Health Economics & Outcome Research: Open Access

Polypharmacy and Socioeconomic Status in the Older Population

Edward Cash^{* *}Correspondence: Edward Cash, Editorial Office, Health Economics and Outcome Research, Brussels, Belgium, Email:

Author info »

Introduction

The presence of more than two chronic illnesses in a person is referred to as multi-morbidity. It differs from co-morbidity, which is the simultaneous existence of two long-term diseases that may happen before or after the commencement of a disease of relevance, despite the fact that the terms are used inconsistently and interchangeably. People with multimorbidity typically have social, mental, and physical health conditions that require care from multiple services. They are also frequently in need of support for additional unplanned emergency care, which makes coordinating their care difficult. Multi-morbidity is a complex and socially patterned phenomenon linked to socio-economic deprivation. While some patients with complex disorders may need a customised approach, others with comparable and well-managed long-term conditions may not benefit from it. Examples include assessing medications, establishing treatment burden, and creating a personalised management plan. Healthcare interventions for those with the illness are complicated by a lack of awareness of the complexity of multi-morbidity, which are frequently impacted by societal variables that affect therapy and enhanced patient experience.

According to estimates, one in three persons worldwide suffers from numerous grave illnesses. This suggests that additional financing for social and healthcare services will be required to address demographic changes brought on by a rise in older people and socioeconomic inequality. Due to the high cost of health care and the gap in income distribution for older individuals from less affluent backgrounds in both developed and developing nations, socio-economic inequality is a problem that makes managing multi-morbidity among older people more difficult. Due to their socioeconomic status, older populations who are poor have unequal access to healthcare.

Healthcare providers spend significantly more money managing patients with multi-morbidity than those without a long-term ailment, in addition to the socioeconomic challenges experienced by less fortunate older persons with this condition. A more comprehensive strategy is required to address the complexity of multi-morbidity because the current level of spending on people with many conditions is unsustainable. The social determinants of health are a key topic for understanding the complexities of multimorbidities, in addition to the variations in health conditions between the wealthy and the less wealthy in society.

Good health is determined by socioeconomic variables throughout life. When older individuals do not receive social care that meets their requirements, they are more likely to have chronic illnesses and higher levels of disability. This is especially true if they are economically poor and socially isolated. This is particularly true because social isolation brought on by socioeconomic inequality is a possibility, and since we are social beings who live in societies, we require friends, social connections, and fulfilling employment in order to feel valued and respected. Age-related susceptibility to depression and other physical and mental health issues increases without socioeconomic protection, and the severity of these conditions is also correlated with social status.

Healthcare clinicians and policymakers frequently highlight the problems with clinical treatment paradigms, socioeconomic status, the healthcare burden brought on by multi-morbidity, and the elevated risk of Adverse Drug Reactions (ADR).

The CSDH framework demonstrates how socio-economic and political mechanisms, including those relating to income, housing, education, and employment, result in economically stratified populations, which in turn affects the status of health determinants and differences in vulnerability to morbid conditions. These elements affect how older people live their lives and have an impact on how well multi-complications morbidity's are managed. To lessen socioeconomic inequality, the study suggests enacting welfare laws or social programmes that redistribute money to citizens. The CARE approach was used to address two more potential interventions: leveraging data from electronic health records and social prescribing to prevent needless drug prescription. A crucial framework for person-centered and empathic interactions in healthcare relationships is the CARE method. It is utilised to accurately explain a patient's condition, perspective, and underlying meanings in a flexible and helpful manner. It entails actively interacting with a patient to establish a line of communication (connecting), listening to them for any associated meanings (accessing), appropriately relaying their understanding to them (responding), and jointly arranging measures with them (empowering). This method's adaptability enables different guiding concepts to be employed in various situations.

Conclusion

In order to inform strategies that give healthcare professionals the right skill-sets to understand the condition and to develop a standardised assessment and treatment tool for patients with long-term conditions, multi-morbidity in older people requires a systematic understanding of its varied complexities. In order to promote patient participation and collaboration and to provide physicians with additional information that will enable them to make well-informed medical decisions, communication from a person-centered perspective is essential.

Countries can quickly overcome obstacles to managing the complications of multi-morbidity by reducing social and health inequalities and redistributing state income through direct taxation and conditional cash transfers. Additionally, the use of electronic health records and the Electronic Frailty Index (EFI) are digital formats that could help to lessen complications brought on by delayed referrals, prolonged hospitalisation, and the provision of information on polypharmacy and other long-term conditions that are not yet fully understood. Social prescribing can be used as a person-centered alternative intervention to decrease the need for additional drug prescriptions, promote social connectedness, and lessen social exclusion among older people with multi-morbidity because polypharmacy is a risk factor for poor health outcomes and mortality.