Polypharmacy among Underserved Older African American Adults

Abstract

The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants' characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively. Thirty-eight percent of participants received prescription medications from at least three providers. Inappropriate drug use occurred among seventy percent of the participants. Multivariate analysis showed that number of providers was the strongest correlate of polypharmacy. Moreover, data show that gender, comorbidity, and potentially inappropriate medication use are other major correlates of polypharmacy. Conclusions. This study shows a high rate of polypharmacy and potentially inappropriate medication use among underserved older African American adults. We documented strong associations between polypharmacy and use of potentially inappropriate medications, comorbidities, and having multiple providers. Polypharmacy and potentially inappropriate medications may be attributed to poor coordination and management of medications among providers and pharmacists. There is an urgent need to develop innovative and effective strategies to reduce inappropriate polypharmacy and potentially inappropriate medication in underserved elderly minority populations.

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

“…Given the nature of the data collection, we defined our medication data collection as comprehensive. Data were gathered between 2015 and 2018 [10,[38][39][40][41][42][43].…”

“…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]. Polypharmacy is also associated with undesirable clinical and health outcomes such as falls [11], hospitalization [12], emergency department visits [12,13], cognitive decline [14][15][16], and premature mortality [17][18][19].…”

Potentially inappropriate medication use among hypertensive older African-American adults

“…Despite these favorable outcomes, suboptimal use of medications among ethnic/racial population limits maximal health benefits [ 7 – 9 ]. Three major medication-related challenges that lead to suboptimal use of medications are: 1) nonadherence to prescribed drug regimens [ 10 – 16 ], 2) excessive and unnecessary use of medication [ 17 , 18 ], and 3) inappropriate use of medications [ 19 ].…”

<p>Self-Reported Nonadherence Associated with Pharmacy and Home Medication Management Inconvenience Factors in a US Adult Population</p>

“…It stands to reason that getting medications from multiple sources and methods may increase management complexity. To date, emphasis has been placed on picking up prescriptions from multiple different pharmacies, 27,28 and not necessarily on different modes. Our findings and the existing literature reflect the importance of fully understanding individuals' experiences in the pharmacy context and simplifying their medication management to make it more convenient.…”