ArticleJournal of general internal medicine2023
Changes in Polypharmacy and Potentially Inappropriate Medications in Homebound Older Adults in Japan, 2015-2019: a Nationwide Study.
Article in Journal of general internal medicine, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
What it found
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The trial behind it
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Who cites it
13 citing papers in PubMed, 15 citations in OpenAlex.
- Discontinuation of Glucagon-Like Peptide-1 Receptor Agonists After Bowel Obstruction or Ileus: A Nationwide, Real-World, Database Study.Journal of evidence-based medicine · 2026Article
- Primary care physician characteristics and potentially inappropriate medications in older adults.Health affairs scholar · 2026Article
- Artificial intelligence-driven risk prediction of polypharmacy in older adults: current advances, clinical applications, and future perspectives.Frontiers in public health · 2026Review
- Potentially Inappropriate Medication in Homebound Older Adults Receiving Home Medical Care.Annals of geriatric medicine and research · 2025Article
- Ikigai in aging hearts: Japan's approach to cardiovascular care.Hypertension research : official journal of the Japanese Society of Hypertension · 2025Review
- Current Status of Drug Prescribing among Older Adults with Advanced-stage Cancer Receiving Home Medical Care in Japan: A Nationwide Study.JMA journal · 2025Article
- Continuity of Visiting Pharmacist Services and Factors Related to Service Discontinuation Among Older Adults in Japan: A Retrospective Cohort Study.Pharmacology research & perspectives · 2025Article
- Coexistence of Nocturia and Frailty and Its Effect on Polypharmacy in Community-Dwelling Older Adults.Cureus · 2025Article
- Polypharmacy and potentially inappropriate medications in older adults who use long-term care services: a cross-sectional study.BMC geriatrics · 2024Article
- Impact of Comorbidities on the Risk of Polypharmacy and Potentially Inappropriate Medications in Older Patients.Journal of general internal medicine · 2024Article
- Response to Letter to the Editor: Impact of Comorbidities on the Risk of Polypharmacy and Potentially Inappropriate Medications in Older Patients.Journal of general internal medicine · 2024Article
- The definition and evaluation of uncoordinated involvement of multiple healthcare providers; "Polydoctoring" as a component of care fragmentation among patients which multimorbidity.Journal of general and family medicine · 2024Article
- Redefining polypharmacy: Shifting from drug counts to patient-centered clinical appropriateness.Perspectives in clinical researchReview
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundWith rising worldwide population aging, the number of homebound individuals with multimorbidity is increasing. Improvement in the quality of home medical care (HMC), including medications, contributes to meeting older adults' preference for "aging in place" and securing healthcare resources.
objectiveTo evaluate the changes in drug prescriptions, particularly potentially inappropriate medications (PIMs), among older adults receiving HMC in recent years, during which measures addressing inappropriate polypharmacy were implemented, including the introduction of clinical practice guidelines and medical fees for deprescribing.
designA cross-sectional study.
participantsUsing data from the national claims database in Japan, this study included older adults aged ≥ 75 years who received HMC in October 2015 (N = 499,850) and October 2019 (N = 657,051). MAIN MEASURES: Number of drugs, prevalence of polypharmacy (≥ 5 regular drugs), major drug categories/classes, and PIMs according to Japanese guidelines were analyzed. Random effects logistic regression models were used to evaluate the differences in medications between 2015 and 2019, considering the correlation within individuals who contributed to the analysis in both years. KEY
resultsThe number of drugs remained unchanged from 2015 to 2019 (median: 6; interquartile range: 4, 9). The prevalence of polypharmacy also remained unchanged at 70.0% in both years (P = 0.93). However, the prescription of some drugs (e.g., direct oral anticoagulants, new types of hypnotics, acetaminophen, proton pump inhibitors, and β-blockers) increased, whereas others (e.g., warfarin, vasodilators, H2 blockers, acetylcholinesterase inhibitors, and benzodiazepines) decreased. Among the frequently prescribed PIMs, benzodiazepines/Z-drugs (25.6% in 2015 to 21.1% in 2019; adjusted odds ratio: 0.52) and H2 blockers (11.2 to 7.3%; 0.45) decreased, whereas diuretics (23.8 to 23.6%; 0.90) and antipsychotics (9.7 to 10.5%; 1.11) remained unchanged.
conclusionsWe observed some favorable changes but identified some continuous and new challenges. This study suggests that continued attention to medication optimization is required to achieve safe and effective HMC.
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