Use of Prescription Medications in an Elderly Rural Population: The Movies Project

Objective To determine the pharmacoepidemiology of prescription drug use in a rural elderly community sample, specifically the numbers and categories of medications taken and the factors associated with them. Design Cross-sectional community survey. Setting The mid-Monongahela Valley of southwestern Pennsylvania. Participants An age-stratified random sample of 1360 community-dwelling individuals, aged 65 years and older. Measures Self-reported use of prescription drugs, demographic characteristics, and use of health services. Results Nine hundred sixty-seven participants (71%) reported regularly taking at least one prescription medication and 157 (10%) reported taking five or more medications (median 2.0, range 0–13). Women took significantly more medications than men (median 2.0, range 0–13 and median 1.0, range 0–9, respectively; p = 0.01). The use of a greater number of medications was independently and statistically significantly associated with older age, hospitalization within the previous 6 months, home health care in previous year, visit to a physician within the previous year, and insurance coverage for prescription medication. Individuals older than 85 years were significantly more likely to be taking cardiovascular agents, anticoagulants, vasodilating agents, diuretics, and potassium supplements. Significantly more women than men were taking nonsteroidal antiinflammatory drugs, antidepressants, potassium supplements, and thyroid replacement medications. Conclusions Both the number and the types of prescription medications vary with age and gender. The demographic and health service use variables associated with greater medication use in the community may help define high-risk groups for polypharmacy and adverse drug reactions. Longitudinal studies are needed.

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Antidepressant use in multiple sclerosis: epidemiologic study of a large community sample

Multiple Sclerosis Journal ◽

10.1177/1352458507077864 ◽

2007 ◽

Vol 13 (8) ◽

pp. 1046-1053 ◽

Cited By ~ 34

Author(s):

K. Cetin ◽

K.L. Johnson ◽

D.M. Ehde ◽

C.M. Kuehn ◽

D. Amtmann ◽

...

Keyword(s):

Multiple Sclerosis ◽

Depressive Symptoms ◽

Community Sample ◽

Epidemiologic Study ◽

Antidepressant Medication ◽

Cross Sectional Study ◽

Community Dwelling ◽

Cross Sectional ◽

Antidepressant Use ◽

Clinically Significant

Depressive symptoms and disorders among individuals with multiple sclerosis (MS) are more common when compared to other chronic illnesses and the general population, but relatively little is known about the use of antidepressant medication in this population. In this cross-sectional study of 542 community-dwelling adults with MS, we examined the prevalence of antidepressant use and employed multivariate logistic regression modeling to identify factors significantly associated with antidepressant use. Thirty-five percent of the sample reported currently using at least one antidepressant medication. Gender, marital status, insurance status, fatigue, and use of disease modifying therapies were all significantly associated with antidepressant use. Just over half of the sample endorsed a clinically significant level of depressive symptoms, and the majority of this group was not currently taking an antidepressant. Conversely, 41% of those with depressive symptoms reported taking at least one antidepressant medication. More research is needed to better understand why people with MS and depressive symptoms use or do not use antidepressant medications and to further explore the possibility of an under-treatment of depressive disorder in this population. Rigorous studies testing the feasibility, acceptability, and efficacy of currently available therapies for depression in the MS population should also be conducted. Multiple Sclerosis 2007; 13: 1046—1053. http://msj.sagepub.com

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Opioid and healthcare service use in medical cannabis patients with chronic pain: a prospective study

BMJ Supportive & Palliative Care ◽

10.1136/bmjspcare-2020-002661 ◽

2021 ◽

pp. bmjspcare-2020-002661

Author(s):

Sharon Sznitman ◽

Carolyn Mabouk ◽

Zahi Said ◽

Simon Vulfsons

Keyword(s):

