Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden

Craftman, Åsa Gransjön; Johnell, Kristina; Fastbom, Johan; Westerbotn, Margareta; Strauss, Esther

doi:10.1016/j.archger.2015.11.010

Cited by 32 publications

(24 citation statements)

References 44 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A Finnish study [24] also reported unchanged prevalences of overall psychotropic drug use between 1990-91 and 1998-99 and a Swedish study [25] observed unchanged prevalences among cognitive intact elderly, but significant rises among cognitive impaired elderly between 1987 and 2007. Contrarily, significant increases in overall psychotropic drug use were reported by an US [26] and a Spanish study [27].…”

Section: Discussionmentioning

confidence: 99%

Changes in prevalence of psychotropic drug use and alcohol consumption among the elderly in Germany: results of two National Health Interview and Examination Surveys 1997-99 and 2008-11

Wolf

Knopf

2017

BMC Psychiatry

View full text Add to dashboard Cite

BackgroundPsychotropic drug use and alcohol consumption among older adults need to be monitored over time as their use or combined use bears risks of harms. Representative data on changes in prevalence, patterns and co-relates of substance use are lacking in Germany.MethodsParticipants were older adults (60–79 years) from two German National Health Surveys: 1997–99 (GNHIES98, N = 1,606) and 2008-11 (DEGS1, N = 2,501). Included were drugs acting on the nervous system used during the last 7 days. Alcohol consumption was measured by frequency (daily drinking) and quantity (risky drinking: ≥20/10 g/day alcohol for men/women). Changes in prevalence adjusted for potential socio-economic and health-related confounders were calculated by logistic regression models approximated by the SAS LSMEANS statement.ResultsThe prevalence of overall psychotropic drug use (20.5% vs. 21.4%) remained constant between the two surveys. Significant changes were observed in the use of some psychotropics (all GNHIES98 vs. DEGS1): Synthetic antidepressants (3.9% vs. 6.9%), St. John’s wort (2.9% vs. 1.1%), benzodiazepines (3.7% vs. 2.5%), benzodiazepine related drugs (0.2% vs. 0.8%), narcotic analgesics (3.0% vs. 4.1%), anti-dementia drugs (2.2% vs. 4.2%) and anti-epileptics (1.0% vs. 2.3%). Significant changes were also observed in long-term use of synthetic anti-depressants (3.2% vs. 5.9%), St. John’s wort (2.0% vs. 0.6%) and opioid analgesics (1.0% vs. 2.2%). Further, we found significant changes in benzodiazepines use (3.3% vs. 1.4%) among men, opioids use (2.9% vs. 7.3%) among people with a lower social status, and overall psychotropics (26.8% vs. 32.5%) as well as opioids use (4.4% vs. 8.1%) among those with a worse health status. Moderate alcohol consumption increased significantly (58.0% vs. 66.9%). Risky drinking remained unchanged (16.6% vs. 17.0%). In spite of significant increases in daily alcohol drinking (13.2% vs. 18.4%) psychotropic drug use combined with daily drinking remained unchanged (1.8% vs. 2.7%).ConclusionsAlthough prevalence of overall psychotropic drug use remained stable, changes in the use of some psychotropic drug groups and alcohol consumption patterns have been observed. Further studies are required to investigate resulting health consequences and public health relevance of those outcomes.

show abstract

Section: Discussionmentioning

confidence: 99%

Changes in prevalence of psychotropic drug use and alcohol consumption among the elderly in Germany: results of two National Health Interview and Examination Surveys 1997-99 and 2008-11

Wolf

Knopf

2017

BMC Psychiatry

View full text Add to dashboard Cite

show abstract

“…In recent decades, debate regarding polypharmacy among old people has been intense [ 1 ]. Haider et al [ 2 ] showed that the prevalence of polypharmacy (use of five or more drugs) in individuals aged ≥ 77 years increased from 18 to 42% during the 1992–2002 period.…”

Section: Introductionmentioning

confidence: 99%

“…Both the extent and the pattern of drug use differs between females and males: According to SNAC-K (Swedish National Study on Aging and Care in Kungsholmen), in Stockholm in 2007 [ 1 ], 51.4% of the females and 33.2% of the males received analgesics. The corresponding percentages for psychotropic drugs were 48.3% for females and 30.8% for males.…”

