Welcome to the website of the International Seminar REPOSI 2013.
The goal and challenge of this International Seminar are to promote more effective and focused clinical and research approaches to multimorbidity in the oldest old, taking into account different European healthcare scenarios, experiences and expertises. In the European Union (EU) the number of people aged >75 years is projected to double by the year 2060, comprising 20% of the total population. These changes will lead to an increase of 20 to 40% of the costs necessary to maintain the existing quality of healthcare services. Multimorbidity is almost constant in the oldest old and has such adverse consequences as higher mortality, poorer quality of life and functional status. Elderly people with multimorbidity are often treated with multiple medications, and polypharmacy leads to drug interactions, adverse reactions, poor compliance, heightened health service use, inadequate coordination of care and higher treatment burden. Current therapeutic guidelines are based upon randomized clinical trials, that enroll only highly selected, relatively young patients suffering from a single disease. This population is obviously very different from the oldest old and very few guidelines take into due account multimorbidity and overall medication burden. This background highlights the need of making drug prescription more appropriate and personalized, also ensuring that decision making takes into account patients’ life expectancy, concerns and priorities. There is also a need to bolster a patient-centered approach instead of the current disease-focused efforts, that inevitably lead to fragmentation of healthcare of the elderly and inappropriate use of facilities.