Potentially inappropriate medicines in a cohort of community-dwelling older people in New Zealand

Aim To examine independent factors associated with potentially inappropriate medicines (PIM) among 316 community‐dwelling people aged ≥75 years living in Dunedin. Methods People aged ≥75 years living in the community in Dunedin, New Zealand, taking ≥1 prescription medicines, randomly sampled from th...

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Veröffentlicht in:Geriatrics & gerontology international 2014-01, Vol.14 (1), p.89-93
Hauptverfasser: Nishtala, Prasad S, Bagge, Michael L, Campbell, A John, Tordoff, June M
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container_issue 1
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container_title Geriatrics & gerontology international
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creator Nishtala, Prasad S
Bagge, Michael L
Campbell, A John
Tordoff, June M
description Aim To examine independent factors associated with potentially inappropriate medicines (PIM) among 316 community‐dwelling people aged ≥75 years living in Dunedin. Methods People aged ≥75 years living in the community in Dunedin, New Zealand, taking ≥1 prescription medicines, randomly sampled from the electoral roll, were interviewed about their medicine‐taking practices. A medication inventory comprising prescription and non‐prescription medicines was taken from each participant at the time of the interview. Participants used a median of seven prescription medicines (range 1–19) and one non‐prescription medicine (0–14). PIM were identified using the updated 2012 Beers criteria. Results PIM were identified in 42.7% (n = 135) older people. A total of 23 (7.2%) took two PIM, five (1.5%) took three PIM, four (1.2%) took four PIM and one (0.3%) took five PIM. Of the 184 total PIM identified, the top three drug classes were non‐COX‐selective non‐steroidal anti‐inflammatory drugs (24.0%), tricyclic antidepressants (16.8%) and benzodiazepines (14.6%). Polypharmacy (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.03–4.12) and the use of any psychotropic drug use (OR 22.05, 95% CI 5.80–83.84) were associated with PIM exposure. In the Poisson regression model, the risk of taking a PIM significantly decreased with age (OR 0.95, CI 0.91–0.99) and increased as the number of drugs prescribed increased (OR 1.11, CI 1.08–1.15). Conclusion The prevalence of PIM is relatively high in community‐dwelling older people aged ≥75 years living in New Zealand. PIM defined by the Beers criteria might be a useful initial screening tool, before efforts to stop unsafe medication use or replace with safer alternatives are initiated. Geriatr Gerontol Int 2014; 14: 89–93.
doi_str_mv 10.1111/ggi.12059
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Methods People aged ≥75 years living in the community in Dunedin, New Zealand, taking ≥1 prescription medicines, randomly sampled from the electoral roll, were interviewed about their medicine‐taking practices. A medication inventory comprising prescription and non‐prescription medicines was taken from each participant at the time of the interview. Participants used a median of seven prescription medicines (range 1–19) and one non‐prescription medicine (0–14). PIM were identified using the updated 2012 Beers criteria. Results PIM were identified in 42.7% (n = 135) older people. A total of 23 (7.2%) took two PIM, five (1.5%) took three PIM, four (1.2%) took four PIM and one (0.3%) took five PIM. Of the 184 total PIM identified, the top three drug classes were non‐COX‐selective non‐steroidal anti‐inflammatory drugs (24.0%), tricyclic antidepressants (16.8%) and benzodiazepines (14.6%). Polypharmacy (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.03–4.12) and the use of any psychotropic drug use (OR 22.05, 95% CI 5.80–83.84) were associated with PIM exposure. In the Poisson regression model, the risk of taking a PIM significantly decreased with age (OR 0.95, CI 0.91–0.99) and increased as the number of drugs prescribed increased (OR 1.11, CI 1.08–1.15). Conclusion The prevalence of PIM is relatively high in community‐dwelling older people aged ≥75 years living in New Zealand. PIM defined by the Beers criteria might be a useful initial screening tool, before efforts to stop unsafe medication use or replace with safer alternatives are initiated. Geriatr Gerontol Int 2014; 14: 89–93.</description><identifier>ISSN: 1444-1586</identifier><identifier>EISSN: 1447-0594</identifier><identifier>DOI: 10.1111/ggi.12059</identifier><identifier>PMID: 23530567</identifier><language>eng</language><publisher>Japan: Blackwell Publishing Ltd</publisher><subject>Age ; Aged ; Aged, 80 and over ; Chronic Disease - drug therapy ; Chronic Disease - epidemiology ; Drug Prescriptions - statistics &amp; numerical data ; drugs ; elderly ; Female ; Geriatrics ; Humans ; inappropriate prescribing ; Inappropriate Prescribing - statistics &amp; numerical data ; Male ; Medical screening ; Middle Aged ; New Zealand - epidemiology ; Polypharmacy ; Prescription drugs ; Prevalence ; Retrospective Studies ; Side effects ; Studies</subject><ispartof>Geriatrics &amp; gerontology international, 2014-01, Vol.14 (1), p.89-93</ispartof><rights>2013 Japan Geriatrics Society</rights><rights>2013 Japan Geriatrics Society.