Section: Introductionmentioning

confidence: 99%

Prescription Changes During Geriatric Care Episodes: A Trend Analysis Conducted in Sweden

et al. 2018

Self Cite

View full text Add to dashboard Cite

BackgroundThe number of drugs prescribed for old people has been rising in recent decades. With increasing age and multiple medications, the risk of complications and drug prescription complexity increases. Multiple changes to prescriptions could be a factor that improves treatment quality.ObjectivesOur objective was to investigate trends in drug prescriptions and factors that contribute to prescription changes. Specific objectives were to find out whether high numbers of prescription changes are significantly correlated with age, sex, comorbidity, length of care episode, and number of drugs.MethodsData were extracted from geriatric clinic records in Stockholm in 2005, 2010, and 2015. Indicators for good drug therapy were used to assess the effects of prescription changes on quality, using an index of inappropriate drug use (IDU). Data were analyzed with Student’s t-test, PR test, Wilcoxon’s rank sum test, and linear regression.ResultsPatients had more comorbidities and used more drugs but had shorter hospital stays and significantly fewer prescription changes in 2015 than in 2005. Length of care episode was significantly associated with prevalence of prescription changes. Our model showed that, for each day by which the length of care episode decreased, the number of prescription changes decreased by 8%. The number of prescription changes was negatively correlated to the IDU index score.ConclusionsThe study showed that more prescription changes were associated with longer care episodes and improved drug prescribing quality as per the IDU index. Given prescription changes are regarded as a quality factor in geriatric care, quality may have decreased along with the length of care episodes between 2005 and 2015.

show abstract

“…Women were more likely to take analgesics, TCAs and SSRIs, compared with men. Craftman et al 36 reported similar findings when they examined medication usage in older adults, over a 20-year period. One possible explanation for our analgesic findings could be that there are gender differences in relation to pain.…”

Section: Discussionmentioning

confidence: 70%

Central nervous system (CNS) medications and polypharmacy in later life: cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA)

2020

View full text Add to dashboard Cite

ObjectivesMany central nervous system (CNS) medications are considered potentially inappropriate for prescribing in older people; however, these medications are common in polypharmacy (≥5 medicines) regimens. This paper aims to determine the prevalence of CNS drug classes commonly taken by older people. Furthermore, this paper aims to determine whether polypharmacy and other factors, previously found to be associated with overall polypharmacy, are associated with the most common CNS drug classes.DesignCross-sectional study.SettingEnglish Longitudinal Study of Ageing (wave 6).Participants7730 participants (≥50 years).Main outcome measuresAdjusted Odds Ratios (OR) and 95% confidence intervals (CI) for CNS drug classes.Results31% of the sample were currently taking ≥5 medications (polypharmacy), of whom 58% (n=1362/2356) were taking CNS medicines as part of their regimen. The most common CNS drug classes in polypharmacy regimens were non-opioid analgesics, opioid analgesics, tricyclic and related antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs) (34.6%, 13.2%, 10.9% and 10.4%, respectively). Compared with people currently taking 1–4 prescribed medicines, polypharmacy was associated with adjusted ORs of 5.71 (95% CI: 4.29 to 7.61, p<0.01) for opioid analgesics, 3.80 (95% CI: 3.25 to 4.44, p<0.01) for non-opioid analgesics, 3.11 (95% CI: 2.43 to 3.98, p<0.01) for TCAs and 2.30 (95% CI: 1.83 to 2.89, p<0.01) for SSRIs. Lower wealth was also associated with the aforementioned CNS drug classes.ConclusionOpioid and non-opioid analgesics were the most prevalent classes of CNS medicines in this study. Polypharmacy is strongly associated with the aforementioned classes of analgesics. Polypharmacy is also associated with TCAs and SSRIs, although to a lesser extent than for analgesics. For all CNS medicine classes, polypharmacy may need to be considered in relation to reducing the risk of potential adverse events. After adjustment, lower wealth is associated particularly with analgesics, highlighting that socioeconomic factors may play a role in the prescribing of CNS medicines. These findings provide a baseline for future research into this area.

show abstract

Time trends in 20 years of medication use in older adults: Findings from three elderly cohorts in Stockholm, Sweden

Cited by 32 publications

References 44 publications

Changes in prevalence of psychotropic drug use and alcohol consumption among the elderly in Germany: results of two National Health Interview and Examination Surveys 1997-99 and 2008-11

Changes in prevalence of psychotropic drug use and alcohol consumption among the elderly in Germany: results of two National Health Interview and Examination Surveys 1997-99 and 2008-11

Prescription Changes During Geriatric Care Episodes: A Trend Analysis Conducted in Sweden

Central nervous system (CNS) medications and polypharmacy in later life: cross-sectional analysis of the English Longitudinal Study of Ageing (ELSA)

Contact Info

Product

Resources

About