Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study
Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845). The prevalence of po...
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| description | Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845).
The prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2-4, 5-9 and ≥10 medicines-so-called 'no polypharmacy', 'monotherapy', 'minor polypharmacy', 'polypharmacy' and 'hyperpolypharmacy.' Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5-90.5). Participant characteristics were examined through descriptive statistics.
Complex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4-8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people ( |
| doi_str_mv | 10.1371/journal.pone.0245648 |
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The prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2-4, 5-9 and ≥10 medicines-so-called 'no polypharmacy', 'monotherapy', 'minor polypharmacy', 'polypharmacy' and 'hyperpolypharmacy.' Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5-90.5). Participant characteristics were examined through descriptive statistics.
Complex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4-8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people (<25th centile Index of Multiple Deprivation (IMD)), despite no difference in the prevalence of cardiovascular disease (p = 0.56) and diabetes (p = 0.92) by IMD.
Considering their complex medical conditions, prescribing is relatively conservative amongst 85-year-olds living in North East England. Prescribing shows significant gender and selected socioeconomic differences. More support for managing preventative medicines, of uncertain benefit, might be helpful in this population.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0245648</identifier><identifier>PMID: 33465141</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Activities of daily living ; Aged ; Aged, 80 and over ; Analgesics ; Analgesics, Non-Narcotic - therapeutic use ; Anti-inflammatory agents ; Antidepressants ; Antidepressive Agents - therapeutic use ; Arthritis ; Beta blockers ; Biology and Life Sciences ; Bisphosphonates ; Calcium ; Calcium channel blockers ; Cardiovascular diseases ; Cardiovascular Diseases - prevention & control ; Cohort Studies ; Demography ; Diabetes mellitus ; Diphosphonates - therapeutic use ; Disease ; Diuretics ; Drug Prescriptions - statistics & numerical data ; Drug therapy ; Editing ; England ; Factor Xa Inhibitors - therapeutic use ; Female ; Gender differences ; Health sciences ; Humans ; Hypertension ; Inappropriate Prescribing - statistics & numerical data ; Inflammation ; Inhibitors ; Male ; Medicine and Health Sciences ; Methodology ; Multimorbidity ; Narcotics ; Nitrates - therapeutic use ; Nonsteroidal anti-inflammatory drugs ; Opioids ; Polypharmacy ; Population ; Prevalence ; Preventive Medicine - statistics & numerical data ; Prospective Studies ; Psychotropic drugs ; Reviews ; Serotonin ; Serotonin uptake inhibitors ; Sociodemographics ; Socioeconomic Factors ; Sodium Potassium Chloride Symporter Inhibitors - therapeutic use ; Statins ; Thiazides ; Vitamin D ; Womens health</subject><ispartof>PloS one, 2021-01, Vol.16 (1), p.e0245648</ispartof><rights>COPYRIGHT 2021 Public Library of Science</rights><rights>2021 Davies et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2021 Davies et al 2021 Davies et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c692t-7f28556df2d8b70654fa54c7d2067d358c8e2d9dd682de9103268b3dc17b87003</citedby><cites>FETCH-LOGICAL-c692t-7f28556df2d8b70654fa54c7d2067d358c8e2d9dd682de9103268b3dc17b87003</cites><orcidid>0000-0003-4931-3270</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815158/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7815158/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79472,79473</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33465141$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Suemoto, Claudia K.</contributor><creatorcontrib>Davies, Laurie E</creatorcontrib><creatorcontrib>Kingston, Andrew</creatorcontrib><creatorcontrib>Todd, Adam</creatorcontrib><creatorcontrib>Hanratty, Barbara</creatorcontrib><title>Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845).
The prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2-4, 5-9 and ≥10 medicines-so-called 'no polypharmacy', 'monotherapy', 'minor polypharmacy', 'polypharmacy' and 'hyperpolypharmacy.' Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5-90.5). Participant characteristics were examined through descriptive statistics.
Complex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4-8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people (<25th centile Index of Multiple Deprivation (IMD)), despite no difference in the prevalence of cardiovascular disease (p = 0.56) and diabetes (p = 0.92) by IMD.
