Detection & avoidance of adverse medication outcomes in older adults living with multimorbidity and polypharmacy
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Date
2026-03-31
Authors
Daunt, Ruth
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Publisher
University College Cork
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Abstract
Advances in pharmacotherapy has transformed modern healthcare, contributing to increased longevity globally. This growing population of older adults, many of whom live with multimorbidity and polypharmacy, is at risk of adverse medication outcomes. Two under-investigated components of adverse medication outcomes include prescribing cascades and the impact of medication on quality of life.
This doctoral thesis, comprising eight chapters, was designed to address these two important and interrelated aspects of adverse medication outcomes. The first chapter provides an introduction, divided into three sections, (i) medications, (ii) prescribing cascades, and (iii) patient-reported outcomes and medication-related burden. The second chapter presents a prospective prevalence study of prescribing cascades in hospitalised older adults with multimorbidity and polypharmacy. The third explores factors influencing hospital physicians’ recognition of prescribing cascades. The fourth chapter develops a modified, short-form of the original MRB-QoL (mMRB-QoL) for older adults with multimorbidity and polypharmacy. Chapter five considers the relevance of the research and outlines potential directions for future research. Chapter six contains peer-reviewed articles that were published during the writing of this thesis. References and appendices are presented in chapters seven and eight, respectively.
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Keywords
Polypharmacy , Multimorbidity , Prescribing cascades , PROM , Older adult , Adverse medication outcomes
Citation
Daunt, R. L. 2026. Detection & avoidance of adverse medication outcomes in older adults living with multimorbidity and polypharmacy. MD Thesis, University College Cork.