Use of medications and polypharmacy are increasing among the elderly

Linjakumpu, Tarja; Hartikainen, Sirpa; Klaukka, Timo; Veijola, Juha; Kivelä, Sirkka‐Liisa; Isoaho, Raimo

doi:10.1016/s0895-4356(02)00411-0

Cited by 411 publications

(394 citation statements)

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“…This variable was categorized into two groups: taking fewer than fi ve medications; taking fi ve or more medications (classifi ed as polypharmacy). 12 Medications taken were classified as: prescribed (prescribed by a doctor, including repeat prescriptions authorized by a nurse); non-prescribed (taken on the individual's own initiative, or recommended by a third party, not of the medical profession); medications unsafe for use by the elderly (should be avoided irrespective of INTRODUCTION dose, duration of treatment or clinical circumstances, either because ineffective or because they present an unacceptably high risk for the elderly -risk exceeds benefi t -according to the Beers-Fick criteria). 6 Independent variables included: socio-demographic characteristics (age, sex, schooling -in completed years, marital status, family arrangements and monthly income -in national minimum wage at time of writing); health (perception of own health; self-reported chronic illness); 11 health related behavior (doing physical activity); use of health care services (number of doctor's appointments in the last 12 months); nutritional state (Body Mass Index, classifi ed according to the cutoff points adopted by Lipschitz).…”

Section: Methodsmentioning

confidence: 99%

“…In this study, polypharmacy is defi ned as taking fi ve or more medications simultaneously. 12 Polypharmacy linked to physiological and clinical conditions which are specifi c to the elderly makes taking medication a cause of concern for the health care sector. 8,9,21,26 It is important to understand this population's patterns of medication use in order to establish rational use, improve quality of life and maintain functional capacity.…”

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confidence: 99%

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Epidemiologia do uso de medicamentos entre idosos em area urbana do Nordeste do Brasil

et al. 2013

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OBJECTIVE:To analyze medication use and associated factors among the elderly. METHODS:A population-based cross-sectional study was carried out with a sample of 400 elderly people aged over 60 living in the urban area covered by the Family Health Strategy program in Recife, Northeastern Brazil in 2009. Individuals were selected by systematic random sampling and household data were collected. Demographic, socio-economic, lifestyle factors including nutrition practices and health variables were evaluated. Medication use was the independent variable. Univariate and multivariate statistical analysis were performed. RESULTS:The prevalence of medication use was 85.5%. Polypharmacy (> 5 drugs) occurred in 11% of cases. Of the 951 drugs reported, 98.2% were prescribed by doctors and 21.6% were considered unsafe for the elderly. The most commonly prescribed groups were: cardiovascular drugs (42.9%), central nervous system agents (20.2%) and drugs with an effect on the digestive tract and metabolism (17.3%). The use of polypharmacy was associated with education (p = 0.008), self-reported health (p = 0.012), self-reported chronic disease (p = 0.000) and the number of doctor appointments per year (0.000). CONCLUSIONS:The results of this study indicate a high proportion of medication use among the elderly, including of those considered unsuitable, and inequality among groups of elderly individuals regarding the use ofmedication, when education, number of doctor appointments and self-reported health are considered .

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Section: Methodsmentioning

confidence: 99%

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confidence: 99%

Epidemiologia do uso de medicamentos entre idosos em area urbana do Nordeste do Brasil

et al. 2013

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“…22 Multiple use of medications is more frequent among elderly people, 1 because of the high prevalence of chronic diseases during this phase of life. 2 In developed countries, population-based pharmacoepidemiological studies have shown that, among elderly people, the number of chronic diseases, 7,8,25 healthcare service usage, 7,8 being female 14 and being at a more advanced age 8,14 are related to multiple use of medications. In Brazil, a study carried out among elderly people living in the metropolitan region of Belo Horizonte 16 showed that there were signifi cant independent associations between the consumption of three or more medications and female sex, older age group (80 years or over), having at least one chronic disease and having three or more medical consultations over the last 12 months.…”

Section: Methodsmentioning

confidence: 99%

“…7,8,14 The basis for this defi nition is solely quantitative and it does not take into account the clinical pertinence of the use of these medications (for example, the presence of multiple diseases) or the adequacy of the proposed therapeutic regimen. 21 In addition to comorbidity, the factors implicated in the genesis of polypharmacy include the number of doctors consulted, absence of questions during consultations concerning the medications in use and self-medication.…”

