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Use of potentially inappropriate medication and polypharmacy in older adults : a repeated cross-sectional study

Thorell, Kristine LU ; Midlöv, Patrik LU ; Fastbom, Johan and Halling, Anders LU (2020) In BMC Geriatrics 20(1).
Abstract

BACKGROUND: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time.

METHODS: This is a registry-based... (More)

BACKGROUND: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time.

METHODS: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15,361 individuals) or on the 31st December 2013 (cohort 2, 15,945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy.

RESULTS: Use of PIM decreased from 10.60 to 7.04% (p-value < 0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55 to 23.66% (p-value < 0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80-84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables.

CONCLUSIONS: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.

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author
; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
BMC Geriatrics
volume
20
issue
1
article number
73
publisher
BioMed Central (BMC)
external identifiers
  • pmid:32075586
  • scopus:85079767642
ISSN
1471-2318
DOI
10.1186/s12877-020-1476-5
language
English
LU publication?
yes
id
cc1385a4-9460-4e91-b413-fd3a97dffef6
date added to LUP
2020-02-23 20:56:03
date last changed
2021-04-27 02:07:04
@article{cc1385a4-9460-4e91-b413-fd3a97dffef6,
  abstract     = {<p>BACKGROUND: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time.</p><p>METHODS: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15,361 individuals) or on the 31st December 2013 (cohort 2, 15,945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy.</p><p>RESULTS: Use of PIM decreased from 10.60 to 7.04% (p-value &lt; 0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55 to 23.66% (p-value &lt; 0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80-84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables.</p><p>CONCLUSIONS: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.</p>},
  author       = {Thorell, Kristine and Midlöv, Patrik and Fastbom, Johan and Halling, Anders},
  issn         = {1471-2318},
  language     = {eng},
  month        = {02},
  number       = {1},
  publisher    = {BioMed Central (BMC)},
  series       = {BMC Geriatrics},
  title        = {Use of potentially inappropriate medication and polypharmacy in older adults : a repeated cross-sectional study},
  url          = {http://dx.doi.org/10.1186/s12877-020-1476-5},
  doi          = {10.1186/s12877-020-1476-5},
  volume       = {20},
  year         = {2020},
}