Socio-demographic differences in polypharmacy and potentially inappropriate drug use among older people with different care needs and in care settings in Stockholm, Sweden

Doheny, Megan; Schön, Pär; Orsini, Nicola; Fastbom, Johan; Burström, Bo; Agerholm, Janne

doi:10.1177/14034948211018384

Cited by 6 publications

(5 citation statements)

References 24 publications

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“…In terms of the most common types of PIM category used, our findings are consistent with those of other studies in that the majority of the elderly patients in this study used potentially inappropriate cardiovascular medications, which were substantially more frequently taken by women than by men. Furthermore, the results of our analysis that women have higher use of a potentially inappropriate prescription is in line with some earlier research that reported a higher prevalence in women compared to men [6,[9][10][11][12][13][14].…”

Section: Discussionsupporting

confidence: 92%

“…Gender disparities have been reported in medication-related utilization and appropriate use of medications, with women at higher risk of potentially inappropriate medications (PIMs) and polypharmacy [ 6 , 9 , 10 , 11 , 12 , 13 , 14 ]. PIMs are defined as “medications that should be avoided due to their risk which outweighs their benefit and when there are equally or more effective but lower risk alternatives are available” [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

“…Few studies have examined sex differences in PIM use among older adults [ 6 , 9 , 10 , 11 , 12 , 13 , 14 ]. For example, using a retrospective cohort study design, Morgan et al evaluated PIM use in 660,679 older adults aged 65 and older.…”

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Alwhaibi

Balkhi

2023

Pharmaceuticals

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Background: Use of potentially inappropriate medication (PIMs) is a prominent concern that leads to significant medication-related issues among older adults. Notably, older women tend to utilize more medicines than men; older women frequently take more drugs. In addition, some evidence suggests that prescription PIMs vary by gender. This study examines the gender-based variation in prescribing PIM among older adults in Saudi Arabia. Methods: A cross-sectional retrospective analysis of electronic medical records from a large hospital in Saudi Arabia was carried out. Patients over the age of 65 who received ambulatory treatment were included in the study. The utilization of PIM was assessed based on Beers criteria. Descriptive statistics and logistic regression were employed to describe patterns of PIM utilization and identify factors associated with their use. All statistical analyses were performed using Version 9.4 of the Statistical Analysis Software (SAS® 9.4). Results: The study comprised 4062 older people (age 65) who visited ambulatory care clinics; the average age was (72.6 ± 6.2) years. The majority of the study sample was women (56.8%). Among older adults, 44.7% of older men and 58.3% of older women reported having PIMs that should be avoided, indicating a higher prevalence of PIMs among women compared to men. In terms of the PIM categories used, women had a much higher utilization rate of cardiovascular and gastrointestinal drugs than men. In men, the use of PIMs was frequently associated with hypertension, ischemic heart disease, asthma, osteoarthritis, and cancer, while in women PIM use was associated with age, dyslipidemia, chronic kidney disease, and osteoporosis. Conclusions: This study revealed sex differences in PIM prescribing among older adults; PIM use is more common among women. Sex differences exist in clinical and socioeconomic characteristics and factors related to using potentially inappropriate medications. This study revealed essential areas that could be targeted by further interventions to improve drug-prescribing practices among older adults at risk of PIM.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

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Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Alwhaibi

Balkhi

2023

Pharmaceuticals

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“…1 Study selection and exclusion according to the PRISMA flow diagram 20-67], 18 studies on income [16, 23, 30, 32-34, 37, 41, 46-48, 50, 53, 61, 63, 64, 66, 68], 6 on wealth [22,27,45,57,67,69], 4 studies on occupation [23,44,48,57], 7 studies on employment [16,17,49,58,60,63,66], 5 studies on social class [17,25,36,38,60], 2 used SES categories [31,70] and 1 used area-level deprivation [20]. Studies were conducted across a range of countries as follow: India [60,66], Jordan [21], Netherlands [70], Sweden [18,23,39,52], Spain [25], Belgium [26,30], Pakistan [29,68], UK [17,20,36,38,69], China [33,44,…”

