scholarly journals Prevalence and Predictors of Potentially Inappropriate Prescribing in Middle-Aged Adults: Repeated Cross-Sectional Study

2021 ◽  
pp. BJGP.2020.1048
Author(s):  
Amandeep Khatter ◽  
Frank Moriarty ◽  
Mark Ashworth ◽  
Stevo Durbaba ◽  
Patrick Redmond
Keyword(s):  
Adverse Drug Events ◽  
Demographic Data ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Prescribing ◽  
Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Gender And Age ◽  
Middle Aged Adults

Background: Potentially inappropriate prescribing (PIP) is common in older adults and known to be associated with polypharmacy and multimorbidity. Less is known about the prevalence and causes of PIP in middle-aged adults. Aim: To determine the prevalence and predictors of PIP in middle-aged adults. Design and Setting: A repeated cross-sectional study was conducted using primary care data in London. Method: PIP was defined using the PRescribing Optimally in Middle-aged People’s Treatment (PROMPT) criteria. Prescribing and demographic data were extracted from Lambeth DataNet (LDN), a pseudonymised database of all patients registered at general practices in Lambeth, for those aged 45-64 years prescribed ≥1 medicines in each year, 2014-2019 (n=46,633-52,582). Prevalence and trends over six years were investigated, including the association of PIP with polypharmacy, multimorbidity, deprivation, gender and age. Results: The prevalence of PIP decreased from 20% in 2014 to 18% in 2019. The most prevalent PROMPT criteria in 2019 were the use of ≥2 drugs from the same pharmacological class (7.6%), use of NSAIDs for >3 months (7%) and use of PPIs above recommended maintenance dosages for >8 weeks (3%). Over the study period, the prevalence of multimorbidity increased (47-52%), and polypharmacy remained stable (27%). Polypharmacy, multimorbidity, deprivation and age were independently associated with PIP. Conclusions: Almost a fifth of middle-aged adults prescribed medicines are exposed to PIP, as defined by the PROMPT criteria. This is likely to be linked with exposure to avoidable adverse drug events. The PROMPT criteria may provide a useful aid in interventions to optimise prescribing.

Potentially inappropriate prescribing in middle-aged adults

2021 ◽  
Vol 60 (1) ◽  
pp. 6-6
Keyword(s):  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Prescribing ◽  
Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Middle Aged Adults

AbstractOverview of: Khatter A, Moriarty F, Ashworth M et al. Prevalence and predictors of potentially inappropriate prescribing in middle-aged adults: a repeated cross-sectional study. Br J Gen Pract. 2021;71:e491–e497.

scholarly journals Excessive polypharmacy and potentially inappropriate prescribing in 147 care-homes: cross-sectional study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0167
Author(s):  
Clare MacRae ◽  
David Henderson ◽  
Stewart Mercer ◽  
Jenni Burton ◽  
Nicosha De Souza ◽  
...  
Keyword(s):  
Adverse Drug Events ◽  
Care Home ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Care Homes ◽  
Potentially Inappropriate Prescribing ◽  
Sectional Study ◽  
Prescribing Practices ◽  
Cross Sectional ◽  
Sectional Analysis

BackgroundCare-home residents often have multiple cognitive and physical impairments and are at high risk of adverse drug events (ADEs).AimDescribe excessive polypharmacy and potentially inappropriate prescribing predisposing care-home residents to ADEs.Design and SettingCross-sectional analysis of all dispensed prescriptions for residents of 147 care-homes.MethodPrevalence of excessive polypharmacy was examined using multilevel logistic regression, by modelling associations between individual and care-home predictors with excessive polypharmacy (≥10 drugs). Prescribing of drugs known to increase the risk of eight clinically important ADE categories was examined. Drugs prescribed within each ADE category, for each resident, were counted.Results32.3% of residents had excessive polypharmacy, which was more common in residents aged 70–74 years (aOR =1.86 [1.04–3.34]) and 80–84 years (aOR =1.75 [1.01–3.02]), living in a residential care-home (aOR =1.50 [95%CI 1.19–1.88]), and located in Fife (aOR =1.37 [1.09–1.71]). Excessive polypharmacy was less common in residents with dementia (aOR =0.73 [0.64–0.84]). 8.9% (5.9%–11.6%) of the variation was attributable to care-home predictors. Potentially inappropriate prescribing of ≥2 drugs was seen across all ADE categories with highest prevalence seen in drugs predisposing to constipation (35.8%), sedation (27.7%), and renal injury (18.0%).ConclusionsExcessive polypharmacy is common in care-home residents and is associated with both individual and care-home predictors. Potentially inappropriate prescribing of drugs that predisposed residents to all included ADEs categories is common. Research is needed to support and evaluate safe care-home prescribing practices.

scholarly journals Influence of Body Composition on Arterial Stiffness in Middle-Aged Adults: Healthy UAL Cross-Sectional Study

Medicina ◽  
2019 ◽  
Vol 55 (7) ◽  
pp. 334 ◽  
Author(s):  
Alba Hernandez-Martinez ◽  
Elena Martinez-Rosales ◽  
Manuel Alcaraz-Ibañez ◽  
Alberto Soriano-Maldonado ◽  
Enrique G. Artero
Keyword(s):  
Body Composition ◽  
Arterial Stiffness ◽  
Metabolic Diseases ◽  
Cross Sectional Study ◽  
Neck Circumference ◽  
Fat Free Mass ◽  
Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Middle Aged Adults

Background and objectives: Several anthropometric and body composition parameters have been linked to arterial stiffness (AS) as a biomarker of cardiovascular disease. However, little is known about which of these closely related factors is more strongly associated with AS. The aim of the present study was to analyze the relationship of different anthropometric and body composition parameters with AS in middle-aged adults. Materials and Methods: This cross-sectional study included 186 middle-aged participants (85 women, 101 men; age = 42.8 ± 12.6 years) evaluated as part of the Healthy UAL study, a population study conducted at the University of Almería with the main purpose of analyzing the etiology and risk factors associated with cardio-metabolic diseases. Anthropometric measures included neck, waist, and hip circumferences, as well as the waist-to-height ratio (WHtr). Bioimpedance-derived parameters included fat-free mass index (FFMI), fat mass index (FMI), and percent of body fat (%BF). AS was measured by pulse wave velocity (PWV). The relationships of interest were examined through stepwise regression analyses in which age and sex were also introduced as potential confounders. Results: Neck circumference (in the anthropometric model; R 2: 0.889; β: age = 0.855, neck = 0.204) and FFMI (in the bio-impedance model; R2: 0.891; β: age = 0.906, FFMI = 0.199) emerged as significant cross-sectional predictors of AS. When all parameters were included together (both anthropometry and bio-impedance), both neck circumference and FFMI appeared again as being significantly associated with AS (R2: 0.894; β: age = 0.882, FFMI = 0.126, neck = 0.093). Conclusion: It was concluded that FFMI and neck circumference are correlated with AS regardless of potential confounders and other anthropometric and bioimpedance-derived parameters in middle-aged adults.

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