</rights><rights>Copyright © 2014 Japan Geriatrics Society</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://onlinelibrary.wiley.com/doi/pdf/10.1111%2Fggi.12059$$EPDF$$P50$$Gwiley$$H</linktopdf><linktohtml>$$Uhttps://onlinelibrary.wiley.com/doi/full/10.1111%2Fggi.12059$$EHTML$$P50$$Gwiley$$H</linktohtml><link.rule.ids>314,780,784,1417,27924,27925,45574,45575</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23530567$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Nishtala, Prasad S</creatorcontrib><creatorcontrib>Bagge, Michael L</creatorcontrib><creatorcontrib>Campbell, A John</creatorcontrib><creatorcontrib>Tordoff, June M</creatorcontrib><title>Potentially inappropriate medicines in a cohort of community-dwelling older people in New Zealand</title><title>Geriatrics &amp; gerontology international</title><addtitle>Geriatrics &amp; Gerontology International</addtitle><description>Aim To examine independent factors associated with potentially inappropriate medicines (PIM) among 316 community‐dwelling people aged ≥75 years living in Dunedin. Methods People aged ≥75 years living in the community in Dunedin, New Zealand, taking ≥1 prescription medicines, randomly sampled from the electoral roll, were interviewed about their medicine‐taking practices. A medication inventory comprising prescription and non‐prescription medicines was taken from each participant at the time of the interview. Participants used a median of seven prescription medicines (range 1–19) and one non‐prescription medicine (0–14). PIM were identified using the updated 2012 Beers criteria. Results PIM were identified in 42.7% (n = 135) older people. A total of 23 (7.2%) took two PIM, five (1.5%) took three PIM, four (1.2%) took four PIM and one (0.3%) took five PIM. Of the 184 total PIM identified, the top three drug classes were non‐COX‐selective non‐steroidal anti‐inflammatory drugs (24.0%), tricyclic antidepressants (16.8%) and benzodiazepines (14.6%). Polypharmacy (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.03–4.12) and the use of any psychotropic drug use (OR 22.05, 95% CI 5.80–83.84) were associated with PIM exposure. In the Poisson regression model, the risk of taking a PIM significantly decreased with age (OR 0.95, CI 0.91–0.99) and increased as the number of drugs prescribed increased (OR 1.11, CI 1.08–1.15). Conclusion The prevalence of PIM is relatively high in community‐dwelling older people aged ≥75 years living in New Zealand. PIM defined by the Beers criteria might be a useful initial screening tool, before efforts to stop unsafe medication use or replace with safer alternatives are initiated. Geriatr Gerontol Int 2014; 14: 89–93.</description><subject>Age</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Chronic Disease - drug therapy</subject><subject>Chronic Disease - epidemiology</subject><subject>Drug Prescriptions - statistics &amp; numerical data</subject><subject>drugs</subject><subject>elderly</subject><subject>Female</subject><subject>Geriatrics</subject><subject>Humans</subject><subject>inappropriate prescribing</subject><subject>Inappropriate Prescribing - statistics &amp; numerical data</subject><subject>Male</subject><subject>Medical screening</subject><subject>Middle Aged</subject><subject>New Zealand - epidemiology</subject><subject>Polypharmacy</subject><subject>Prescription drugs</subject><subject>Prevalence</subject><subject>Retrospective Studies</subject><subject>Side effects</subject><subject>Studies</subject><issn>1444-1586</issn><issn>1447-0594</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2014</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkTtPwzAUhS0EglIY-AMoEgtLiu34EY8IQalUXgKExGI5sVNcnDjkodJ_j2kLAxNefGR_9-recwA4QnCEwjmbzewIYUjFFhggQngcJNleaRIjmrI9sN-2cwgRFwjtgj2c0ARSxgdA3fvOVJ1Vzi0jW6m6bnzdWNWZqDTa5rYybXiPVJT7N990kS-CKsu-st0y1gvjnK1mkXfaNFFtfO3MN35rFtGrUU5V-gDsFMq15nBzD8Hz1eXTxXU8vRtPLs6nsU04EbFWRKO00KwQiue4YClmGTeoQFQnOsuylHCsRCryouAZyQVJCckIw5RngiqWDMHpum_Y4KM3bSdL2-ZhPlUZ37cSEcFSISCG_0EhxwlOk4Ce_EHnvm-qsEigOMMIUSICdbyh-izYJoODpWqW8sfnAJytgYV1Zvn7j6D8DlCGAOUqQDkeT1YiVMTrCtt25vO3QjXvMvTjVL7cjiWBN_CRkgdJky8E55uQ</recordid><startdate>201401</startdate><enddate>201401</enddate><creator>Nishtala, Prasad S</creator><creator>Bagge, Michael L</creator><creator>Campbell, A John</creator><creator>Tordoff, June M</creator><general>Blackwell Publishing Ltd</general><scope>BSCLL</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>K9.