Evidence map›Paper›PMID 39183449›Full record

ArticleBritish journal of clinical pharmacology2024

Analysis of longitudinal patterns and predictors of medicine use in residential aged care using group-based trajectory modelling: The MEDTRAC-Polypharmacy longitudinal cohort study.

Nasir Wabe, Rachel Urwin, Karla Seaman, Andrea Timothy, Magdalena Z Raban, Johanna Westbrook

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Article in British journal of clinical pharmacology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
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1 · What the graph read from it

What it found

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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

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3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

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4 · The record

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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

6 authors.

Nasir WabeAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
Rachel UrwinAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.ORCID https://orcid.org/0000-0001-7026-8043
Karla SeamanAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
Andrea TimothyAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
Magdalena Z RabanAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.
Johanna WestbrookAustralian Institute of Health Innovation, Macquarie University, North Ryde, New South Wales, Australia.

Funding

National Health and Medical Research Council APP1143941National Health and Medical Research Council APP1174021National Health and Medical Research Council APP2006957
6 · The paper itself

Abstract

aimsPolypharmacy serves as a quality indicator in residential aged care facilities (RACFs) due to concerns about inappropriate medication use. However, aggregated polypharmacy rates at a single time offer limited value. Longitudinal analysis of polypharmacy patterns provides valuable insights into identifying potential overuse of medicines. We aimed to determine long-term trajectories of polypharmacy (≥9 medicines) and factors associated with each polypharmacy trajectory group.

methodsThis was a longitudinal cohort study using electronic data from 30 RACFs in New South Wales, Australia. We conducted group-based trajectory modelling to identify and characterize polypharmacy trajectories over 3 years. We evaluated the model fitness using the Bayesian Information Criterion, entropy (with a value of ≥0.8 considered ideal) and several other metrics.

resultsThe study included 2837 permanent residents (median age = 86 years, 61.7% female and 47.4% had dementia). We identified five polypharmacy trajectory groups: group 1 (no polypharmacy, 46.0%); group 2 (increasing polypharmacy, 9.4%); group 3 (decreasing polypharmacy, 9.2%); group 4 (increasing-then decreasing polypharmacy, 10.0%), and group 5 (persistent polypharmacy, 25.4%). The model showed excellent performance (e.g., entropy = 0.9). Multinomial logistic regressions revealed the profile of each trajectory group (e.g., group 5 residents had higher odds of chronic respiratory disease compared with group 1).

conclusionsOur study identified five polypharmacy trajectory groups, including one with over a quarter of residents following a persistently high trajectory, signalling concerning medication overuse. Quality indicator programs should adopt tailored metrics to monitor diverse polypharmacy trajectory groups, moving beyond the current one-size-fits-all approach and better capturing the evolving dynamics of residents' medication regimens.

Indexed as

Homes for the AgedPolypharmacyAgedAged, 80 and overBayes TheoremCohort StudiesDementiaFemaleHumansInappropriate PrescribingLongitudinal StudiesMaleNew South WalesNursing HomesGBTMpolypharmacyquality indicator programsresidential aged care

Identifiers

PMID39183449
PMCPMC11602946

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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.