Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.

<h4>Background/objectives</h4>With an aging population suffering from increased prevalence of chronic conditions in the United States (U.S.), a large portion of these patients are on multiple medications. High-risk medications can increase the risk for drug-drug interactions and medicati...

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Autores principales:	Eric H Young, Samantha Pan, Alex G Yap, Kelly R Reveles, Kajal Bhakta
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/610336bed4ff449d90a2a7e8cf30445a
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spelling	oai:doaj.org-article:610336bed4ff449d90a2a7e8cf30445a2021-12-02T20:15:17ZPolypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.1932-620310.1371/journal.pone.0255642https://doaj.org/article/610336bed4ff449d90a2a7e8cf30445a2021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0255642https://doaj.org/toc/1932-6203<h4>Background/objectives</h4>With an aging population suffering from increased prevalence of chronic conditions in the United States (U.S.), a large portion of these patients are on multiple medications. High-risk medications can increase the risk for drug-drug interactions and medication nonadherence. This study aims to describe the prevalence of polypharmacy and high-risk medication prescribing in U.S. physician offices.<h4>Methods</h4>This was a cross-sectional study of the Centers for Disease Control and Prevention's National Ambulatory Medical Care Survey from 2009 to 2016. All patients over 65 years old were included. Polypharmacy was categorized as no polypharmacy (< 2 medications), minor polypharmacy (2-3 medications), moderate polypharmacy (4-5 medications), and major polypharmacy (>5 medications). Medications were further categorized into high-risk medication categories (anticholinergics, cardiovascular agents, central nervous system (CNS) medications, pain medications, and other). Comparisons between the degrees of polypharmacy were performed utilizing chi-square or Wilcoxon rank-sum tests with JMP Pro 14® (SAS Institute, Cary, NC).<h4>Results</h4>Over 2 billion patient visits were included. Overall, Polypharmacy was common (65.1%): minor polypharmacy (16.2%), moderate polypharmacy (12.1%), and major polypharmacy (36.8%). Patients with major polypharmacy were older compared to those with moderate or minor polypharmacy (75 vs. 73 years, respectively) and were most frequently prescribed pain medications (477.3 per 1,000 total visits). NSAIDs were the most frequently prescribed, with 232.4 per 1,000 total visits resulting in one high-risk NSAID prescription, while 21.9 per 1,000 total visits resulted in two or more high-risk NSAIDs.<h4>Conclusion</h4>Most patients over 65 years experienced some degree of polypharmacy, with many experiencing major polypharmacy. This indicates an increased need for expanded pharmacist roles through medication therapy management and safety monitoring in this patient population.Eric H YoungSamantha PanAlex G YapKelly R RevelesKajal BhaktaPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 8, p e0255642 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Eric H Young Samantha Pan Alex G Yap Kelly R Reveles Kajal Bhakta Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
description	<h4>Background/objectives</h4>With an aging population suffering from increased prevalence of chronic conditions in the United States (U.S.), a large portion of these patients are on multiple medications. High-risk medications can increase the risk for drug-drug interactions and medication nonadherence. This study aims to describe the prevalence of polypharmacy and high-risk medication prescribing in U.S. physician offices.<h4>Methods</h4>This was a cross-sectional study of the Centers for Disease Control and Prevention's National Ambulatory Medical Care Survey from 2009 to 2016. All patients over 65 years old were included. Polypharmacy was categorized as no polypharmacy (< 2 medications), minor polypharmacy (2-3 medications), moderate polypharmacy (4-5 medications), and major polypharmacy (>5 medications). Medications were further categorized into high-risk medication categories (anticholinergics, cardiovascular agents, central nervous system (CNS) medications, pain medications, and other). Comparisons between the degrees of polypharmacy were performed utilizing chi-square or Wilcoxon rank-sum tests with JMP Pro 14® (SAS Institute, Cary, NC).<h4>Results</h4>Over 2 billion patient visits were included. Overall, Polypharmacy was common (65.1%): minor polypharmacy (16.2%), moderate polypharmacy (12.1%), and major polypharmacy (36.8%). Patients with major polypharmacy were older compared to those with moderate or minor polypharmacy (75 vs. 73 years, respectively) and were most frequently prescribed pain medications (477.3 per 1,000 total visits). NSAIDs were the most frequently prescribed, with 232.4 per 1,000 total visits resulting in one high-risk NSAID prescription, while 21.9 per 1,000 total visits resulted in two or more high-risk NSAIDs.<h4>Conclusion</h4>Most patients over 65 years experienced some degree of polypharmacy, with many experiencing major polypharmacy. This indicates an increased need for expanded pharmacist roles through medication therapy management and safety monitoring in this patient population.
format	article
author	Eric H Young Samantha Pan Alex G Yap Kelly R Reveles Kajal Bhakta
author_facet	Eric H Young Samantha Pan Alex G Yap Kelly R Reveles Kajal Bhakta
author_sort	Eric H Young
title	Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
title_short	Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
title_full	Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
title_fullStr	Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
title_full_unstemmed	Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.
title_sort	polypharmacy prevalence in older adults seen in united states physician offices from 2009 to 2016.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/610336bed4ff449d90a2a7e8cf30445a
work_keys_str_mv	AT erichyoung polypharmacyprevalenceinolderadultsseeninunitedstatesphysicianofficesfrom2009to2016 AT samanthapan polypharmacyprevalenceinolderadultsseeninunitedstatesphysicianofficesfrom2009to2016 AT alexgyap polypharmacyprevalenceinolderadultsseeninunitedstatesphysicianofficesfrom2009to2016 AT kellyrreveles polypharmacyprevalenceinolderadultsseeninunitedstatesphysicianofficesfrom2009to2016 AT kajalbhakta polypharmacyprevalenceinolderadultsseeninunitedstatesphysicianofficesfrom2009to2016
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Polypharmacy prevalence in older adults seen in United States physician offices from 2009 to 2016.

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