Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review

Rodrigues, Maria Cristina Soares; Oliveira, César de

doi:10.1590/1518-8345.1316.2800

Cited by 132 publications

(105 citation statements)

References 52 publications

(106 reference statements)

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“…Polypharmacy increases the risk of a wide range of undesirable health outcomes and events such as adverse drug events and drug-drug interactions [4,5]. Polypharmacy is associated with reduced medication adherence [6][7][8][9] and an increase in potentially inappropriate medication (PIM) use [10].…”

Section: Introductionmentioning

confidence: 99%

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

et al. 2020

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Although previous research has linked polypharmacy to lower cognitive function in the general population, we know little about this association among economically challenged African American (AA) older adults. This study explored the link between polypharmacy and memory function among AA older adults. This community-based study recruited 399 AA older adults who were 65+ years old and living in economically disadvantaged areas of South Los Angeles. Polypharmacy (taking 5+ medications) was the independent variable, memory function was the outcome variable (continuous variable), and gender, age, living arrangement, socioeconomic status (educational attainment and financial strain), health behaviors (current smoking and any binge drinking), and multimorbidity (number of chronic diseases) were the covariates. Linear regression was used for data analyses. Polypharmacy was associated with lower scores on memory function, above and beyond covariates. Among AA older adults, polypharmacy may be linked to worse cognitive function. Future research should test the mechanisms by which polypharmacy is associated with lower levels of cognitive decline. There is a need for screening for memory problems in AA older adults who are exposed to polypharmacy.

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Section: Introductionmentioning

confidence: 99%

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

et al. 2020

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“…Polypharmacy is said to not only increase irrational use of drugs but also can increase the risk of drug interactions, medication errors and adverse effects. 11,12 In present study it was observed that the percentage of drugs prescribed by generic name was 41.4%. Use of generic drugs is said to decrease the expenditure of medicine.…”

Section: Discussionmentioning

confidence: 48%

Study of drug utilization pattern in the department of radiotherapy in a tertiary care teaching hospital

Chandan

Ranganathan

Nagabushan

2019

Int J Basic Clin Pharmacol

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Background: Drug utilization studies are an important tool in evaluating the rationality of therapeutic practice and also it is said to improvise the therapeutic use of drugs. The present study will be undertaken to evaluate the drug utilization pattern in the department of Radiotherapy.Methods: This was a prospective, observational study that was undertaken in the department of Radiotherapy in a tertiary care teaching hospital. The study was conducted for a period of 6 months after obtaining permission from Institutional Ethical Committee. The study was conducted among cancer patients undergoing radiotherapy. The data was collected from the patient case records and was analyzed as per the WHO prescribing indicators.Results: In the present study it was observed that the average number of drugs prescribed per encounter was 7.7. The drugs prescribed by generic name were 41.4%. Percentage of encounters with an antibiotic prescribed was 100. Percentage of encounters with an injection prescribed was 20.5%. Percentage of drugs prescribed from essential drugs list was 35.8%.Conclusions: Drug utilization studies helps in modifying the prescription pattern and helps in making the drug usage more rational.

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“…42,43 Frailty is also associated with a deterioration in physical function and increased risk of falls, injury, fracture, hospital admission and mortality. 39,[44][45][46][47][48][49] Although the use of anticholinergic and sedative medications further impairs physical function, 16 there were no significant differences between drug burden and the frail and non-frail groups, possibly due to the sample size and self-reported measures of frailty.…”

Section: Discussionmentioning

confidence: 99%

“…The older people residing in ACFs portray vulnerability and their health needs are complex due to multiple comorbidities and age‐related changes in pharmacokinetic and pharmacodynamic characteristics . Frailty is also associated with a deterioration in physical function and increased risk of falls, injury, fracture, hospital admission and mortality . Although the use of anticholinergic and sedative medications further impairs physical function, there were no significant differences between drug burden and the frail and non‐frail groups, possibly due to the sample size and self‐reported measures of frailty.…”

Section: Discussionmentioning

confidence: 99%

Drug burden index, polypharmacy and patient health outcomes in cognitively intact older residents of aged care facilities in Malaysia

Hasan

Chang

Thiruchelvam

et al. 2020

Pharmacy Practice and Res

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Background The complexity of drug regimens among older people tend to increase over time, as multiple medications are required to treat a single condition. Aim This study examined the association of the drug burden index (DBI) and polypharmacy with patient health outcomes among cognitively intact older residents in aged care facilities (ACFs). Methods A review of prescribed medications and related outcomes was conducted in a cross‐sectional sample of older adults (≥60 years), recruited from 11 ACFs in Peninsular Malaysia. Frailty and quality of life (QoL) were evaluated using the Groningen frailty indicator and ‘Older People's Quality of Life – 35’ questionnaire, respectively; patients’ exposure to anticholinergic and sedative medicines was quantified using the DBI; and the mental health of residents was evaluated using the Hospital Anxiety and Depression Scale. Results More than two‐thirds of a sampled population received at least one anticholinergic or sedative medication and more than one‐quarter was exposed to polypharmacy. Exposure to DBI‐associated medications was noted in three of every four frail participants and was significantly correlated with frailty (r = 0.184, p = 0.023). The frail population had significantly increased risk of polypharmacy (odds ratio 6.07; 95% confidence interval 1.71–21.56; p = 0.005), but exposure to DBI‐associated medications was not significantly associated with overall QoL and activity of daily living measures. Conclusion Polypharmacy and anticholinergic and sedative burden were noticed in a substantial number of older adults in residential aged care facilities and were associated with frailty. Investing in the recruitment of pharmacists may benefit recognition of residential ACF quality of care, because pharmacy services (including pharmacists) are virtually non‐existent in Malaysian residential ACFs.

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Drug-drug interactions and adverse drug reactions in polypharmacy among older adults: an integrative review

Cited by 132 publications

References 52 publications

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

Polypharmacy Is Associated with Lower Memory Function in African American Older Adults

Study of drug utilization pattern in the department of radiotherapy in a tertiary care teaching hospital

Drug burden index, polypharmacy and patient health outcomes in cognitively intact older residents of aged care facilities in Malaysia

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