Evidence map›Paper›PMID 25889849›Full record

ArticleBMC medicine2015

The rising tide of polypharmacy and drug-drug interactions: population database analysis 1995-2010.

Bruce Guthrie, Boikanyo Makubate, Virginia Hernandez-Santiago, Tobias Dreischulte

Registry-linked trialAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05971407 (The Effect of Chronic Remote Ischaemic Preconditioning on Blood Pressure in Older Adults), which is not on this map. Cited by 382 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
382citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

NCT05971407 nacompletednot on this mapstarted 2022, after this paper: background citation

The Effect of Chronic Remote Ischaemic Preconditioning on Blood Pressure in Older Adults

TypeinterventionalSponsorUniversity of NottinghamRan2022 to 2024Enrolled60ConditionsHypertension, Vascular DiseasesArmsRemote Ischaemic Preconditioning, Sham Remote Ischaemic Preconditioning
3 · Its place in the literature

Who cites it

382 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  19. [Falls and polypharmacy-an exploration of both the frequency and approaches to prevention].Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz · 2026
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  20. Review

322 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Bruce GuthriePopulation Health Sciences Division, Medical Research Institute, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK. b.guthrie@dundee.ac.uk.
Boikanyo MakubateDepartment of Public Health, Faculty of Medicine, University of Botswana, Private Bag UB 0022, Gaborone, Botswana. makubateb@biust.ac.bw.
Virginia Hernandez-SantiagoPopulation Health Sciences Division, Medical Research Institute, University of Dundee, Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK. v.z.hernandezsantiago@dundee.ac.uk.
Tobias DreischulteNHS Tayside Medicines Governance Unit, Mackenzie Building, Kirsty Semple Way, Dundee, DD2 4BF, UK. t.dreischulte@dundee.ac.uk.

Funding

Chief Scientist Office ARPG/07/02Chief Scientist Office ARPG/07/2Chief Scientist Office CAF/12/07
6 · The paper itself

Abstract

backgroundThe escalating use of prescribed drugs has increasingly raised concerns about polypharmacy. This study aims to examine changes in rates of polypharmacy and potentially serious drug-drug interactions in a stable geographical population between 1995 and 2010.

methodsThis is a repeated cross-sectional analysis of community-dispensed prescribing data for all 310,000 adults resident in the Tayside region of Scotland in 1995 and 2010. The number of drug classes dispensed and the number of potentially serious drug-drug interactions (DDIs) in the previous 84 days were calculated, and age-sex standardised rates in 1995 and 2010 compared. Patient characteristics associated with receipt of ≥ 10 drugs and with the presence of one or more DDIs were examined using multilevel logistic regression to account for clustering of patients within primary care practices.

resultsBetween 1995 and 2010, the proportion of adults dispensed ≥ 5 drugs doubled to 20.8%, and the proportion dispensed ≥ 10 tripled to 5.8%. Receipt of ≥ 10 drugs was strongly associated with increasing age (20-29 years, 0.3%; ≥ 80 years, 24.0%; adjusted OR, 118.3; 95% CI, 99.5-140.7) but was also independently more common in people living in more deprived areas (adjusted OR most vs. least deprived quintile, 2.36; 95% CI, 2.22-2.51), and in people resident in a care home (adjusted OR, 2.88; 95% CI, 2.65-3.13). The proportion with potentially serious drug-drug interactions more than doubled to 13% of adults in 2010, and the number of drugs dispensed was the characteristic most strongly associated with this (10.9% if dispensed 2-4 drugs vs. 80.8% if dispensed ≥ 15 drugs; adjusted OR, 26.8; 95% CI 24.5-29.3).

conclusionsDrug regimens are increasingly complex and potentially harmful, and people with polypharmacy need regular review and prescribing optimisation. Research is needed to better understand the impact of multiple interacting drugs as used in real-world practice and to evaluate the effect of medicine optimisation interventions on quality of life and mortality.

Indexed as

Drug InteractionsPolypharmacyAdultAgedAged, 80 and overCross-Sectional StudiesDatabases, FactualFemaleHumansLogistic ModelsMaleMiddle AgedPractice Patterns, Physicians'Primary Health CareQuality of LifeResidence Characteristics

Identifiers

PMID25889849
PMCPMC4417329

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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.