the next two decades. In 2026, the population of the elderly over the age of 60 will reach 304 million, and in 2039, it will reach 400 million. Aging has become a major social problem. Elderly people often suffer from multiple chronic diseases at the same time. In China, 42% of the elderly suffer from two or more diseases at the same time, of which the combination of cardiovascular system diseases and neuropsychiatric diseases is one of the most common multi-disease comorbidities. Studies have shown that the proportion of patients with cardiovascular disease associated with depression and anxiety is relatively high, 22.8% and 70.9%, respectively. Elderly people with multiple diseases are more prone to adverse drug reactions due to their own pathophysiological change. Meanwhile, multiple medication is very common in these patients, which also increases the incidence of adverse drug reactions and adverse drug interactions, some of which may lead to serious consequences. Using scientific standards to evaluate potential inappropriate drug use in elderly patients can detect potential inappropriate drug use early, prevent the occurrence of adverse events, and guide clinical use of drugs more rationally. At present, many countries and regions have formulated corresponding standards or guidelines for the assessment of potentially inappropriate drug use in the elderly, but each standard has its own emphasis, its geographical limitations, standard differences, differences in coverage and lack of evidence-based evidence are very obvious (Beers standard), and none of them involve potentially inappropriate drug use in the context of multiple comorbidities in the elderly. This expert consensus will mainly focus on the potential inappropriate medication of the elderly in the state of cardiovascular disease combined with neuropsychiatric disease. On the basis of drawing on foreign assessment tools, use evidence-based methods as much as possible to improve the elderly with cardiovascular disease combined with neuropsychiatric disease in China. In order to reduce the adverse clinical outcomes of the elderly in my country, the evaluation criteria for potentially inappropriate drug use should be actively promoted in clinical practice.