Chronic Pain ◽

Service Use ◽

Prescription Medication ◽

Healthcare Services ◽

Prescription Medications ◽

Medical Cannabis ◽

Opioid Prescription ◽

Study Results ◽

Small Effect Size

BackgroundVarious jurisdictions have legalised medical cannabis (MC) for use in chronic pain treatment. The objective of this study was to determine if the use of MC is related to a reduction in the use of prescription opioids and other prescription medications and healthcare services.MethodsA retrospective cohort study was conducted using the medical files of 68 Israeli patients with chronic pain using MC. Number of prescription medications filled and healthcare services used were recorded separately for the baseline period (6 months prior to the start of MC treatment) and 6 months’ follow-up. Paired t-tests were used to compare each individual to himself/herself from baseline to follow-up.ResultsPatients filled less opioid prescription medication at follow-up compared with baseline, and the reduction was of small effect size. There were no significant changes in the use of other medications or use of healthcare services from pre-MC treatment to follow-up.ConclusionsMC may be related to a significant yet small reduction in opioid prescription medication. Further prospective studies with representative samples are warranted to confirm the potential small opioid-sparing effects of MC treatment, its clinical importance, if any, and potential lack of association with other healthcare-related services and medication use. Due to methodological limitations of the data used in this study, results may be regarded as preliminary and causal inferences cannot be made.

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Prevalence of simultaneous use of alcohol and prescription medication in older adults: findings from a cross-sectional survey (Health Survey for England 2013)

BMJ Open ◽

10.1136/bmjopen-2018-023730 ◽

2019 ◽

Vol 9 (6) ◽

pp. e023730 ◽

Cited By ~ 2

Author(s):

John Foster ◽

Swatee Patel

Keyword(s):

Older Adults ◽

Health Survey ◽

Prescription Drugs ◽

Prescription Medication ◽

Well Being ◽

Secondary Outcome ◽

Cross Sectional Survey ◽

Related Factors ◽

Cross Sectional ◽

Concurrent Use

ObjectivesTo investigate the concurrent use of ‘at-risk’ (AR) drinking (>10 units of alcohol per week) and prescription medications, while controlling for sociodemographic, and health-related factors, among older adults (aged 65–89 years).DesignCross-sectional survey.SettingData from Health Survey of England, 2013.InterventionsNone.ParticipantsGeneral population survey of 2169 adults aged 65–89 years.Primary outcome measuresAR drinking (>10 units per week). Secondary outcome was AR drinking defined as >14 units of alcohol per week limit (the cut-off used by the Department of Health for AT drinking).ResultsTwenty-seven per cent (n=568) of the sample were AR drinkers. Factors associated with alcohol consumption were gender, age, social class, marital status, rurality of dwelling, deprivation index, self-reported general health, cigarette smoking, body mass index, exercise level, health and well-being scores’ and number of prescription drugs. Logistic regression analysis showed that males were more likely to be AR drinkers (OR 3.44, 95% CI 2.59 to 4.57, p<0.0001) than females. Each year increase in age, lowered the probability of AR drinking by a factor of 0.95 (95% CI 0.93 to 0.98, p<0.0001). Using prescription drugs reduced AR drinking by a factor of 0.92 (95% CI 0.85 to 0.93, p=0.033), after controlling for age, sex and rurality of dwelling. No other predictors were significant. Similar results were obtained for AR drinking of >14units per week.ConclusionAR drinking is more likely in older men than women. The odds of AR drinking lessens, as individuals age, and using prescription drugs also reduces AR drinking.

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Association between Skin Conditions and Depressive Disorders in Community-Dwelling Older Adults

Journal of Cutaneous Medicine and Surgery ◽

10.2310/7750.2013.13167 ◽

2014 ◽

Vol 18 (4) ◽

pp. 256-264 ◽

Cited By ~ 2

Author(s):

Samantha Gontijo Guerra ◽

Michel Préville ◽

Helen-Maria Vasiliadis ◽

Djamal Berbiche

Keyword(s):

Older Adults ◽

Older Adult ◽

Depressive Disorders ◽

Adult Population ◽

Community Sample ◽

The Elderly ◽

Population Based ◽

Community Dwelling ◽

Cross Sectional ◽

Skin Conditions

Background: Depression is frequently observed in dermatologic patients. However, the association between depressive disorders and skin conditions has rarely been explored through population-based studies, especially within older-adult populations. Objective: To test this association in a representative sample of an older-adult population. Methods: Data came from the Survey on the Health of the Elderly (Enquête sur la Santé des Aînés [ESA]), a longitudinal survey conducted in Quebec among 2,811 older adults. Cross-lagged panel models were used to simultaneously examine cross-sectional and longitudinal relationships between the presence of skin conditions and depressive disorders. Results: The prevalence of skin conditions was 13%, and the prevalence of depressive disorders among participants presenting with skin conditions was 11%. Our results indicated significant cross-sectional correlation ( ζ = 0.20) between skin conditions and depressive disorders, but no longitudinal association was observed. Conclusion: Our results reinforce the hypothesis that skin conditions and depressive disorders are concurrently associated in older adults. However, no evidence of the predictive effect of skin problems on depression (and vice versa) was found in our community sample. Despite the deleterious effect of the coexistence of these problems in older adults, studies are lacking. This article highlights the importance of this issue and emphasizes the need for further research on this topic.

