Evidence map›Paper›PMID 29332840›Full record

ArticleBMJ open2018

Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study.

Peter Hanlon, Barbara I Nicholl, Bhautesh Dinesh Jani, Ross McQueenie, Duncan Lee, Katie I Gallacher, Frances S Mair

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
54citing papers in PubMed, 4 pooled it
7.1field-weighted citation impact, top 2% of its field
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

54 citing papers in PubMed, 4 syntheses or guidelines pooled it, 83 citations in OpenAlex.

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  15. Polypharmacy in Patients With COPD: A Scoping Review.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2025
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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

7 authors at 1 institution in 1 country.

Peter HanlonGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.ORCID 0000-0002-5828-3934
Barbara I NichollGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Bhautesh Dinesh JaniGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Ross McQueenieGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Duncan LeeSchool of Mathematics and Statistics, University of Glasgow, Glasgow, UK.
Katie I GallacherGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
Frances S MairGeneral Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK.
University of Glasgow · GB

Funding

Chief Scientist Office CGA/16/39Medical Research Council MC_QA137853
6 · The paper itself

Abstract

objectiveThis study aims: (1) to describe the pattern and extent of multimorbidity and polypharmacy in UK Biobank participants with chronic obstructive pulmonary disease (COPD) and (2) to identify which comorbidities are associated with increased risk of adverse drug reactions (ADRs) resulting from polypharmacy.

designCross-sectional.

settingCommunity cohort.

participantsUK Biobank participants comparing self-reported COPD (n=8317) with no COPD (n=494 323). OUTCOMES: Multimorbidity (≥4 conditions) and polypharmacy (≥5 medications) in participants with COPD versus those without. Risk of ADRs (taking ≥3 medications associated with falls, constipation, urinary retention, central nervous system (CNS) depression, bleeding or renal injury) in relation to the presence of COPD and individual comorbidities.

resultsMultimorbidity was more common in participants with COPD than those without (17% vs 4%). Polypharmacy was highly prevalent (52% with COPD taking ≥5 medications vs 18% in those without COPD). Adjusting for age, sex and socioeconomic status, those with COPD were significantly more likely than those without to be prescribed ≥3 medications contributing to falls (OR 2.27, 95% CI 2.13 to 2.42), constipation (OR 3.42, 95% CI 3.10 to 3.77), urinary retention (OR 3.38, 95% CI 2.94 to 3.87), CNS depression (OR 3.75, 95% CI 3.31 to 4.25), bleeding (OR 4.61, 95% CI 3.35 to 6.19) and renal injury (OR 2.22, 95% CI 1.86 to 2.62). Concomitant cardiovascular disease was associated with the greatest risk of taking ≥3 medications associated with falls/renal injury. Concomitant mental health conditions were most strongly associated with medications linked with CNS depression/urinary retention/bleeding.

conclusionsMultimorbidity is common in COPD and associated with high levels of polypharmacy. Co-prescription of drugs with various ADRs is common. Future research should examine the effects on healthcare outcomes of co-prescribing multiple drugs with similar potential ADRs. Clinical guidelines should emphasise assessment of multimorbidity and ADR risk.

Indexed as

MultimorbidityPolypharmacyAgedCohort StudiesCross-Sectional StudiesDrug-Related Side Effects and Adverse ReactionsFemaleHumansLogistic ModelsMaleMiddle AgedPulmonary Disease, Chronic ObstructiveSelf ReportUnited Kingdomadverse eventschronic airways diseasemultimorbiditypolypharmacy

Identifiers

PMID29332840
PMCPMC5781016
OpenAlexW2783373815

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.