</scope><scope>7X8</scope><scope>7U1</scope><scope>7U2</scope><scope>C1K</scope></search><sort><creationdate>201401</creationdate><title>Potentially inappropriate medicines in a cohort of community-dwelling older people in New Zealand</title><author>Nishtala, Prasad S ; Bagge, Michael L ; Campbell, A John ; Tordoff, June M</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-i3749-da4d18fd6f9a7c2f6826b7e1f15d3dbbb8472a989cff7b4c94844b46257b95a63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2014</creationdate><topic>Age</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Chronic Disease - drug therapy</topic><topic>Chronic Disease - epidemiology</topic><topic>Drug Prescriptions - statistics &amp; numerical data</topic><topic>drugs</topic><topic>elderly</topic><topic>Female</topic><topic>Geriatrics</topic><topic>Humans</topic><topic>inappropriate prescribing</topic><topic>Inappropriate Prescribing - statistics &amp; numerical data</topic><topic>Male</topic><topic>Medical screening</topic><topic>Middle Aged</topic><topic>New Zealand - epidemiology</topic><topic>Polypharmacy</topic><topic>Prescription drugs</topic><topic>Prevalence</topic><topic>Retrospective Studies</topic><topic>Side effects</topic><topic>Studies</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Nishtala, Prasad S</creatorcontrib><creatorcontrib>Bagge, Michael L</creatorcontrib><creatorcontrib>Campbell, A John</creatorcontrib><creatorcontrib>Tordoff, June M</creatorcontrib><collection>Istex</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>ProQuest Health &amp; Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>Risk Abstracts</collection><collection>Safety Science and Risk</collection><collection>Environmental Sciences and Pollution Management</collection><jtitle>Geriatrics &amp; gerontology international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Nishtala, Prasad S</au><au>Bagge, Michael L</au><au>Campbell, A John</au><au>Tordoff, June M</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Potentially inappropriate medicines in a cohort of community-dwelling older people in New Zealand</atitle><jtitle>Geriatrics &amp; gerontology international</jtitle><addtitle>Geriatrics &amp; Gerontology International</addtitle><date>2014-01</date><risdate>2014</risdate><volume>14</volume><issue>1</issue><spage>89</spage><epage>93</epage><pages>89-93</pages><issn>1444-1586</issn><eissn>1447-0594</eissn><abstract>Aim To examine independent factors associated with potentially inappropriate medicines (PIM) among 316 community‐dwelling people aged ≥75 years living in Dunedin. Methods People aged ≥75 years living in the community in Dunedin, New Zealand, taking ≥1 prescription medicines, randomly sampled from the electoral roll, were interviewed about their medicine‐taking practices. A medication inventory comprising prescription and non‐prescription medicines was taken from each participant at the time of the interview. Participants used a median of seven prescription medicines (range 1–19) and one non‐prescription medicine (0–14). PIM were identified using the updated 2012 Beers criteria. Results PIM were identified in 42.7% (n = 135) older people. A total of 23 (7.2%) took two PIM, five (1.5%) took three PIM, four (1.2%) took four PIM and one (0.3%) took five PIM. Of the 184 total PIM identified, the top three drug classes were non‐COX‐selective non‐steroidal anti‐inflammatory drugs (24.0%), tricyclic antidepressants (16.8%) and benzodiazepines (14.6%). Polypharmacy (adjusted odds ratio [OR] 2.06, 95% confidence interval [CI] 1.03–4.12) and the use of any psychotropic drug use (OR 22.05, 95% CI 5.80–83.84) were associated with PIM exposure. In the Poisson regression model, the risk of taking a PIM significantly decreased with age (OR 0.95, CI 0.91–0.99) and increased as the number of drugs prescribed increased (OR 1.11, CI 1.08–1.15). Conclusion The prevalence of PIM is relatively high in community‐dwelling older people aged ≥75 years living in New Zealand. PIM defined by the Beers criteria might be a useful initial screening tool, before efforts to stop unsafe medication use or replace with safer alternatives are initiated. Geriatr Gerontol Int 2014; 14: 89–93.</abstract><cop>Japan</cop><pub>Blackwell Publishing Ltd</pub><pmid>23530567</pmid><doi>10.1111/ggi.12059</doi><tpages>5</tpages></addata></record>
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subjects Age
Aged
Aged, 80 and over
Chronic Disease - drug therapy
Chronic Disease - epidemiology
Drug Prescriptions - statistics & numerical data
drugs
elderly
Female
Geriatrics
Humans
inappropriate prescribing
Inappropriate Prescribing - statistics & numerical data
Male
Medical screening
Middle Aged
New Zealand - epidemiology
Polypharmacy
Prescription drugs
Prevalence
Retrospective Studies
Side effects
Studies
title Potentially inappropriate medicines in a cohort of community-dwelling older people in New Zealand
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