Objective  To explore the current status, research hotspots and development trends of safe medication in the global elderly with multimorbidity, and to provide theoretical reference for research in this field.

Methods  CNKI, Yiigle and Web of Science were searched for studies on medication safety in the elderly with multimorbidity. The search time was from the establishment of the database to May 1, 2024. R language and other software were used to visually analyze the annual number of publications, institutions, and the clustering, refinement, and hotspots and trends of keywords.

Results  A total of 20 Chinese articles and 654 English articles were included. There is little global attention to this field, and cooperation between institutions needs to be further strengthened. General practice, general practitioners, Beers criteria, polypharmacy, primary care, inappropriate prescribing, medication adherence, deprescribing are the key directions of concern in this field globally. At present, most of the Chinese literature is from the perspective of clinical practice, such as medication management and intervention measures. The English literature mainly focuses on the safety of chronic disease medication, quality of life, medication adherence, and risk of chronic disease medication from the patients' perspective. With the increasing popularity of deprescribing, future research in this area of medication management will place greater emphasis on personalized and precision medicine.

Conclusions  The study of drug safety in the elderly with multimorbidity needs to establish and improve the primary care mechanism, improve the adherence of patients, and use relevant standards to effectively evaluate the safety and potential risks of polypharmacy in the elderly with multimorbidity, identify potentially inappropriate drugs and deprescribing, to reduce the risk of adverse drug reactions, and to further improve the quality of life and reduce medical costs in the elderly with multimorbidity.

1.李庆. 民政部、全国老龄办发布《2023年度国家老龄事业发展公报》[N]. 公益时报, 2024-10-15 (002). DOI: 10.28297/n.cnki.ngysp.2024.000226.

2.Salive ME. Multimorbidity in older adults[J]. Epidemiol Rev, 2013, 35: 75-83. DOI: 10.1093/epirev/mxs009.

3.Lochner KA, Cox CS. Prevalence of multiple chronic conditions among medicare beneficiaries, United States, 2010[J]. Prev Chronic Dis, 2013, 10: E61. DOI: 10.5888/pcd10.120137.

4.McPhail SM. Multimorbidity in chronic disease: impact on health care resources and costs[J]. Risk Manag Healthc Policy, 2016, 9: 143-156. DOI: 10.2147/rmhp.s97248.

5.Scripcaru G, Mateus C, Nunes C. Adverse drug events-analysis of a decade. a Portuguese case-study, from 2004 to 2013 using hospital database[J]. PLoS One, 2017, 12(6): e0178626. DOI: 10.1371/journal.pone.0178626.

6.Jinkyung P, Young AH. Medication safety education in nursing research: text network analysis and topic modeling [J]. Nurse Educ Today, 2023, 121: 105674-105674. DOI: 10.1016/j.nedt.2022.105674.

7.Jelodar H, Wang Y, Yuan C, et al. Latent Dirichlet allocation (LDA) and topic modeling: models, applications, a survey[J]. Multimedia Tools App, 2019, 78(11): 15169-15211. DOI: 10.1007/s11042-018-6894-4.

8.钟华, 戚龙, 吴正蓉, 等. 共病多重用药的对策[J]. 现代临床医学, 2014, 40(6): 467-468, 472. [Zhong H, Qi L, Wu ZR, et al. Countermeasure of comorbidity and polypharmacy[J]. Journal of Modern Clinical Medicine, 2014, 40(6): 467-468, 472.] DOI: 10.11851/j.issn.1673-1557.2014.06.030.

9.Leung KK, Tang LY, Lue BH. Self-rated health and mortality in Chinese institutional elderly persons[J]. J Clin Epidemiol, 1997, 50(10): 1107-1116. DOI: 10.1016/s0895-4356(97)00153-4.

10.吴晓秋, 吕娜. 基于关键词共现频率的热点分析方法研究[J]. 情报理论与实践, 2012, 35(8): 115-119. [Wu XQ, Lyu N. Research on the hotspot analysis method based on the co-occurrence frequency of keywords[J]. Information Studies: Theory & Application, 2012, 35(8): 115-119.] DOI: 10.16353/j.cnki.1000-7490.2012.08.026.

11.McDaniel CC, Chou C, Camp C, et al. Primary care physicians', psychiatrists', and oncologists' coordination while prescribing medications for patients with multiple chronic conditions[J]. J Patient Saf, 2022, 18(2): e424-e430. DOI: 10.1097/pts.0000000000000838.

12.Skou ST, Mair FS, Fortin M, et al. Multimorbidity[J]. Nat Rev Dis Primers, 2022, 8(1): 48. DOI: 10.1038/s41572-022-00376-4.

