ArticlePloS one2014
Potential therapeutic competition in community-living older adults in the U.S.: use of medications that may adversely affect a coexisting condition.
Article in PloS one, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 51 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
51 citing papers in PubMed, 1 synthesis or guideline pooled it, 95 citations in OpenAlex.
- Measuring the Quality of Care for Older Adults With Multimorbidity: Results of the MULTIqual Project.The Gerontologist · 2022Pooled it
- Efficacy of Umeclidinium/Vilanterol in Elderly Patients with COPD: A Pooled Analysis of Randomized Controlled Trials.Drugs & aging · 2018Trial
- Trial
- How to handle polypharmacy in heart failure. A clinical consensus statement of the Heart Failure Association of the ESC.European journal of heart failure · 2025Review
- Article
- Therapeutic competitions and frailty among older adults in São Paulo city: a cross-sectional population-based study, 2015.Epidemiologia e servicos de saude : revista do Sistema Unico de Saude do Brasil · 2025Article
- [Preventive care for geriatric patients in general medicine].Zeitschrift fur Gerontologie und Geriatrie · 2024Review
- Definition of Polypharmacy in Heart Failure: A Scoping Review of the Literature.Cardiology research · 2024Article
- Patient Priorities-Aligned Care for Older Adults With Multiple Conditions: A Nonrandomized Controlled Trial.JAMA network open · 2024Article
- The what matters most survey: A measurement evaluation of a self-reported patient values elicitation tool among cancer survivors.Patient education and counseling · 2023Observational
- Article
- Polypharmacy and precision medicine.Cambridge prisms. Precision medicine · 2023Review
- Medication Complexity Among Older Adults with HF: How Can We Assess Better?Drugs & aging · 2022Review
- N-of-1 trials to facilitate evidence-based deprescribing: Rationale and case study.British journal of clinical pharmacology · 2022Review
- Polypharmacy and Cardiovascular Diseases: Consideration for Older Adults and Women.Current atherosclerosis reports · 2022Review
- Geriatric Cardiology: Coming of Age.JACC. Advances · 2022Article
- A Qualitative Analysis to Understand Perception about Medication-Related Problems among Older Minority Adults in a Historically Black Community.Pharmacy (Basel, Switzerland) · 2022Article
- Complex and Potentially Harmful Medication Patterns in Heart Failure with Preserved Ejection Fraction.The American journal of medicine · 2021Observational
- Polypharmacy in Older Adults Hospitalized for Heart Failure.Circulation. Heart failure · 2020Observational
- Goal-Based Shared Decision-Making: Developing an Integrated Model.Journal of patient experience · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveThe 75% of older adults with multiple chronic conditions are at risk of therapeutic competition (i.e. treatment for one condition may adversely affect a coexisting condition). The objective was to determine the prevalence of potential therapeutic competition in community-living older adults.
methodsCross-sectional descriptive study of a representative sample of 5,815 community-living adults 65 and older in the U.S, enrolled 2007-2009. The 14 most common chronic conditions treated with at least one medication were ascertained from Medicare claims. Medication classes recommended in national disease guidelines for these conditions and used by ≥ 2% of participants were identified from in-person interviews conducted 2008-2010. Criteria for potential therapeutic competition included: 1), well-acknowledged adverse medication effect; 2) mention in disease guidelines; or 3) report in a systematic review or two studies published since 2000. Outcomes included prevalence of situations of potential therapeutic competition and frequency of use of the medication in individuals with and without the competing condition.
resultsOf 27 medication classes, 15 (55.5%) recommended for one study condition may adversely affect other study conditions. Among 91 possible pairs of study chronic conditions, 25 (27.5%) have at least one potential therapeutic competition. Among participants, 1,313 (22.6%) received at least one medication that may worsen a coexisting condition; 753 (13%) had multiple pairs of such competing conditions. For example, among 846 participants with hypertension and COPD, 16.2% used a nonselective beta-blocker. In only 6 of 37 cases (16.2%) of potential therapeutic competition were those with the competing condition less likely to receive the medication than those without the competing condition.
conclusionsOne fifth of older Americans receive medications that may adversely affect coexisting conditions. Determining clinical outcomes in these situations is a research and clinical priority. Effects on coexisting conditions should be considered when prescribing medications.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.