Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study.
<h4>Background</h4>Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006...
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doaj-b6351e20e88341c087f013efec640f4a2021-06-19T05:30:10ZengPublic Library of Science (PLoS)PLoS ONE1932-62032021-01-01161e024564810.1371/journal.pone.0245648Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study.Laurie E DaviesAndrew KingstonAdam ToddBarbara Hanratty<h4>Background</h4>Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845).<h4>Methods</h4>The prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2-4, 5-9 and ≥10 medicines-so-called 'no polypharmacy', 'monotherapy', 'minor polypharmacy', 'polypharmacy' and 'hyperpolypharmacy.' Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5-90.5). Participant characteristics were examined through descriptive statistics.<h4>Results</h4>Complex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4-8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people (<25th centile Index of Multiple Deprivation (IMD)), despite no difference in the prevalence of cardiovascular disease (p = 0.56) and diabetes (p = 0.92) by IMD.<h4>Conclusion</h4>Considering their complex medical conditions, prescribing is relatively conservative amongst 85-year-olds living in North East England. Prescribing shows significant gender and selected socioeconomic differences. More support for managing preventative medicines, of uncertain benefit, might be helpful in this population.https://doi.org/10.1371/journal.pone.0245648 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Laurie E Davies Andrew Kingston Adam Todd Barbara Hanratty |
spellingShingle |
Laurie E Davies Andrew Kingston Adam Todd Barbara Hanratty Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study. PLoS ONE |
author_facet |
Laurie E Davies Andrew Kingston Adam Todd Barbara Hanratty |
author_sort |
Laurie E Davies |
title |
Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study. |
title_short |
Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study. |
title_full |
Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study. |
title_fullStr |
Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study. |
title_full_unstemmed |
Characterising polypharmacy in the very old: Findings from the Newcastle 85+ Study. |
title_sort |
characterising polypharmacy in the very old: findings from the newcastle 85+ study. |
publisher |
Public Library of Science (PLoS) |
series |
PLoS ONE |
issn |
1932-6203 |
publishDate |
2021-01-01 |
description |
<h4>Background</h4>Polypharmacy is potentially harmful and under-researched amongst the fastest growing subpopulation, the very old (aged ≥85). We aimed to characterise polypharmacy using data from the Newcastle 85+ Study-a prospective cohort of people born in 1921 who turned 85 in 2006 (n = 845).<h4>Methods</h4>The prevalence of polypharmacy at baseline (mean age 85.5) was examined using cut-points of 0, 1, 2-4, 5-9 and ≥10 medicines-so-called 'no polypharmacy', 'monotherapy', 'minor polypharmacy', 'polypharmacy' and 'hyperpolypharmacy.' Cross-tabulations and upset plots identified the most frequently prescribed medicines and medication combinations within these categories. Mixed-effects models assessed whether gender and socioeconomic position were associated with prescribing changes over time (mean age 85.5-90.5). Participant characteristics were examined through descriptive statistics.<h4>Results</h4>Complex multimorbidity (44.4%, 344/775) was widespread but hyperpolypharmacy was not (16.0%, 135/845). The median medication count was six (interquartile range 4-8). Preventative medicines were common to all polypharmacy categories, and prescribing regimens were diverse. Nitrates and oral anticoagulants were more frequently prescribed for men, whereas bisphosphonates, non-opioid analgesics and antidepressants were more common in women. Cardiovascular medicines, including loop diuretics, tended to be more frequently prescribed for socioeconomically disadvantaged people (<25th centile Index of Multiple Deprivation (IMD)), despite no difference in the prevalence of cardiovascular disease (p = 0.56) and diabetes (p = 0.92) by IMD.<h4>Conclusion</h4>Considering their complex medical conditions, prescribing is relatively conservative amongst 85-year-olds living in North East England. Prescribing shows significant gender and selected socioeconomic differences. More support for managing preventative medicines, of uncertain benefit, might be helpful in this population. |
url |
https://doi.org/10.1371/journal.pone.0245648 |
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