Section: Study Characteristicsmentioning

confidence: 99%

Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis

et al. 2023

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Background Socioeconomic status (SES) may influence prescribing, concordance and adherence to medication regimens. This review set out to investigate the association between polypharmacy and an individual’s socioeconomic status. Methods A systematic review and meta-analyses of observational studies was conducted across four databases. Older people (≥ 55 years) from any healthcare setting and residing location were included. The search was conducted across four databases: Medline (OVID), Web of Science, Embase (OVID) and CINAHL. Observational studies from 1990 that reported polypharmacy according to SES were included. A random-effects model was undertaken comparing those with polypharmacy (≥ 5 medication usage) with no polypharmacy. Unadjusted odds ratios (ORs), 95% confidence intervals (CIs) and standard errors (SE) were calculated for each study. Results Fifty-four articles from 13,412 hits screened met the inclusion criteria. The measure of SES used were education (50 studies), income (18 studies), wealth (6 studies), occupation (4 studies), employment (7 studies), social class (5 studies), SES categories (2 studies) and deprivation (1 study). Thirteen studies were excluded from the meta-analysis. Lower SES was associated with higher polypharmacy usage: individuals of lower educational backgrounds displayed 21% higher odds to be in receipt of polypharmacy when compared to those of higher education backgrounds. Similar findings were shown for occupation, income, social class, and socioeconomic categories. Conclusions There are socioeconomic inequalities in polypharmacy among older people, with people of lower SES significantly having higher odds of polypharmacy. Future work could examine the reasons for these inequalities and explore the interplay between polypharmacy and multimorbidity.

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“…We also highlight the potential role of less suspected classes, such as serotonin–norepinephrine reuptake inhibitors and incretin mimetics. Polypharmacy notoriously concerns older individuals, therefore increasing their risk of drug-related parosmia [ 59 ]. An iatrogenic etiology should be especially evoked when parosmia occurs in the elderly.…”

Section: Discussionmentioning

confidence: 99%

Drug-Associated Parosmia: New Perspectives from the WHO Safety Database

Merino

Gérard

Thümmler

et al. 2022

JCM

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Parosmia is a qualitative distortion of smell perception. Resulting from central causes, sinonasal diseases, and infections, parosmia has also been associated with medications. Therefore, we aimed to investigate potential signals for drugs associated with parosmia. VigiBase® (the WHO pharmacovigilance database) was queried for all reports of “Parosmia” (MedDRA Preferred Term), registered up to 23 January 2022. Disproportionality analysis relied on the reporting odds ratio and the information component. A signal is detected when the lower end of the 95% confidence interval of the information component is positive. We found 14,032 reports of parosmia, with a median patient age of 53 years. Most reported drugs were antiinfectives, among which COVID-19 vaccines accounted for 27.1% of reports. Antibiotics and corticosteroids were involved in 6.8% and 4.6% of reports. Significant disproportionate reporting was detected for corticosteroids, antibiotics, drugs used in nicotine dependence, COVID-19 and HPV vaccines, serotonin–norepinephrine reuptake inhibitors (SNRI), and incretin mimetics. We suggest potential safety signals involving nicotine replacement therapies and vaccines. We also highlight the potential role of less suspected classes, such as SNRIs and incretin mimetics. An iatrogenic etiology should be evoked when parosmia occurs, especially in the elderly.

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Socio-demographic differences in polypharmacy and potentially inappropriate drug use among older people with different care needs and in care settings in Stockholm, Sweden

Cited by 6 publications

References 24 publications

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Are there socioeconomic inequalities in polypharmacy among older people? A systematic review and meta-analysis

Drug-Associated Parosmia: New Perspectives from the WHO Safety Database

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