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Prevalence of drug–herb and drug–supplement interactions in older adults: a cross-sectional survey

British Journal of General Practice ◽

10.3399/bjgp18x699101 ◽

2018 ◽

Vol 68 (675) ◽

pp. e711-e717 ◽

Cited By ~ 14

Author(s):

Taofikat B Agbabiaka ◽

Neil H Spencer ◽

Sabina Khanom ◽

Claire Goodman

Keyword(s):

Older Adults ◽

Drug Interactions ◽

Dietary Supplements ◽

Prescription Drugs ◽

Community Dwelling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Evening Primrose ◽

Supplement Use ◽

Concurrent Use

BackgroundPolypharmacy is common among older adults, with increasing numbers also using prescription drugs with herbal medicinal products (HMPs) and dietary supplements. There is no reliable evidence from the UK on concurrent use of HMPs and dietary supplements with prescription drugs in older adults.AimTo establish prevalence of concurrent prescription drugs, HMPs, and dietary supplements among UK community-dwelling older adults and identify potential interactions.Design and settingCross-sectional survey of older adults registered at two general practices in South East England.MethodA questionnaire asking about prescription medications, HMPs, and sociodemographic information was posted to 400 older adults aged ≥65 years, identified as taking ≥1 prescription drug.ResultsIn total 155 questionnaires were returned (response rate = 38.8%) and the prevalence of concurrent HMPs and dietary supplements with prescriptions was 33.6%. Females were more likely than males to be concurrent users (43.4% versus 22.5%; P = 0.009). The number of HMPs and dietary supplements ranged from 1 to 8, (mean = 3, median = 1; standard deviation = 1.65). The majority of concurrent users (78.0%) used dietary supplements with prescription drugs. The most commonly used dietary supplements were cod liver oil, glucosamine, multivitamins, and vitamin D. Others (20.0%) used only HMPs with prescription drugs. Common HMPs were evening primrose oil, valerian, and Nytol Herbal® (a combination of hops, gentian, and passion flower). Sixteen participants (32.6%) were at risk of potential adverse drug interactions.ConclusionGPs should routinely ask questions regarding herbal and supplement use, to identify and manage older adults at potential risk of adverse drug interactions.

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Case Management in Primary Care Associated With Service Use by Adults With Dementia and Comorbidities

Innovation in Aging ◽

10.1093/geroni/igab046.1287 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 333-334

Author(s):

Emma Quach ◽

Lauren Moo ◽

Christine Hartmann ◽

Shibei Zhao ◽

Pengsheng Ni

Keyword(s):

Primary Care ◽

Case Management ◽

Service Use ◽

Psychosocial Support ◽

Care Program ◽

Management Program ◽

Community Dwelling ◽

Case Management Program ◽

Cross Sectional ◽

Home Based

Abstract Community-dwelling adults with dementia are at higher risks than counterpart without dementia of poor health outcomes, and those with dementia and co-occurring conditions face even greater risks. Optimal treatment for dementia includes functional and psychosocial support through long-term services and supports (LTSS), but use remains low. Our study investigated whether case management provided in primary care and in dementia care settings facilitated LTSS use for Veterans with dementia and comorbidities. We performed a cross-sectional analysis of 2019 VA-paid health care on a cohort of Veterans with dementia, defined by clinical diagnoses (International Classification of Disease, Tenth Revision). Receipt of case management was measured by whether or not a Veteran enrolled in a VA (1) home-based primary care, (2) geriatric primary care, or (3) dementia clinic. Comorbidities were measured by an adapted Elixhauser comorbidities index and dichotomized as ≤ 3 or ≥ 4 comorbidities. LTSS use was measured by whether or not Veterans used home health, home respite, adult day care, hospice, or veteran-directed care. Multivariate logistic regressions showed that LTSS use was higher for enrollees in each case management program compared to Veterans not enrolled in any. LTSS use was also higher for enrollees in each primary care program with more comorbidities than program counterparts with fewer comorbidities. Case management in primary care settings may facilitate functional and psychosocial support to meet dementia and non-dementia related needs for adults who have dementia with comorbidities.

