Multimorbidity / comorbidity and polypharmacy in stroke rehabilitation

Abstract

Introduction. Stroke is one the top causes of morbidity and disability in high and low-income countries. Specialized treatment and rehabilitation services contributed to a high level of functioning in stroke patients for a longer period. At the same time, advancing in age is related to a higher number of chronic conditions that have a harmful effect on patient quality of life. One of the most difficult issues for clinicians is to adjust pharmacological treatment for patient adherence for medication. Aim of the study. To analyze the incidence and characteristics of comorbidities/ multimorbidity and polypharmacy for patients enrolled in stroke rehabilitation. Materials and methods. A number of 155 medical records of patients with stroke admitted to the department of Neurological Rehabilitation of the Institute of Neurology and Neurosurgery, Diomid Gherman from Republic of Moldova were analyzed. Results. The study examined the medical records of the patient enrolled in the stroke rehabilitation program according to ICD 10 coding system. In the studied population, 75.5 % (117) of patients suffered an ischemic stroke and 24.5 % (38) a hemorrhagic stroke. The average age is 63, with the range of 34 to 83 years. The most frequent comorbid conditions of patients was hemiplegia - 87.7%(136), hypertension -85.8%(133), followed by atrial fibrillation 22.5%(35%), diabetes -17.41%(27), obesity -10.9%(17).Most of the patients have 5-6 (53.5%) additional morbidities, average number of morbidities are 5.56. Patients who use a 4 drugs represented 14.1%(22), 5 drugs -16.1%(25),6 drugs -23.2%(36),7 drugs -23.8%(37),8 drugs -10.3%(16),9 drugs -10.3%(16),10 drugs -6.4%(3) - the average number of prescribed each patients receives 6 medications. Conclusions. Multimorbidity and polypharmacy are common in stroke rehabilitation and have a negative impact on patient. Future research of comorbidity structure and combination of specific drugs would be useful for, medical stuff from stroke rehabilitation services.