Background: Polypharmacy has become a major and growing public health issue, with significant implications for health outcomes and expenditure on healthcare resources. In this study, a risk prediction model of polypharmacy represented by a nomogram for community-dwelling elderly patients based on the Chinese population was constructed. Methods: A cross-sectional study was conducted in Shanghai, China. The variables data affecting polypharmacy were fetched from the information system database of health government departments in Shanghai. The Least Absolute Shrinkage Selection Operator (LASSO) regression analysis was used to select the predictor variables, and multivariate logistic regression was used to establish the prediction model. A visual tool of the nomogram was established for predicting the risk of polypharmacy in the elderly population. In addition, the receiver operating characteristic (ROC) curve, calibration curve, and decision curve analysis (DCA) were used to estimate the performance of the model. Results: A total of 80,012 elderly patients were included in this study. Eight variables, containing age, residential area, preferred medical institutions, number of visits to tertiary hospitals, number of visits to secondary hospitals, number of visits to community health centers, number of diagnoses, and main types of disease, were included in the risk prediction model of nomogram. The area under the curve (AUC) of the nomogram was 0.782 in both sets, demonstrating that the model has a good discriminant ability. The calibration chart shows that the prediction model fits well with the validation set. DCA results displayed that the threshold probabilities of the two sets in the prediction model reached up to 90%, implying that the model had a preferable application value. Conclusion: This study explored the risk factors for polypharmacy among the elderly in Shanghai, China, and applied the nomogram to establish a predictive model via eight variables, which provided an effective tool for early screening and timely prevention of polypharmacy. Family physicians or pharmacists could scientifically use the tool to closely observe community-dwelling elderly patients, decreasing the adverse health effects caused by medication for the elderly.

Elderly patients are associated with a higher risk of nosocomial cross infection during the COVID-19 pandemic. Providing medical services and primary care for elderly patients is a worldwide challenge. A new telegeriatrics system was established to provide medical services and primary care for elderly patients treated by family physicians. This study aimed to describe the operation mechanism of the new system and investigate the demands of telegeriatrics medical services for elderly patients treated by family physicians during the COVID-19 pandemic.
A total of 1,353 elderly patients (aged≥60) treated by family physicians were enrolled. The proportion of the top 10 diseases of elderly patients applying the new system was analyzed. Differences in main diseases between elderly patients applying telegeriatrics medical services and outpatients in hospitals were compared. Differences between the new telegeriatrics system in our study and telemedicine systems of other studies in other countries were analyzed.
Constituent ratios of chronic kidney disease, type 2 diabetes mellitus, and coronary heart disease have the highest rate in elderly patients applying the new telegeriatrics system. Digestive diseases, cardiovascular diseases, and neurology diseases were the top three diseases of elderly outpatients.
This is the first time that a new telegeriatrics system has been applied to provide medical services for elderly patients treated by family physicians during the COVID-19 pandemic. Chronic kidney disease, Type 2 diabetes mellitus, and coronary heart disease were found to be the top three diseases of elderly patients applying telegeriatrics medical services during the COVID-19 pandemic, which were different from the outpatients in general hospitals. The new telegeriatrics system guarantees elderly patients get equal rights to medical services. Results will provide a basis for the government health administrative department to formulate new telegeriatrics policies for elderly patients.

There is a paucity of evidence regarding the association between family physicians\' panel size and health outcomes of patients with hypertension in China.
To examine the association between family physicians\' panel size and health outcomes of patients with hypertension in urban China.
This retrospective cohort study during 1 contract year from July 1, 2018, to June 31, 2019, was set in four community health centers (CHCs) in Xiamen City, China.
A total of 18,119 adult patients (18+) diagnosed with hypertension and their 61 family physicians were included.
Family physicians\' panel size was measured by the number of registered patients in the preceding 6 months. The outcome measures included blood pressure (BP) control rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) measured at each follow-up visit.
Every additional 100 patients to the panel size were associated with an average of 17% increase in BP control rate (95% confidence interval [CI] = 1.15 to 1.19), and decrease in SBP (- 0.3 mmHg, 95% CI: - 0.38 to - 0.30), DBP (- 0.4 mmHg, 95% CI: - 0.39 to - 0.34), and MAP (- 0.4 mmHg, 95% CI: - 0.38 to - 0.33). After entering the quadratic term of panel size in the model, the panel size was negatively associated with BP control rate and positively associated with SBP, DBP, and MAP, while for the quadratic term, the odds ratio for BP control rate was positive and the coefficients for SBP, DBP, and MAP were negative. A U-shape association was found between panel size and health outcomes of patients with hypertension, and the turning point was about 600 patients.
The panel size of family physicians was curvilinearly associated with health outcomes of patients with hypertension in urban China.