Is suboptimal prescribing a risk factor for poor health outcomes in community-dwelling elders? The ICARe Dicomano study

Pharmacoepidemiology and Drug Safety
C PozziM Di Bari

Abstract

Mostly because of comorbidity and drugs consumption, older persons are often exposed to an increased risk of sub-optimal prescribing (SP). At present, few studies investigated the association between SP and long-term health outcomes. We examined the relation between SP and the risk of mortality and hospitalization in Italian older community-dwellers. Older (65+ years) community-dwelling residents of a small town in Tuscany were enrolled in a longitudinal study. SP was defined as polypharmacy (use of 5+ drugs), prescription of inappropriate drugs (ID) according to Beers' criteria, and of potentially interacting drugs (PID), evaluated in 1995 and 1999. These three forms of SP were entered as time-dependent exposures into multivariable Cox regression analysis models, whose outcomes were mortality and hospitalizations through 2003. Of 1022 participants (mean age 73.0 +/- 6.8, 57% women), 220 were evaluated in 1995, 234 in 1999 and 568 in both waves. In univariate analysis, mortality was two-fold higher in participants with polypharmacy (73.4/1000 person/years, 95% CI 58.2-92.4 vs. 34.1, 95% CI 29.7-39.2; p < 0.001) or PID (72.7/1000 person/years, 95% CI 46.3-113.9 vs. 38.0, 95% CI 33.5-43.1; p < 0.001), whereas it was unrelated to ...Continue Reading

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Citations

Apr 5, 2011·The American Journal of Geriatric Pharmacotherapy·Emily P PeronSteven M Handler
Dec 18, 2014·Journal of the American Geriatrics Society·Terri R FriedDeanna K Martin
Jan 22, 2017·European Journal of Clinical Pharmacology·Mariana Martins Gonzaga do NascimentoAntônio Ignácio de Loyola Filho
Nov 5, 2020·Scientific Reports·Tae Ik ChangSeung Hyeok Han

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