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Prevalence of Musculoskeletal Pain and Analgesic Treatment Among Home-Dwelling Older Adults: Changes 1999–2019

Innovation in Aging ◽

10.1093/geroni/igab046.3214 ◽

2021 ◽

Vol 5 (Supplement_1) ◽

pp. 891-892

Author(s):

Tuuli Lehti ◽

Kaisu Pitkälä

Keyword(s):

Musculoskeletal Pain ◽

Temporal Trends ◽

Community Dwelling ◽

Western World ◽

Prescription Medications ◽

Opioid Use ◽

Older Population ◽

Cross Sectional ◽

Medical Diagnoses ◽

Aging Study

Abstract Pain has been shown to be undertreated in the older population. At the same time, the increased opioid use is of concern in the Western world. This study analyzes temporal trends in pain management among home-dwelling people aged 75 to 95 using cross-sectional cohort data spanning 20 years. The Helsinki Aging Study recruited random samples aged 75, 80, 85, 90, and 95 in 1999, 2009, and 2019. In total, 5,707 community-dwelling people participated in the questionnaire survey. Participants reported their medical diagnoses, regular prescription medications, and the presence of back pain or joint pain within the last 2 weeks (never, sometimes, or daily). We compared analgesics use in people reporting musculoskeletal pain and in people not reporting pain in 1999, 2009, and 2019. Of participants, 57–61% reported intermittent or daily musculoskeletal pain. The percentage of people taking a daily analgesic increased from 9% in 1999 to 16% in 2019. The use of NSAIDs decreased from 1999 to 2019, while the use of paracetamol increased from 2% to 11%. Of participants, 3% took daily opioids in 2019. Of those reporting daily musculoskeletal pain, 20% in 1999, 35% in 2009 and 32% in 2019 took regular pain medication. Pain remains undertreated in the older population, although the use of regular prescribed analgesics increased from 1999. The use of NSAIDs diminished, while the use of paracetamol increased. Daily opioid use remained modest from 1999 to 2019.

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Continue Or Not To Continue? Attitudes Towards Deprescribing Among Community- Dwelling Older Adults In China

10.21203/rs.3.rs-1111462/v1 ◽

2021 ◽

Author(s):

Jie Tan ◽

MinHong Wang ◽

XiaoRui Pei ◽

Quan Sun ◽

ChongJun Lu ◽

...

Keyword(s):

Older Adults ◽

Chronic Disease ◽

Inappropriate Prescribing ◽

Prescription Medication ◽

Adverse Outcomes ◽

Community Dwelling ◽

Potentially Inappropriate Medications ◽

Cross Sectional ◽

Wide Range ◽

Community Dwelling Older Adults

Abstract Background: Inappropriate prescribing of medications and polypharmacy among older adults are associated with a wide range of adverse outcomes. It is critical to understand the attitudes towards deprescribing—reducing the use of potentially inappropriate medications (PIMs)—among this vulnerable group. Such information is particularly lacking in low - and middle-income countries.Methods: The present study examined attitudes towards deprescribing and individual-based characteristics that might be associated with these attitudes among community-dwelling older adults in China. We conducted a cross-sectional study through in-person interviews using the Patients' Attitudes Towards Deprescribing (PATD) and the revised PATD (rPATD) (version for older adults) questionnaires in two communities through the community-based physical examination platform in China. Participants were 65 years and older and had at least one chronic disease and one regular prescription medication.Results: Of the 1,897 participants in this study, average age was 73.8 years (SD=6.2 years) and 1,023 (53.9%) were women. The majority had one chronic disease (n=1,364 [71.9%]) and took 1-2 medications (n=1,483 [78.2%]). A total of 947 (50.0%) older adults reported being willing to stop taking one or more of their medicines if their physician said it was possible, and 1,204 (63.5%) older adults wanted to stop a medicine been taking for a long time. We did not find Individual-level factors to be associated with attitudes towards deprescribing. Conclusions: The proportions of participants’ willingness to deprescribing were much lower than what prior investigations among western populations reported. It is important to identify the reasons for the low wiliness to deprescribe and develop a patient-centered and practical deprescribing guideline that is suitable for Chinese older adults.

