Utilization and Spending on Potentially Inappropriate Medications by US Older Adults with Multiple Chronic Conditions using Multiple Medications.

Jungo, Katharina Tabea; Streit, Sven; Lauffenburger, Julie C (2020). Utilization and Spending on Potentially Inappropriate Medications by US Older Adults with Multiple Chronic Conditions using Multiple Medications. Archives of gerontology and geriatrics, 93, p. 104326. Elsevier 10.1016/j.archger.2020.104326

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BACKGROUND

The utilization of potentially inappropriate medications (PIMs) in older adults can lead to adverse events and increased healthcare costs. Polypharmacy, the concurrent utilization of multiple medications, is common in older adults with multiple chronic conditions.

OBJECTIVE

To investigate the utilization and costs of PIMs in multimorbid older adults with polypharmacy over time.

METHODS

This retrospective cross-sectional study used linked Medicare claims and electronic health records from seven hospitals/medical centers in Massachusetts (2007-2014). Participants were ≥65 years old, had ≥2 chronic conditions (to define multimorbidity), and used drugs from ≥5 pharmaceutical classes for ≥90 days (to define polypharmacy). Chronic conditions were defined using the Chronic Conditions Indicator from the Agency for Health Research and Quality. PIMs were defined using the American Geriatrics Society 2019 version of the Beers criteria. We calculated the percentage of patients with ≥1 PIMs and the percentages of patients using different types of PIMs. We used logistic regression analyses to test the odds of taking ≥1 PIMs. We calculated mean costs spent on PIMs by dividing the costs spent on PIMs by the total medication cost.

RESULTS

≥69% of patients used ≥1 PIM. After adjusting for healthcare utilization, chronic conditions, medication intake, and demographic factors, female sex (2014: Odds ratio (OR)=1.27, 95%CI 1.25-1.30), age (2014: OR=0.92, 95%CI 0.90-0.93), and Hispanic ethnicity (2014: OR=1.41, 95%CI 1.27-1.56) were associated with PIM use. Gastrointestinal drugs and central nervous system drugs were the most commonly-used PIMs. In patients using ≥1 PIM, >10% of medication costs were spent on PIMs.

CONCLUSION

The utilization of PIMs in US older adults with multimorbidity and polypharmacy is high.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

Graduate School:

Graduate School for Health Sciences (GHS)

UniBE Contributor:

Jungo, Katharina Tabea and Streit, Sven

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0167-4943

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

11 Feb 2021 09:57

Last Modified:

13 Mar 2021 20:42

Publisher DOI:

10.1016/j.archger.2020.104326

PubMed ID:

33516154

Uncontrolled Keywords:

Potentially inappropriate medication use multimorbidity older adults polypharmacy

BORIS DOI:

10.48350/152147

URI:

https://boris.unibe.ch/id/eprint/152147

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