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Kidney Function, Polypharmacy, and Potentially Inappropriate Medication Use in a Community-Based Cohort of Older Adults.

TitleKidney Function, Polypharmacy, and Potentially Inappropriate Medication Use in a Community-Based Cohort of Older Adults.
Publication TypeJournal Article
Year of Publication2018
AuthorsSecora A, G Alexander C, Ballew SH, Coresh JJ
Secondary AuthorsGrams ME
JournalDrugs Aging
Volume35
Issue8
Pagination735-750
Date Published2018 08
ISSN1179-1969
KeywordsAged, Aged, 80 and over, Cohort Studies, Female, Hospitalization, Humans, Inappropriate Prescribing, Male, Polypharmacy, Potentially Inappropriate Medication List, Prevalence, Renal Insufficiency, Chronic, Risk Factors
Abstract

BACKGROUND: Chronic kidney disease (CKD) afflicts many older adults and increases the risk for medication-related adverse events.

OBJECTIVE: The aim of this study was to assess the prevalence and associated morbidity and mortality of polypharmacy (use of several medications concurrently), and potentially inappropriate medication (PIM) use in older adults, looking for differences by CKD status.

METHODS: We quantified medication and PIM use (from Beers criteria, the Screening Tool of Older People's Prescriptions, and Micromedex) by level of estimated glomerular filtration rate (eGFR) for participants aged 65 years or older attending a baseline study visit in the Atherosclerosis Risk in Communities study (n =6392). We used zero-inflated negative binomial and Cox proportional hazards regressions to assess the relationship between baseline polypharmacy, PIM use, and subsequent hospitalization and death.

RESULTS: Mean age at baseline was 76 (± 5) years, 59% were female, and 29% had CKD (eGFR 

CONCLUSION: Polypharmacy and PIM use were common, with greater numbers of medications associated with higher risk of hospitalization and death; relative risks were similar for those with and without CKD.

DOI10.1007/s40266-018-0563-1
Alternate JournalDrugs Aging
PubMed ID30039344
PubMed Central IDPMC6093216
Grant ListHHSN268201100012C / HL / NHLBI NIH HHS / United States
HHSN268201100009I / HL / NHLBI NIH HHS / United States
HHSN268201100010C / HL / NHLBI NIH HHS / United States
HHSN268201100008C / HL / NHLBI NIH HHS / United States
HHSN268201100005G / HL / NHLBI NIH HHS / United States
HHSN268201100008I / HL / NHLBI NIH HHS / United States
HHSN268201100007C / HL / NHLBI NIH HHS / United States
HHSN268201100011I / HL / NHLBI NIH HHS / United States
HHSN268201100011C / HL / NHLBI NIH HHS / United States
T32 HL007024 / HL / NHLBI NIH HHS / United States
HHSN268201000012C / NHLBI NIH HHS / National Heart, Lung, and Blood Institute / United States
U01 FD004977 / FD / FDA HHS / United States
HHSN268201000011C / NHLBI NIH HHS / National Heart, Lung, and Blood Institute / United States
HHSN268201100006C / HL / NHLBI NIH HHS / United States
HHSN268201100005I / HL / NHLBI NIH HHS / United States
HHSN268201000010C / NHLBI NIH HHS / National Heart, Lung, and Blood Institute / United States
HHSN268201100009C / HL / NHLBI NIH HHS / United States
HHSN268201100005C / HL / NHLBI NIH HHS / United States
HHSN268201100007I / HL / NHLBI NIH HHS / United States
K08 DK092287 / DK / NIDDK NIH HHS / United States