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The fall risk assessment and correlated factors among Iranians’ older adults

Working with Older People ◽

10.1108/wwop-11-2018-0020 ◽

2019 ◽

Vol 23 (1) ◽

pp. 27-36

Author(s):

Leili Salehi ◽

Elham Akhondzadeh ◽

Sara Esmaelzadeh Saeieh ◽

Mansoureh Yazd Khasti

Keyword(s):

Risk Factors ◽

Marital Status ◽

Preventive Intervention ◽

Statistical Tests ◽

Risk Groups ◽

Community Dwelling ◽

Cross Sectional ◽

Content Type ◽

Falling Risk ◽

Correlated Factors

Purpose Falling was distinguished as leading cause of fatal and non-fatal injuries among elderly; there is a lack of information regarding the falling risk factors in developing countries. The purpose of this paper is to investigate the falling risk and correlated factors in community-dwelling elderly. Design/methodology/approach This cross-sectional study was performed on 280 elderly using a multi-sectional questionnaire in Karaj, Iran. The simple stratified random sampling was used. Adult who were over the age of 60, living independently, able to ambulate independently and safely, no cognition problem and speaking in Persian entered in the study. Exclusion criteria were residing in assisted living facility or unwilling to participate. Several statistical tests including logistic regression analysis were used to analyse the data. Findings The mean age of participants was 69.55±8.82 and 51 per cent of them were female. The results showed that there are significant differences between low-, medium- and high-risk groups regarding age, marital status, diabetes, blood pressure and osteoarthritis (p<0.05). Due to finding, the main predictors to higher chance of falling were age (OR=1.61; 95% CI 1.025–1.097), marital status (OR=1.485; 95% CI 1.170–1.279), vision acuity (OR=1.603; 95% CI 1.297–2.223), activities of daily living (OR=2.10; 95% CI 1.047–3.859), heart disease (OR=1.448; 95% CI 1.268–1.728), osteoarthritis (OR=1.238; 95% CI 1.711–2.127), falling history (OR=1.026; 95% CI 1.015–1.089) and medication (OR=5.975; 95% CI 1.525–23.412). Practical implications Better understanding of falling risk factors can lead to the implementation of effective preventive intervention, thus reducing public health expenditure, and improving the quality of life. Originality/value This study was conducted for the first time to assess the risk of falling in older people in Iran.

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The Abuse of Prescription Medications and Employment History

The International Journal of Psychiatry in Medicine ◽

10.2190/pm.43.3.f ◽

2012 ◽

Vol 43 (3) ◽

pp. 273-278

Author(s):

Randy A. Sansone ◽

Justin S. Leung ◽

Michael W. Wiederman

Keyword(s):

Internal Medicine ◽

Survey Methodology ◽

Prescription Medication ◽

Self Report ◽

Prescription Medications ◽

Cross Sectional ◽

Employment History ◽

Significant Relationships ◽

Medication Abuse ◽

The Relationship

Objective: The relationship between prescription medication abuse and employment history is rarely studied and is the focus of the present study. Method: Using a cross-sectional consecutive sample of 325 internal medicine outpatients and a self-report survey methodology, we examined prescription medication abuse (“Have you ever intentionally, or on purpose, abused prescription medications?”) and four employment variables. Results: We found statistically significant relationships between the abuse of prescription medications and all four employment variables—i.e., number of different jobs held since age 18 (5.05 in nonabusers versus 7.81 in past abusers), estimated percentage of time employed since age 18 (79.0% in nonabusers versus 63.3% in past abusers), being paid “under the table” (24.9% in nonabusers versus 77.4% in past abusers), and being fired (37.2% in nonabusers versus 64.5% in past abusers)—all indicating less employment viability in participants with past histories of prescription medication abuse. Conclusions: The abuse of prescription medications is associated with impaired functionality in the work arena.

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