Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12

2.50
Hdl Handle:
http://hdl.handle.net/11287/594034
Title:
Any versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12
Authors:
Ble, A.; Masoli, Jane A; Barry, H. E.; Winder, R. E.; Tavakoly, B.; Henley, W. E.; Kuchel, G. A.; Valderas, J. M.; Melzer, D.; Richards, S. H.
Abstract:
BACKGROUND: High risk medications are commonly prescribed to older US patients. Currently, less is known about high risk medication prescribing in other Western Countries, including the UK. We measured trends and correlates of high risk medication prescribing in a subset of the older UK population (community/institutionalized) to inform harm minimization efforts. METHODS: Three cross-sectional samples from primary care electronic clinical records (UK Clinical Practice Research Datalink, CPRD) in fiscal years 2003/04, 2007/08 and 2011/12 were taken. This yielded a sample of 13,900 people aged 65 years or over from 504 UK general practices. High risk medications were defined by 2012 Beers Criteria adapted for the UK. Using descriptive statistical methods and regression modelling, prevalence of 'any' (drugs prescribed at least once per year) and 'long-term' (drugs prescribed all quarters of year) high risk medication prescribing and correlates were determined. RESULTS: While polypharmacy rates have risen sharply, high risk medication prevalence has remained stable across a decade. A third of older (65+) people are exposed to high risk medications, but only half of the total prevalence was long-term (any = 38.4 % [95 % CI: 36.3, 40.5]; long-term = 17.4 % [15.9, 19.9] in 2011/12). Long-term but not any high risk medication exposure was associated with older ages (85 years or over). Women and people with higher polypharmacy burden were at greater risk of exposure; lower socio-economic status was not associated. Ten drugs/drug classes accounted for most of high risk medication prescribing in 2011/12. CONCLUSIONS: High risk medication prescribing has not increased over time against a background of increasing polypharmacy in the UK. Half of patients receiving high risk medications do so for less than a year. Reducing or optimising the use of a limited number of drugs could dramatically reduce high risk medications in older people. Further research is needed to investigate why the oldest old and women are at greater risk. Interventions to reduce high risk medications may need to target shorter and long-term use separately.
Citation:
BMC Geriatr. 2015 Nov 5;15:146
Publisher:
BioMed Central
Journal:
BMC geriatrics
Issue Date:
5-Nov-2015
URI:
http://hdl.handle.net/11287/594034
DOI:
10.1186/s12877-015-0143-8
PubMed ID:
26542116
Additional Links:
http://www.biomedcentral.com/1471-2318/15/146
Note:
This article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.
Type:
Journal Article
Language:
eng
ISSN:
1471-2318
Appears in Collections:
2015 RD&E publications; Healthcare for Older People

Full metadata record

DC FieldValue Language
dc.contributor.authorBle, A.en
dc.contributor.authorMasoli, Jane Aen
dc.contributor.authorBarry, H. E.en
dc.contributor.authorWinder, R. E.en
dc.contributor.authorTavakoly, B.en
dc.contributor.authorHenley, W. E.en
dc.contributor.authorKuchel, G. A.en
dc.contributor.authorValderas, J. M.en
dc.contributor.authorMelzer, D.en
dc.contributor.authorRichards, S. H.en
dc.date.accessioned2016-01-19T12:38:52Zen
dc.date.available2016-01-19T12:38:52Zen
dc.date.issued2015-11-05en
dc.identifier.citationBMC Geriatr. 2015 Nov 5;15:146en
dc.identifier.issn1471-2318en
dc.identifier.pmid26542116en
dc.identifier.doi10.1186/s12877-015-0143-8en
dc.identifier.urihttp://hdl.handle.net/11287/594034en
dc.description.abstractBACKGROUND: High risk medications are commonly prescribed to older US patients. Currently, less is known about high risk medication prescribing in other Western Countries, including the UK. We measured trends and correlates of high risk medication prescribing in a subset of the older UK population (community/institutionalized) to inform harm minimization efforts. METHODS: Three cross-sectional samples from primary care electronic clinical records (UK Clinical Practice Research Datalink, CPRD) in fiscal years 2003/04, 2007/08 and 2011/12 were taken. This yielded a sample of 13,900 people aged 65 years or over from 504 UK general practices. High risk medications were defined by 2012 Beers Criteria adapted for the UK. Using descriptive statistical methods and regression modelling, prevalence of 'any' (drugs prescribed at least once per year) and 'long-term' (drugs prescribed all quarters of year) high risk medication prescribing and correlates were determined. RESULTS: While polypharmacy rates have risen sharply, high risk medication prevalence has remained stable across a decade. A third of older (65+) people are exposed to high risk medications, but only half of the total prevalence was long-term (any = 38.4 % [95 % CI: 36.3, 40.5]; long-term = 17.4 % [15.9, 19.9] in 2011/12). Long-term but not any high risk medication exposure was associated with older ages (85 years or over). Women and people with higher polypharmacy burden were at greater risk of exposure; lower socio-economic status was not associated. Ten drugs/drug classes accounted for most of high risk medication prescribing in 2011/12. CONCLUSIONS: High risk medication prescribing has not increased over time against a background of increasing polypharmacy in the UK. Half of patients receiving high risk medications do so for less than a year. Reducing or optimising the use of a limited number of drugs could dramatically reduce high risk medications in older people. Further research is needed to investigate why the oldest old and women are at greater risk. Interventions to reduce high risk medications may need to target shorter and long-term use separately.en
dc.language.isoengen
dc.publisherBioMed Centralen
dc.relation.urlhttp://www.biomedcentral.com/1471-2318/15/146en
dc.titleAny versus long-term prescribing of high risk medications in older people using 2012 Beers Criteria: results from three cross-sectional samples of primary care records for 2003/4, 2007/8 and 2011/12en
dc.typeJournal Articleen
dc.identifier.journalBMC geriatricsen
dc.description.noteThis article is available via Open Access. Please click on the 'Additional Link' above to access the full-text.en
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