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. 2022 Oct;31(10):1056-1074.
doi: 10.1002/pds.5506. Epub 2022 Jul 15.

Potentially inappropriate medication use by level of polypharmacy among US Veterans 49-64 and 65-70 years old

Jordan Guillot  1   2   3   4 , Christopher T Rentsch  1   2   5 , Kirsha S Gordon  1   2 , Amy C Justice  1   2   6 , Julien Bezin  3
Affiliations

Potentially inappropriate medication use by level of polypharmacy among US Veterans 49-64 and 65-70 years old

Jordan Guillot et al. Pharmacoepidemiol Drug Saf. 2022 Oct.

Abstract

Background: Potentially inappropriate medications (PIMs) are medications contra-indicated in particular circumstances. We sought to characterize PIMs by level of polypharmacy by age, sex, and race/ethnicity.

Methods: We performed a cross-sectional drug dispensing study using electronic health records available through the US Department of Veterans Affairs. We extracted pharmacy fill and refill records during fiscal year 2016 (i.e., October 1, 2015-September 30, 2016) for all patients aged 49-70 who accessed care in the preceding fiscal year. PIMs were defined by the combined Beers and Laroche (henceforth Beers Laroche) criteria used for older patients and the PROMPT criteria used for middle-aged.

Results: In the 1 499 586 patients aged 49-64, PIMs prevalence by PROMPT in patients with 0-4, 5-9, and ≥10 medications was 14.0%, 62.2%, and 86.1%, respectively, and by Beers Laroche was 14.3%, 63.4%, and 85.7%, respectively. In the 1 249 119 patients aged 65-70, PIMs prevalence by Beers Laroche was 14.8%, 59.9%, and 83.3%, and by PROMPT was 13.9%, 57.4%, and 82.0%, respectively. Meaningful differences in prevalence were shown by sex and race/ethnicity according to both set of criteria (e.g. PROMPT in patients with 5-9 medications: 66.1% women vs. 59.3% men; standardized-mean-differences [SMD] = 0.14; 61.7% of White vs. 54.5% of non-White; SMD = 0.15). The most common PIMs were digestive, analgesic, antidiabetic, and psychotropic medications.

Conclusion: Prevalence of PIMs was high and increased with polypharmacy. Beers Laroche and PROMPT provided similar estimations inside and outside their target age, suggesting that PIMs are common among those with polypharmacy regardless of age.

Keywords: age; data analysis; drug utilization study; middle-aged; older; pharmacoepidemiology; polypharmacy; population health; potentially inappropriate medications.

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Conflict of interest statement

Conflict of interest: None declared

Figures

Figure 1:
Figure 1:
Definition of exposure to chronic polypharmacy and potentially inappropriate medications (PIMs) in 2016. The exemple presented defined an individuals who is prevalent of PIMs and polypharmacy in 2016 PPI: Proton pump inhibitor; NSAID: Non-steroidal Anti-Inflammatory Drug
See this image and copyright information in PMC

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