A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study

Abstract

Polypharmacy is commonly defined based on the number of medications taken concurrently using standard cut-offs, but several studies have highlighted the need for a multidimensional assessment. We developed a multidimensional measure of polypharmacy and compared with standard cut-offs. Data were extracted for 2141 respondents of the 2007 Prescription Drug Survey, a sub-study of the Health Retirement Study. Latent classes were identified based on multiple indicators of polypharmacy, including quantity, temporality and risk profile. A four-class model was selected based on fit statistics and clinical interpretability: ‘High risk, long-term’ (Class 1), ‘Low risk, long-term’ (Class 2), ‘High risk, short-term’ (Class 3), and ‘High risk for drug interactions, medium-term, regular’ (Class 4). Classes differed regarding sex, cohabitation, disability and multimorbidity. Participants in the ‘low risk’ class tended to be male, cohabitating, and reported fewer health conditions, compared to ‘high risk’ classes. Polypharmacy classes were compared to standard cut-offs (5+ or 9+ medications) in terms of overlap and mortality risk. The three ‘high risk’ classes overlapped with the groups concurrently taking 5+ and 9+ medications per month. However, the multidimensional measure further differentiated individuals in terms of risk profile and temporality of medication taking, thus offering a richer assessment of polypharmacy.

6ER-039 Pain management: opioid use in hospitals

“…1 N Guillon*, 1 F Lindenberg, 2 P Guérin, 2 J Plessis, 3 A Fresselinat, 2 S Quéric, 3 A Aitgougam, 4 X Iriart, 1,5 J Clouet, 1 D Feldman, 1,5 F Nativel. Background and Importance Patent foramen ovale (PFO) and atrial septal defect (ASD) are heart diseases characterised by persistent communication between the two atria.…”

Unveiling the Burden of Interactions Among Clinical Risk Factors for 1-Year Mortality in Hospitalized Older Patients

“…Low handgrip strength is a dynamic indicator of poor muscle function (10) and the main risk factor for diagnosing sarcopenia (11); it was shown to predict mortality, disability, and physical functioning (12). Finally, medication burden was also associated with increased mortality (13), and exposure to anticholinergic medications is an important predictor of poor outcomes among hospitalized older patients (14)(15)(16)(17).…”