Considering their complex medical conditions, prescribing is relatively conservative amongst 85-year-olds living in North East England. Prescribing shows significant gender and selected socioeconomic differences. 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therapeutic use</subject><subject>Female</subject><subject>Gender differences</subject><subject>Health sciences</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Inappropriate Prescribing - statistics & numerical data</subject><subject>Inflammation</subject><subject>Inhibitors</subject><subject>Male</subject><subject>Medicine and Health Sciences</subject><subject>Methodology</subject><subject>Multimorbidity</subject><subject>Narcotics</subject><subject>Nitrates - therapeutic use</subject><subject>Nonsteroidal anti-inflammatory drugs</subject><subject>Opioids</subject><subject>Polypharmacy</subject><subject>Population</subject><subject>Prevalence</subject><subject>Preventive Medicine - statistics & numerical data</subject><subject>Prospective Studies</subject><subject>Psychotropic drugs</subject><subject>Reviews</subject><subject>Serotonin</subject><subject>Serotonin uptake inhibitors</subject><subject>Sociodemographics</subject><subject>Socioeconomic Factors</subject><subject>Sodium Potassium Chloride Symporter Inhibitors - 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therapeutic use</topic><topic>Anti-inflammatory agents</topic><topic>Antidepressants</topic><topic>Antidepressive Agents - therapeutic use</topic><topic>Arthritis</topic><topic>Beta blockers</topic><topic>Biology and Life Sciences</topic><topic>Bisphosphonates</topic><topic>Calcium</topic><topic>Calcium channel blockers</topic><topic>Cardiovascular diseases</topic><topic>Cardiovascular Diseases - prevention & control</topic><topic>Cohort Studies</topic><topic>Demography</topic><topic>Diabetes mellitus</topic><topic>Diphosphonates - therapeutic use</topic><topic>Disease</topic><topic>Diuretics</topic><topic>Drug Prescriptions - statistics & numerical data</topic><topic>Drug therapy</topic><topic>Editing</topic><topic>England</topic><topic>Factor Xa Inhibitors - therapeutic use</topic><topic>Female</topic><topic>Gender differences</topic><topic>Health sciences</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Inappropriate Prescribing - statistics & numerical data</topic><topic>Inflammation</topic><topic>Inhibitors</topic><topic>Male</topic><topic>Medicine and Health Sciences</topic><topic>Methodology</topic><topic>Multimorbidity</topic><topic>Narcotics</topic><topic>Nitrates - 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We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845).
The prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2-4, 5-9 and ≥10 medicines-so-called 'no polypharmacy', 'monotherapy', 'minor polypharmacy', 'polypharmacy' and 'hyperpolypharmacy.' Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5-90.5). Participant characteristics were examined through descriptive statistics.
Complex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4-8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people (<25th centile Index of Multiple Deprivation (IMD)), despite no difference in the prevalence of cardiovascular disease (p = 0.56) and diabetes (p = 0.92) by IMD.
Considering their complex medical conditions, prescribing is relatively conservative amongst 85-year-olds living in North East England. Prescribing shows significant gender and selected socioeconomic differences. More support for managing preventative medicines, of uncertain benefit, might be helpful in this population.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>33465141</pmid><doi>10.1371/journal.pone.0245648</doi><tpages>e0245648</tpages><orcidid>https://orcid.org/0000-0003-4931-3270</orcidid><oa>free_for_read</oa></addata></record> |
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| identifier | ISSN: 1932-6203 |
| ispartof | PloS one, 2021-01, Vol.16 (1), p.e0245648 |
| issn | 1932-6203 1932-6203 |
| language | eng |
| recordid | cdi_plos_journals_2479032269 |
| source | MEDLINE; DOAJ Directory of Open Access Journals; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Public Library of Science (PLoS); PubMed Central; Free Full-Text Journals in Chemistry |
| subjects | Activities of daily living Aged Aged, 80 and over Analgesics Analgesics, Non-Narcotic - therapeutic use Anti-inflammatory agents Antidepressants Antidepressive Agents - therapeutic use Arthritis Beta blockers Biology and Life Sciences Bisphosphonates Calcium Calcium channel blockers Cardiovascular diseases Cardiovascular Diseases - prevention & control Cohort Studies Demography Diabetes mellitus Diphosphonates - therapeutic use Disease Diuretics Drug Prescriptions - statistics & numerical data Drug therapy Editing England Factor Xa Inhibitors - therapeutic use Female Gender differences Health sciences Humans Hypertension Inappropriate Prescribing - statistics & numerical data Inflammation Inhibitors Male Medicine and Health Sciences Methodology Multimorbidity Narcotics Nitrates - therapeutic use Nonsteroidal anti-inflammatory drugs Opioids Polypharmacy Population Prevalence Preventive Medicine - statistics & numerical data Prospective Studies Psychotropic drugs Reviews Serotonin Serotonin uptake inhibitors Sociodemographics Socioeconomic Factors Sodium Potassium Chloride Symporter Inhibitors - therapeutic use Statins Thiazides Vitamin D Womens health |
| title | Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-08T02%3A07%3A05IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-gale_plos_&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Characterising%20polypharmacy%20in%20the%20very%20old:%20Findings%20from%20the%20Newcastle%2085+%20Study&rft.jtitle=PloS%20one&rft.au=Davies,%20Laurie%20E&rft.date=2021-01-19&rft.volume=16&rft.issue=1&rft.spage=e0245648&rft.pages=e0245648-&rft.issn=1932-6203&rft.eissn=1932-6203&rft_id=info:doi/10.1371/journal.pone.0245648&rft_dat=%3Cgale_plos_%3EA649078806%3C/gale_plos_%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2479032269&rft_id=info:pmid/33465141&rft_galeid=A649078806&rft_doaj_id=oai_doaj_org_article_b6351e20e88341c087f013efec640f4a&rfr_iscdi=true |