Evidence map›Paper›PMID 39169279›Full record

ArticleBMC geriatrics2024

Polypharmacy and potentially inappropriate medications in older adults who use long-term care services: a cross-sectional study.

Shotaro Hagiwara, Jun Komiyama, Masao Iwagami, Shota Hamada, Masato Komuro, Hiroyuki Kobayashi, Nanako Tamiya

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC geriatrics, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 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.

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

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

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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.

Shotaro HagiwaraDepartment of Hematology, Tsukuba University Hospital Mito Clinical Education and Training Center, 3-2-7 Miya-Cho, Mito, Ibaraki, Japan. hagiwara.shotaro@md.tsukuba.ac.jp.
Jun KomiyamaDepartment of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
Masao IwagamiDepartment of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
Shota HamadaDepartment of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.
Masato KomuroJapan Health Research Promotion Bureau, Section of Information Platform for Medical Research and Collaboration, Tokyo, Japan.
Hiroyuki KobayashiDepartment of Internal Medicine, Tsukuba University Hospital Mito Clinical Education and Training Center, Ibaragi, Japan.
Nanako TamiyaDepartment of Health Services Research, Institute of Medicine, University of Tsukuba, Ibaraki, Japan.

Funding

JSPS KAKENHI JP23K09521
6 · The paper itself

Abstract

backgroundOlder adults requiring care often have multiple morbidities that lead to polypharmacy, including the use of potentially inappropriate medications (PIMs), leading to increased medical costs and adverse drug effects. We conducted a cross-sectional study to clarify the actual state of drug prescriptions and the background of polypharmacy and PIMs.

methodsUsing long-term care (LTC) and medical insurance claims data in the Ibaraki Prefecture from April 2018 to March 2019, we included individuals aged ≥ 65 who used LTC services. The number of drugs prescribed for ≥ 14 days and the number of PIMs were counted. A generalized linear model was used to analyze the association between the backgrounds of individuals and the number of drugs; logistic regression analysis was used for the presence of PIMs. PIMs were defined by STOPP-J and Beers Criteria.

resultsHerein, 67,531 older adults who received LTC services were included. The median number of total prescribed medications and PIMs was 7(IQR 5-9) and 1(IQR 0-1), respectively. The main PIMs were loop diuretics/aldosterone antagonists (STOPP-J), long-term use of proton pump inhibitors (Beers Criteria), benzodiazepines/similar hypnotics (STOPP-J and Beers Criteria), and nonsteroidal anti-inflammatory drugs (STOPP-J and Beers Criteria). Multivariate analysis revealed that the number of medications and presence of PIMs were significantly higher in patients with comorbidities and in those visiting multiple medical institutions. However, patients requiring care level ≥1, nursing home residents, users of short-stay service, and senior daycare were negatively associated with polypharmacy and PIMs.

conclusionsPolypharmacy and PIMs are frequently observed in older adults who require LTC. This was prominent among individuals with comorbidities and at multiple consulting institutions. Utilization of nursing care facilities may contribute to reducing polypharmacy and PIMs.

Indexed as

Inappropriate PrescribingLong-Term CarePolypharmacyPotentially Inappropriate Medication ListAgedAged, 80 and overCross-Sectional StudiesFemaleHumansJapanMaleCross-sectional studyLong-term careOlder adultsPolypharmacyPotentially inappropriate medication

Identifiers

PMID39169279
PMCPMC11337775

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LicenceCC BY-NC-ND
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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.