13.闫巍, 陈雪, 丁静. 全科医师面对老年共病患者多重用药的应对策略[J]. 中国全科医学, 2020, 23(15): 1859-1863, 1872. [Yan W, Chen X, Ding J. General practitioners' coping strategies for polypharmacy in elderly patients with multimorbidity[J]. Chinese General Practice, 2020, 23(15): 1859-1863, 1872.] DOI: 10.12114/j.issn.1007-9572.2020.00.325.

14.Laroche ML, Sirois C, Reeve E, et al. Pharmacoepidemiology in older people: purposes and future directions[J]. Therapie, 2019, 74(2): 325-332. DOI: 10.1016/j.therap.2018.10.006.

15.Hilmer SN, McLachlan AJ, Le Couteur DG. Clinical pharmacology in the geriatric patient[J]. Fundam Clin Pharmacol, 2007, 21(3): 217-230. DOI: 10.1111/j.1472-8206.2007.00473.x.

16.Hilmer SN, Gnjidic D, Le Couteur DG. Thinking through the medication list-appropriate prescribing and deprescribing in robust and frail older patients[J]. Aust Fam Physician, 2012, 41(12): 924-928. DOI: 10.4104/pcrj.2012.00084.

17.Quiñones AR, Valenzuela SH, Huguet N, et al. Prevalent multimorbidity combinations among middle-aged and older adults seen in community health centers[J]. J Gen Intern Med, 2022, 37(14): 3545-3553. DOI: 10.1007/s11606-021-07198-2.

18.Kim J, Parish AL. Polypharmacy and medication management in older adults[J]. Nurs Clin North Am, 2017, 52(3): 457-468. DOI: 10.1016/j.cnur.2017.04.007.

19.Barbe AG. Medication-induced xerostomia and hyposalivation in the elderly: culprits, complications, and management[J]. Drugs Aging, 2018, 35(10): 877-885. DOI: 10.1007/s40266-018-0588-5.

20.Saluja S, Hochman M, Bourgoin A, et al. Primary care: the new frontier for reducing readmissions[J]. J Gen Intern Med, 2019, 34(12): 2894-2897. DOI: 10.1007/s11606-019-05428-2.

21.陈维尔, 邱艳, 潘晓华, 等. 我国共病患者服药依从性的研究进展[J]. 中华全科医学, 2023, 21(10): 1745-1748. [Chen WE, Qiu Y, Pan XH, et al. Progress on medication compliance of patients with multimorbidity in China[J]. Chinese Journal of General Practice, 2023, 21(10): 1745-1748.] DOI: 10.16766/j.cnki.issn.1674-4152.003215.

22.Wang W, Luan W, Zhang Z, et al. Association between medication literacy and medication adherence and the mediating effect of self-efficacy in older people with multimorbidity[J]. BMC Geriatr, 2023, 23(1): 378. DOI: 10.1186/s12877-023-04072-0.

23.Patton DE, Cadogan CA, Ryan C, et al. Improving adherence to multiple medications in older people in primary care: selecting intervention components to address patient-reported barriers and facilitators[J]. Health Expect, 2018, 21(1): 138-148. DOI: 10.1111/hex.12595.

24.Wenger NK, Doherty CL, Gurwitz JH, et al. Optimization of drug prescription and medication management in older adults with cardiovascular disease[J]. Drugs Aging, 2017, 34(11): 803-810. DOI: 10.1007/s40266-017-0494-2.

25.González-Bueno J, Sevilla-Sánchez D, Puigoriol-Juvanteny E, et al. Factors associated with medication non-adherence among patients with multimorbidity and polypharmacy admitted to an intermediate care center[J]. Int J Environ Res Public Health, 2021, 18(18): 9606. DOI: 10.3390/ijerph18189606.

26.Yang C, Hui Z, Zeng D, et al. A community-based nurse-led medication self-management intervention in the improvement of medication adherence in older patients with multimorbidity: protocol for a randomised controlled trial[J]. BMC Geriatr, 2021, 21(1): 152. DOI: 10.1186/s12877-021-02097-x.

27.Moynihan R, Doust J, Henry D. Preventing overdiagnosis: how to stop harming the healthy[J]. BMJ, 2012, 344: e3502. DOI: 10.1136/bmj.e3502.

28.Le Bosquet K, Barnett N, Minshull J. Deprescribing: practical ways to support person-centred, evidence-based deprescribing[J]. Pharmacy (Basel), 2019, 7(3): 129. DOI: 10.3390/pharmacy7030129.