The Influence of Educational Level on Polypharmacy and Inappropriate Drug Use: A Register‐Based Study of More Than 600,000 Older People

Haider, Syed Imran; Johnell, Kristina; Weitoft, Gunilla Ringbäck; Thorslund, Mats; Fastbom, Johan

doi:10.1111/j.1532-5415.2008.02040.x

Cited by 199 publications

(220 citation statements)

References 38 publications

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“…Concerns about polypharmacy include increased ADRs, drug interactions, prescribing cascade and higher costs [23]. Polypharmacy is often associated with a decreased quality of life, decreased mobility and cognition [24].…”

Section: Discussionmentioning

confidence: 99%

A Study of Drug Utilization Pattern of the Geriatric Patients in the Department of Geriatric Medicine in a Tertiary Care Hospital in Assam, India

Borah

Devi

Debnath

et al. 2017

Asian J Pharm Clin Res

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Objective: To investigate the drug utilization pattern and the prevalence of potentially inappropriate medications (PIMs) using updated AGS Beers Criteria 2012 among the elderly patients who attended the geriatric outpatient departments as well as admitted indoor patients in a Tertiary Care Hospital at Guwahati, Assam, India. Methods:A hospital-based prospective, observational and cross sectional study, involving patients aged 65 years and above was planned and conducted over a period of 6-months from January 2016 to June 2016. Patients were visited daily, interviewed and case records were collected. Data were analyzed using Microsoft Office Excel Sheets.Results: A total of 150 patients aged 65 years and above were analyzed. 97 patients (65%) were males and 53 (35%) were females. Majority of the patients (61 numbers, 41%) belonged to the age group of 65-70 years, and least were in the age group of 86-90 years (13 numbers, 9%). Prescription of five or more medications (polypharmacy) was observed in 117 (78%) patients. Majority of the patients presented with diseases of cardiovascular system (25.7%). Using the World Health Organization drug use indicators, the average number of drugs per prescription was found to be 5.6. The percentage of drugs prescribed by generic name was 86%. The percentage of encounters in which antibiotics were prescribed was 61%. Injection was prescribed was 65% cases and the percentage of drugs prescribed from the National List of Essential Medicines of India was 96%. 43 patients received PIMs from Beers list; majority were belonging to Category 1. Spironolactone was most commonly prescribed PIM. Conclusion:Irrational prescribing practices and polypharmacy were detected in our study. Prescribers should be educated about the rational use of drugs and Beers Criteria for elderly.

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Section: Discussionmentioning

confidence: 99%

A Study of Drug Utilization Pattern of the Geriatric Patients in the Department of Geriatric Medicine in a Tertiary Care Hospital in Assam, India

Borah

Devi

Debnath

et al. 2017

Asian J Pharm Clin Res

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show abstract

“…Furthermore, we were not able to include variables that are not routinely captured in the claims database, such as tobacco or alcohol consumption. Finally, because the NHIRD only recorded up to 5 diagnoses per patient visit, 18 we may have underestimated the prevalence of comorbidities in our cohort.…”

Section: Limitationsmentioning

confidence: 99%

“…17 We defined polypharmacy and excessive poly pharmacy as the concomitant use of 5 or more and 10 or more drugs, respectively, based on previous studies. 7,18 We defined potentially inappropriate medications using the 2012 update to the Ameri can Geriatrics Society's Beers Criteria.…”

Section: Outcome Measuresmentioning

confidence: 99%

Effect of polypharmacy, potentially inappropriate medications and anticholinergic burden on clinical outcomes: a retrospective cohort study

Wen

Chen

et al. 2015

CMAJ

180

179

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Background: Polypharmacy, potentially inappropriate medications and anticholinergic burden (as assessed by the anticholinergic risk scale) are commonly used as quality indicators of pharmacotherapy in older adults. However, their role in clinical practice is undefined. We sought to investigate longitudinal changes in these indicators and their effects on clinical outcomes. Methods:We used Taiwan's Longitudinal Health Insurance Database to retrieve quarterly information about drug use for people aged 65 years and older over a 10-year period. We analyzed the association between indicators and all-cause admission to hospital, fracture-specific admission to hospital and death using generalized estimating equations. (-0.15 [-0.26 to -0.04]). Polypharmacy, potentially inappropriate medications and anticholinergic risk scale were each associated with an increased risk of admission to hospital, but not with death. In addition, both polypharmacy (5-9 drugs: odds ratio [OR] 1.18, 95% CI 1.12-1.24; ≥ 10 drugs: OR 1.54, 95% CI 1.42-1.66) and anticholinergic burden (score 1-2: 1.39, 95% CI 1.31-1.48; ≥ 3: 1.53, 95% CI 1.41-1.66) showed dose-response relations with fracture-specific admission to hospital. Results Interpretation:The total number of drugs taken (polypharmacy), number of potentially inappropriate medications and anticholinergic risk changed during follow-up and varied across age groups in this cohort of older adult patients. These indicators showed dose-response relations with admission to hospital, but not with death. AbstractSee also review, www.cmaj.ca/lookup

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“…Age is the strongest predictor for using several drugs and polypharmacy (defined as a daily intake of five or more specific drugs) is common among older people. Haider et al [2] investigated the drug use of 626 258 people in Sweden aged 75 -89 and found that polypharmacy occurred in 57% of the sample and that 18% had a daily intake of ten or more specific drugs. Polypharmacy was also more common among those of low socioeconomic status indicating that patient education F o r P e e r R e v i e w 4 interventions targeting this group could be important.…”

Section: Introductionmentioning

confidence: 99%

“…polypharmacy [2], medication errors [3], inappropriate drug use (i.e prescription of drugs that might be especially harmful to older people) [4] and adherence [5]. Age is the strongest predictor for using several drugs and polypharmacy (defined as a daily intake of five or more specific drugs) is common among older people.…”

Section: Introductionmentioning

confidence: 99%

Healthcare utilisation and knowledge concerning prescribed drugs among older people

Kristensson

Modig

Midlöv

et al. 2010

Eur J Clin Pharmacol

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The Influence of Educational Level on Polypharmacy and Inappropriate Drug Use: A Register‐Based Study of More Than 600,000 Older People

Cited by 199 publications

References 38 publications

A Study of Drug Utilization Pattern of the Geriatric Patients in the Department of Geriatric Medicine in a Tertiary Care Hospital in Assam, India

A Study of Drug Utilization Pattern of the Geriatric Patients in the Department of Geriatric Medicine in a Tertiary Care Hospital in Assam, India

Effect of polypharmacy, potentially inappropriate medications and anticholinergic burden on clinical outcomes: a retrospective cohort study

Healthcare utilisation and knowledge concerning prescribed drugs among older people

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