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Comorbidity and polypharmacy in the practice of a general practitioner


Professor E. Polozova(1), MD; V. Skvortsov(2), MD; Professor S. Aksenova(1), MD; D.
Zinyakov(1); T. Levina, Candidate of Medical Sciences(1), N. Nefedov(1); M. Narvatkina(1) (1)N.P. Ogarev
Mordovia State University, Saransk (2)Volgograd State Medical University, Ministry of Health of Russia

The high prevalence of cardiovascular diseases and their pathophysiological association with various comorbid conditions contributes to the progressive increase in the number of patients with a concurrence of several diseases. Combined pathology creates a new clinical situation that requires the consideration of its features when choosing therapeutic, diagnostic, and preventive strategies. A comorbid patient is a serious problem for any clinician, since in this case it is necessary to take into account several components of therapy, which makes it difficult to control treatment efficiency, contributes to an increase in polypharmacy, the risk of local and systemic side effects of drugs, and reduces adherence to therapy. Treatment for comorbid disorders requires careful compliance with the requirements of rational pharmacotherapy, high clinical professionalism, and a wide range of knowledge of related specialties. The paper describes and discusses the clinical case of a comorbid patient in the practice of a general practitioner. It gives the steps in the performed diagnostic search, by verifying the clinical diagnosis and prescribed pharmacotherapy strategies. The presented data show that it is difficult for a physician to avoid polypharmacy in case of comorbidities. Such difficulties are daily encountered by any clinician regardless of his/her clinical experience and awareness of medical science.

clinical case

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