Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study
Abstract Background Older adults have the highest drug utilization due to multimorbidity. Although the number of people over age 70 is expected to double within the next decades, population-based data on their medication patterns are scarce especially in combination with polypharmacy and potentially...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Geriatrics |
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| Online Access: | https://doi.org/10.1186/s12877-020-1430-6 |
| _version_ | 1831737445978210304 |
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| author | Nina Mielke Dörte Huscher Antonios Douros Natalie Ebert Jens Gaedeke Markus van der Giet Martin K. Kuhlmann Peter Martus Elke Schaeffner |
| author_facet | Nina Mielke Dörte Huscher Antonios Douros Natalie Ebert Jens Gaedeke Markus van der Giet Martin K. Kuhlmann Peter Martus Elke Schaeffner |
| author_sort | Nina Mielke |
| collection | DOAJ |
| description | Abstract Background Older adults have the highest drug utilization due to multimorbidity. Although the number of people over age 70 is expected to double within the next decades, population-based data on their medication patterns are scarce especially in combination with polypharmacy and potentially inappropriate medication (PIM). Our objective was to analyse the frequency of polypharmacy, pattern of prescription (PD) and over-the-counter (OTC) drug usage, and PIMs according to age and gender in a population-based cohort of very old adults in Germany. Methods Cross-sectional baseline data of the Berlin Initiative Study, a prospective cohort study of community-dwelling adults aged ≥70 years with a standardized interview including demographics, lifestyle variables, co-morbidities, and medication assessment were analysed. Medication data were coded using the Anatomical Therapeutic Chemical (ATC) classification. Age- and sex-standardized descriptive analysis of polypharmacy (≥5 drugs, PD and OTC vs. PD only and regular and on demand drugs vs regular only), medication frequency and distribution, including PIMs, was performed by age (</≥80) and gender. Results Of 2069 participants with an average age of 79.5 years, 97% (95%CI [96%;98%]) took at least one drug and on average 6.2 drugs (SD = 3.5) with about 40 to 66% fulfilling the criteria of polypharmacy depending on the definition. Regarding drug type more female participants took a combination of PD and OTC (male: 68%, 95%CI [65%;72%]); female: 78%, 95%CI [76%;80%]). Most frequently used were drugs for cardiovascular diseases (85%, 95%CI [83%;86%]). Medication frequency increased among participants aged ≥80 years, especially for cardiovascular drugs, antithrombotics, psychoanaleptics and dietary supplements. Among the top ten prescription drugs were mainly cardiovascular drugs including lipid-lowering agents (simvastatin), beta-blockers (metoprolol, bisoprolol) and ACE inhibitors (ramipril). The most common OTC drug was acetylsalicylic acid (35%; 95%CI [33%;37%])). Dose-independent PIM were identified for 15% of the participants. Conclusions Polypharmacy was excessive in older adults, with not only PD but also OTC drugs contributing to the high point prevalence. The medication patterns reflected the treatment of chronic diseases in this age group. There was even an increase in medication frequency between below and above 80 years especially for drugs of cardiovascular diseases, antithrombotic medication, psychoanaleptics, and dietary supplements. |
| first_indexed | 2024-12-21T13:04:08Z |
| format | Article |
| id | doaj.art-c1f05e3f5f2844799eede1258eea993e |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-21T13:04:08Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-c1f05e3f5f2844799eede1258eea993e2022-12-21T19:03:06ZengBMCBMC Geriatrics1471-23182020-01-0120111210.1186/s12877-020-1430-6Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative StudyNina Mielke0Dörte Huscher1Antonios Douros2Natalie Ebert3Jens Gaedeke4Markus van der Giet5Martin K. Kuhlmann6Peter Martus7Elke Schaeffner8Institute of Public Health, Charité Universitätsmedizin BerlinInstitute of Public Health, Charité Universitätsmedizin BerlinInstitute of Clinical Pharmacology and Toxicology, Charité – Universitätsmedizin BerlinInstitute of Public Health, Charité Universitätsmedizin BerlinDepartement of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin BerlinDepartement of Nephrology and Medical Intensive Care, Charité – Universitätsmedizin BerlinDepartment of Nephrology, Vivantes Klinikum im FriedrichshainInstitute of Clinical Epidemiology and Medical Biostatistics, Eberhard Karls-UniversityInstitute of Public Health, Charité Universitätsmedizin BerlinAbstract Background Older adults have the highest drug utilization due to multimorbidity. Although the number of people over age 70 is expected to double within the next decades, population-based data on their medication patterns are scarce especially in combination with polypharmacy and potentially inappropriate medication (PIM). Our objective was to analyse the frequency of polypharmacy, pattern of prescription (PD) and over-the-counter (OTC) drug usage, and PIMs according to age and gender in a population-based cohort of very old adults in Germany. Methods Cross-sectional baseline data of the Berlin Initiative Study, a prospective cohort study of community-dwelling adults aged ≥70 years with a standardized interview including demographics, lifestyle variables, co-morbidities, and medication assessment were analysed. Medication data were coded using the Anatomical Therapeutic Chemical (ATC) classification. Age- and sex-standardized descriptive analysis of polypharmacy (≥5 drugs, PD and OTC vs. PD only and regular and on demand drugs vs regular only), medication frequency and distribution, including PIMs, was performed by age (</≥80) and gender. Results Of 2069 participants with an average age of 79.5 years, 97% (95%CI [96%;98%]) took at least one drug and on average 6.2 drugs (SD = 3.5) with about 40 to 66% fulfilling the criteria of polypharmacy depending on the definition. Regarding drug type more female participants took a combination of PD and OTC (male: 68%, 95%CI [65%;72%]); female: 78%, 95%CI [76%;80%]). Most frequently used were drugs for cardiovascular diseases (85%, 95%CI [83%;86%]). Medication frequency increased among participants aged ≥80 years, especially for cardiovascular drugs, antithrombotics, psychoanaleptics and dietary supplements. Among the top ten prescription drugs were mainly cardiovascular drugs including lipid-lowering agents (simvastatin), beta-blockers (metoprolol, bisoprolol) and ACE inhibitors (ramipril). The most common OTC drug was acetylsalicylic acid (35%; 95%CI [33%;37%])). Dose-independent PIM were identified for 15% of the participants. Conclusions Polypharmacy was excessive in older adults, with not only PD but also OTC drugs contributing to the high point prevalence. The medication patterns reflected the treatment of chronic diseases in this age group. There was even an increase in medication frequency between below and above 80 years especially for drugs of cardiovascular diseases, antithrombotic medication, psychoanaleptics, and dietary supplements.https://doi.org/10.1186/s12877-020-1430-6Older adultsMedicationPolypharmacyPotentially inappropriate medicationPrescription drugsOver-the-counter drugs |
| spellingShingle | Nina Mielke Dörte Huscher Antonios Douros Natalie Ebert Jens Gaedeke Markus van der Giet Martin K. Kuhlmann Peter Martus Elke Schaeffner Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study BMC Geriatrics Older adults Medication Polypharmacy Potentially inappropriate medication Prescription drugs Over-the-counter drugs |
| title | Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study |
| title_full | Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study |
| title_fullStr | Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study |
| title_full_unstemmed | Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study |
| title_short | Self-reported medication in community-dwelling older adults in Germany: results from the Berlin Initiative Study |
| title_sort | self reported medication in community dwelling older adults in germany results from the berlin initiative study |
| topic | Older adults Medication Polypharmacy Potentially inappropriate medication Prescription drugs Over-the-counter drugs |
| url | https://doi.org/10.1186/s12877-020-1430-6 |
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