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...

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Autores principales:	Ewan Carr, Alex Federman, Olubanke Dzahini, Richard J. Dobson, Rebecca Bendayan
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/ca8001ffc7544f6da6e6de535fb2c936
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spelling	oai:doaj.org-article:ca8001ffc7544f6da6e6de535fb2c9362021-12-02T18:27:49ZA multidimensional measure of polypharmacy for older adults using the Health and Retirement Study10.1038/s41598-021-86331-x2045-2322https://doaj.org/article/ca8001ffc7544f6da6e6de535fb2c9362021-04-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-86331-xhttps://doaj.org/toc/2045-2322Abstract 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.Ewan CarrAlex FedermanOlubanke DzahiniRichard J. DobsonRebecca BendayanNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Ewan Carr Alex Federman Olubanke Dzahini Richard J. Dobson Rebecca Bendayan A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study
description	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.
format	article
author	Ewan Carr Alex Federman Olubanke Dzahini Richard J. Dobson Rebecca Bendayan
author_facet	Ewan Carr Alex Federman Olubanke Dzahini Richard J. Dobson Rebecca Bendayan
author_sort	Ewan Carr
title	A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study
title_short	A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study
title_full	A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study
title_fullStr	A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study
title_full_unstemmed	A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study
title_sort	multidimensional measure of polypharmacy for older adults using the health and retirement study
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/ca8001ffc7544f6da6e6de535fb2c936
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A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study

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