A longitudinal evaluation of drug use in an ambulatory elderly population

Stewart, Ronald B.; Moore, Mary T.; May, Franklin E.; Marks, Ronald G.; Hale, William E.

doi:10.1016/0895-4356(91)90096-r

Cited by 44 publications

(35 citation statements)

References 13 publications

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“…These findings are consistent with previous observations in studies both in Brazil 16 and elsewhere 9,13,14 . Greater use of medications by women can be explained, at least in part, by greater use of healthcare services, greater knowledge of medications, quantitative and qualitative differences in disease patterns, and greater attention to their own health problems 16 .…”

Section: Discussionsupporting

confidence: 94%

“…In the current study, the most widely used drug classes (cardiovascular, nervous system, alimentary tract and metabolism, blood and blood forming organs, and musculoskeletal system) reproduce a consumption pattern observed in elderly populations in different countries 13,14 and in Brazil 15,16 . The use of these drug classes relates to treatment and prevention of typical health events for this phase of life, like hypertension, coronary disease, diabetes, and chronic pain.…”

Section: Discussionmentioning

confidence: 73%

“…Studies in other countries 12,13,14 and in Brazil 15,16 have identified drugs for the cardiovascular system, central nervous system, metabolism, and alimentary tract as the most frequently consumed among the elderly. More recently, changes in the pattern of use of some drug classes have been observed in some populations, especially in the pattern of consumption of drugs for hypertension 17,18 , as well as an increase in the use of lipid modifying 5,17 , psychoactive 19,20 , and antiepileptic drugs 21 .…”

mentioning

confidence: 99%

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Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

et al. 2011

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This study examined differences in the use of medications in two birth cohorts (born from 1916 to 1926 and from 1927 to 1937) wave, in 2008 (n = 620). The number of medications currently consumed (mean = 4.6 and 3.4, respectively) and prevalence of polypharmacy (46.6% and 29.1%, respectively) The high prevalence of chronic illnesses among the elderly is associated with high consumption of medications by this population group 3 . In the elderly population, the risks associated with consumption of medications compete with the expected benefits, due to the physiological changes proper to aging, including the decrease in muscle mass and body water, with effects on the pharmacodynamics and pharmacokinetics of medications. Thus, unwanted effects (adverse effects and drug-drug interactions) are more likely to occur 4 .The prevalence of polypharmacy is high in the elderly 5,6,7 , and is one of the strongest predictors of health problems associated with use of medications 4 . Polypharmacy is defined as the use of multiple medications, a basically quantita-ARTIGO ARTICLE Loyola Filho AI et al.

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Section: Discussionsupporting

confidence: 94%

Section: Discussionmentioning

confidence: 73%

mentioning

confidence: 99%

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Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

et al. 2011

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“…This was consistent with the findings reported. 11,12 The use of Ant diabetics were high in this study (83.3%) as compared to others who reported the use ranging 40%. 13 A total of 111 (92.5%) patients suffered from co-morbid conditions which were similar to another study conducted in pune.…”

Section: Discussioncontrasting

confidence: 49%

Assessment of Factors Associated with Low Adherence to Pharmacotherapy in Elderly Patients

Roy¹,

Sajith²,

Bansode³

2017

JYP

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Objective: To assess factors associated with low adherence to pharmacotherapy in elderly patients. Methods: A prospective cross sectional observational study was conducted in Bharati Hospital and Research Centre, Pune over a period of 6 months. A total of 240 Elderly patients (≥60 years), taking 4 or more medications daily for any medical illness or illnesses were enrolled in the study. The details like age, gender, educational and employment status, physical activity, social history, past medical and medication history, current medications were noted in self pre designed patient pro forma. The medication adherence was assessed by using Brief Medication Questionnaire (BMQ). Results: The assessment of the patient's responses to the four scale BMQ showed that out of 240 patients, only 5.8% patients were adherent in regimen scale, 60% were adherent in belief scale, 15% were adherent in recall scale and 37.5% were adherent in access scale. Complexity of medication regimen (74.1%) was the main barrier to medication adherence. More than half of patients were unable to name their medications (68.3%). The main reason for non adherence would be related to patient related factors such as lack of knowledge about the disease (63.3%), inadequate knowledge regarding therapy (60%), taking so many pills at the same time (51.7%), forgetfulness (50.84%), difficulty in remembering to take all the pills (48.3%) and difficulty on refilling in time (20.0%). Conclusion: Various factors associated with medication nonadherence were complexity of medication regimen, lack of knowledge about the disease and therapy, difficulty in remembering to take medications and taking so many pills at the same time.

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“…the use of excessive medications, ≥ 3 drugs or ≥ 6 drugs, among other defi nitions [ 7,8 ] . Although, there is no consensus, we used > 3 medications to defi ne polypharmacy.…”

Section: Methodsmentioning

confidence: 99%

Population‐based study of erectile dysfunction and polypharmacy

et al. 2011

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What ' s known on the subject? and What does the study add?It is known that medical conditions such as diabetes, high blood pressure, high cholesterol, smoking and prescribed medications cause erectile dysfunction (ED). This has been studied at the molecular level and reported in population studies. The present study shows that, after accounting for known medical problems, there is a doseresponse relationship, in which worsening degrees of ED are seen when a greater number of medications are taken, regardless if they are prescribed or over the counter.The study can help primary care doctors and urologists to make a differential diagnosis of ED and it can also help improve patient ' s erectile function by tailoring and curtailing current medication use to maximize therapeutic benefi t but minimize ED side effects in men, thus improving health-related quality of life. OBJECTIVE• To study the association between erectile dysfunction (ED) and polypharmacy use in a large, ethnically and racially diverse cohort of men enrolled in the California Men ' s Health Study (CMHS). PATIENTS AND METHODS• Men from the Kaiser Permanente Southern California (KPSC) health plan, enrolled in the CMHS in 2002, had an age range of 45 -69 years. ED and comorbidities of these subjects were identifi ed by questionnaire responses.• The number of drugs taken was determined from the year before enrollment through electronic pharmacy records and questionnaire responses. RESULTS• Among the 37 712 (KPSC) subjects, 10 717 (29%) reported moderate or severe ED.• Across all age groups, ED was more prevalent as the number of medications increased.• In men taking 0 -2, 3 -5,6 -9 and ≥ 10 medications, the percentage of men reporting moderate ED was 15.9, 19.7, 25.5 and 30.9%, respectively ( P < 0.001).• With adjustment for age, race, smoking, diabetes, hypertension, hyperlipidaemia, peripheral vascular disease, coronary artery disease and body mass index, men taking > 10 drugs were more likely to have ED (odds ratio = 2.32, 95% confi dence interval 2.14 -2.52) with evidence of a dose -response relationship. CONCLUSION• These data suggest that the number of medications a man takes is associated with worse ED, even after comorbidities have been taken into account. KEYWORDS

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A longitudinal evaluation of drug use in an ambulatory elderly population

Cited by 44 publications

References 13 publications

Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

Birth cohort differences in the use of medications in a Brazilian population of older elderly: the Bambuí cohort study of aging (1997 and 2008)

Assessment of Factors Associated with Low Adherence to Pharmacotherapy in Elderly Patients

Population‐based study of erectile dysfunction and polypharmacy

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