Journal article
Prescription Medication Use in Older Adults Without Major Cardiovascular Disease Enrolled in the Aspirin in Reducing Events in the Elderly (ASPREE) Clinical Trial
Pharmacotherapy, Vol.40(10), pp.1042-1053
10/2020
DOI: 10.1002/phar.2461
PMCID: PMC7957955
PMID: 33078479
Abstract
Background
Efforts to minimize medication risks among older adults include avoidance of potentially inappropriate medications. Contemporary analysis of medication use in community-dwelling older people compared with the general population is lacking.
Participants
A total of 19,114 community-dwelling adults in Australia and the United States aged 70 years or older (65 years or older for U.S. minorities) without histories of major cardiovascular disease, cognitive impairment, or disability participated in a randomized, placebo-controlled trial of aspirin: ASPirin in Reducing Events in the Elderly study.
2.1 Measurements
Prescribed baseline medications obtained by self-report and medical record review were grouped by World Health Organization Anatomic and Therapeutic Chemical category. Potentially inappropriate medications were defined using a modified American Geriatrics Society Beers Criteria. Polypharmacy was defined as 5 or more medications, and hyperpolypharmacy defined as 10 or more medications. Cross-sectional descriptive statistics and adjusted odds ratios were computed.
Results
The median number of prescription medications per participant was three, regardless of age. Women had a higher medication prevalence. Cardiovascular drugs (primarily antihypertensives) were the most commonly reported (64%). Overall, 39% of the cohort reported taking at least one potentially inappropriate medication, with proton-pump inhibitors being the most commonly reported (21.2% of cohort). Of the cohort, 27% had polypharmacy, and 2% hyperpolypharmacy. Age 75 years or older, less than 12 years of education, hypertension, diabetes mellitus, chronic kidney disease, frailty, gastrointestinal complaint, and depressive symptoms were associated with an increased likelihood of potentially inappropriate medications and polypharmacy. For almost all medication classes, prevalence was equivalent or lower than the general older population.
Conclusion
Overall medication burden and polypharmacy are low in older adults free of major cardiovascular disease, disability, and cognitive impairment. The prevalence of potentially inappropriate medications is higher than previously reported and similar to more vulnerable populations as a result of the introduction of proton-pump inhibitors to the American Geriatrics Society Beers Criteria. Longitudinal follow-up is required to further understand the balance of benefits and risks for potentially inappropriate medications and polypharmacy in community-dwelling older people.
Details
- Title: Subtitle
- Prescription Medication Use in Older Adults Without Major Cardiovascular Disease Enrolled in the Aspirin in Reducing Events in the Elderly (ASPREE) Clinical Trial
- Creators
- Jessica E. Lockery - Monash UniversityMichael E. Ernst - University of IowaJonathan C. Broder - Monash UniversitySuzanne G. Orchard - Monash UniversityAnne Murray - Hennepin Healthcare Research InstituteMark R. Nelson - University of TasmaniaNigel P. Stocks - The University of AdelaideRory Wolfe - Monash UniversityChristopher M. Reid - Monash UniversityDanny Liew - Monash UniversityRobyn L. Woods - Monash UniversityASPREE Investigator Group
- Resource Type
- Journal article
- Publication Details
- Pharmacotherapy, Vol.40(10), pp.1042-1053
- DOI
- 10.1002/phar.2461
- PMID
- 33078479
- PMCID
- PMC7957955
- NLM abbreviation
- Pharmacotherapy
- ISSN
- 0277-0008
- eISSN
- 1875-9114
- Grant note
- DOI: 10.13039/100000049, name: National Institute on Aging, award: U01AG029824
- Language
- English
- Date published
- 10/2020
- Academic Unit
- Family and Community Medicine; Pharmacy Practice and Science
- Record Identifier
- 9984297442702771
Metrics
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