Section: Introductionmentioning

confidence: 99%

Influência da renda na associação entre disfunção cognitiva e polifarmácia: Projeto Bambuí

et al. 2008

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OBJECTIVE:To evaluate the prevalence of polypharmacy and the infl uence of income on the association between medication use and cognitive impairment among elderly people. METHODS:Out of the 1,606 baseline members of the Bambuí cohort of elderly people, which started in 1997, 1,554 took part in the study. The MiniMental State Examination was applied to all the participants. The association between cognitive impairment and polypharmacy was tested by means of multivariate ordinal regression, performed for the whole population and for each of the income strata. RESULTS:The prevalence of polypharmacy (two or more medications consumed) was 70.4% and the number of medications used presented an independent negative association with cognitive impairment (OR=0.72; 95% CI: 0.55;0.95). When this was stratifi ed according to personal income (<2 minimum monthly salaries versus > 2 minimum monthly salaries), a negative association was observed between medication use and cognitive impairment among elderly people with lower income (OR=0.64; 95% CI: 0.48;0.86), but not among those with higher income (OR=1.74; 95% CI: 0.81;3.74). CONCLUSIONS:With regard to the association between cognitive impairment and number of medications consumed, the results indicate social inequality in the use of medications. It is possible that these elderly people are not consuming the medicines needed for appropriate treatment of their health problems.

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“…However, the literature supports that many of these comorbidities have in fact increased in prevalence over time. [58][59][60] Our study is also limited by the administrative nature of the data set; it does not include laboratory values or physiological variables. Thus, we are not able to directly link patients to their pharmaceutical treatments or bone densitometry.…”

Section: Commentmentioning

confidence: 99%

Incidence and Mortality of Hip Fractures in the United States

&NA;

2010

Survey of Anesthesiology

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Context-Understanding the incidence and subsequent mortality following hip fracture is essential to measuring population health and the value of improvements in health care.Objective-To examine trends in hip fracture incidence and resulting mortality over 20 years in the US Medicare population. Main Outcome Measures-Age-and sex-specific incidence of hip fracture and age-and riskadjusted mortality rates. ©2009 American Medical Association. All rights reserved.Corresponding Author: Carmen A. Brauer, MD, MSc, FRCSC, Division of Orthopedic Surgery, University of Calgary, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, AB, Canada T3B 6A8 (carmen.brauer@albertahealthservices.ca). Financial Disclosures: None reported.Disclaimer: This research was performed at the National Bureau of Economic Research, Cambridge, Massachusetts.Additional Information: eTables 1 through 3 are available at http://www.jama.com. Additional Contributions:We thank Douglas M. Norton, BA, a research assistant at the National Bureau of Economic Research, for help with the initial data analysis. He received no compensation for his help.Author Contributions: Dr Brauer had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Role of the Sponsor:The supporters had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. Conclusion-In the United States, hip fracture rates and subsequent mortality among persons 65 years and older are declining, and comorbidities among patients with hip fractures have increased. HHS Public AccessThe Number of Hip Fractures occurring in the United States and the resulting postsurgical outcome are a major public health concern. About 30% of people with a hip fracture will die in the following year, 1-3 and many more will experience significant functional loss. [4][5][6][7] The long-term consequences may be great as well. Some studies have shown excess long-term mortality even 10 years after an episode, [8][9][10][11][12] although other studies have only shown moderate increases in mortality. [13][14][15][16][17] Treating hip fractures is also very expensive. A typical patient with a hip fracture spends US $40 000 in the first year following hip fracture for direct medical costs and almost $5000 in subsequent years. 1,[18][19][20] Despite recent literature indicating that the hip fracture incidence may be stabilizing or decreasing, 21-29 concern still exists that because of the aging of the population, the hip fracture incidence will increase worldwide unless additional steps are taken. 7,19,20,22,[30][31][32][33][34][35] Understanding the incidence and postsurgical outcome of hip fractures is a vital first step in improving population health. Our primary objective was to assess trends in the age-and sexspecific incidence and subsequent age-and risk-adjusted mortality of hip fractures among elderly indivi...

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Use of medications and polypharmacy are increasing among the elderly

Cited by 411 publications

References 21 publications

Epidemiologia do uso de medicamentos entre idosos em area urbana do Nordeste do Brasil

Epidemiologia do uso de medicamentos entre idosos em area urbana do Nordeste do Brasil

Influência da renda na associação entre disfunção cognitiva e polifarmácia: Projeto Bambuí

Incidence and Mortality of Hip Fractures in the United States

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