Anticholinergic and sedative medication use in older community‐dwelling people: A national population study in the Netherlands

Autor: Helene G van der Meer, Martina Teichert, Hans Wouters, Lisa G. Pont, Fabienne Griens, Katja Taxis
Přispěvatelé: PharmacoTherapy, -Epidemiology and -Economics, Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET)
Jazyk: angličtina
Rok vydání: 2019
Předmět:
Male
pharmacoepidemiology
drug burden index
Epidemiology
Health Services for the Aged
Psychological intervention
030226 pharmacology & pharmacy
Psycholeptic
Cholinergic Antagonists
0302 clinical medicine
Original Report
Hypnotics and Sedatives
Pharmacology (medical)
Pharmacology & Pharmacy
030212 general & internal medicine
muscarinic antagonists
VERSION
SCALE
ASSOCIATIONS
Netherlands
PHYSICAL FUNCTION
Aged
80 and over
Pharmacoepidemiology
Latent class model
aged
Population study
Female
Independent Living
medicine.medical_specialty
medicine.drug_class
FUNCTIONAL BURDEN
Pharmacy
03 medical and health sciences
Internal medicine
Original Reports
Anticholinergic
medicine
latent class analysis
Humans
EXPOSURE
Aged
business.industry
MORTALITY
ADULTS
Cross-Sectional Studies
drug utilisation research
Sedative
Pharmaceutical Services
Polypharmacy
business
Zdroj: Pharmacoepidemiology and Drug Safety
Pharmacoepidemiology and Drug Safety, 28(3), 315-321. Wiley
Pharmacoepidemiology and Drug Safety, 28(3), 315-321
ISSN: 1099-1557
1053-8569
Popis: © 2019 The Authors Pharmacoepidemiology & Drug Safety Published by John Wiley & Sons Ltd Purpose: To identify the proportion of older adults with a high anticholinergic/sedative load and to identify patient subgroups based on type of central nervous system (CNS)-active medication used. Methods: A cross-sectional study of a nationwide sample of patients with anticholinergic/sedative medications dispensed by 1779 community pharmacies in the Netherlands (90% of all community pharmacies) in November 2016 was conducted. Patients aged older than 65 years with a high anticholinergic/sedative load defined as having a drug burden index (DBI) greater than 1 were included. Proportion of patients with a high anticholinergic/sedative load was calculated by dividing the number of individuals in our study population by the 2.4 million older patients using medications dispensed from study pharmacies. Patient subgroups based on type of CNS-active medications used were identified with latent class analysis. Results: Overall, 8.7% (209 472 individuals) of older adults using medications had a DBI greater than 1. Latent class analysis identified four patient subgroups (classes) based on the following types of CNS-active medications used: “combined psycholeptic/psychoanaleptic medication” (class 1, 57.9%), “analgesics” (class 2, 17.9%), “antiepileptic medication” (class 3, 17.8%), and “anti-Parkinson medication” (class 4, 6.3%). Conclusions: A large proportion of older adults in the Netherlands had a high anticholinergic/sedative load. Four distinct subgroups using specific CNS-active medication were identified. Interventions aiming at reducing the overall anticholinergic/sedative load should be tailored to these subgroups.
Databáze: OpenAIRE
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