| Quality use of medicines and health outcomes among a cohort of community dwelling older men: an observational study. | |
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MedLine Citation:
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PMID: 21395652 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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AIM: To determine the prevalence of potentially suboptimal medication use and association with adverse outcomes. METHODS: A prospective, observational cohort study of 4260 community-dwelling older men from Perth, Western Australia (mean age of 77 ± 3.6 years) was conducted. Follow-up was for 4.5 years (or until death, if sooner). Cox proportional hazard models were used to explore associations between suboptimal medication use and prospective clinical outcomes. Logistic regression analyses were used to explore predictors of a fall in the previous 12 months. RESULTS: Use of potentially inappropriate medicines (48.7%), polypharmacy (≥5 medications, 35.8%) and potential under-utilization (56.7%) were highly prevalent, and overall 82.3% of participants reported some form of potentially suboptimal medication use. A self-reported history of falls in the previous 12 months was independently associated with the number of medicines taken (odds ratio [OR]= 1.06, 95% confidence interval [CI] 1.02, 1.09) and use of one or more potentially inappropriate medicines (OR = 1.23, 95% CI 1.04, 1.45). After adjusting for age, co-morbidity, smoking status, body mass index, hypertension and educational attainment, the number of medicines reported was associated with admission to hospital (hazard ratio [HR]= 1.04, 95% CI 1.03, 1.06), cardiovascular events (HR = 1.09, 95% CI 1.06, 1.12) and all cause mortality (HR = 1.04, 95% CI 1.00, 1.07). Use of one or more potentially inappropriate medicines was associated with admission to hospital (HR = 1.16, 95% CI 1.08, 1.24). Potential under-utilization was associated with cardiovascular events (HR = 1.20, 95% CI 1.03, 1.40). CONCLUSIONS: These data suggest that both medication over-use and under-use occur frequently among older men and may be harmful. |
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Authors:
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Christopher Beer; Zoë Hyde; Osvaldo P Almeida; Paul Norman; Graeme J Hankey; Bu B Yeap; Leon Flicker |
Publication Detail:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: British journal of clinical pharmacology Volume: 71 ISSN: 1365-2125 ISO Abbreviation: Br J Clin Pharmacol Publication Date: 2011 Apr |
Date Detail:
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Created Date: 2011-03-14 Completed Date: 2011-06-21 Revised Date: 2012-04-02 |
Medline Journal Info:
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Nlm Unique ID: 7503323 Medline TA: Br J Clin Pharmacol Country: England |
Other Details:
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Languages: eng Pagination: 592-9 Citation Subset: IM |
Copyright Information:
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© 2011 The Authors. British Journal of Clinical Pharmacology © 2011 The British Pharmacological Society. |
Affiliation:
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Western Australian Centre for Health and Ageing, Centre for Medical Research, Western Australian Institute for Medical Research, Perth, WA, Australia. cdbeer@graduate.uwa.edu.au |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Accidental Falls
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mortality,
statistics & numerical data* Aged Aged, 80 and over Attitude to Health Cardiovascular Diseases / complications, drug therapy*, mortality Cohort Studies Geriatrics Hospitalization / statistics & numerical data* Humans Male Medication Errors* Nonprescription Drugs / adverse effects* Polypharmacy* Prescription Drugs / adverse effects* Proportional Hazards Models Prospective Studies Quality of Life Risk Factors Western Australia |
| Chemical | |
Reg. No./Substance:
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0/Nonprescription Drugs; 0/Prescription Drugs |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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