Changing Prevalence of Medication Use in People with Cirrhosis: A Retrospective Cohort Study Using Pharmaceutical Benefits Scheme Data

Autor: Kelly L. Hayward, Rianne A. Weersink, Christina M. Bernardes, Carolyn McIvor, Tony Rahman, Richard Skoien, Paul J. Clark, Katherine A. Stuart, Gunter Hartel, Patricia C. Valery, Elizabeth E. Powell
Jazyk: angličtina
Rok vydání: 2023
Předmět:
Zdroj: Drugs - Real World Outcomes, Vol 10, Iss 4, Pp 605-618 (2023)
Druh dokumentu: article
ISSN: 2199-1154
2198-9788
DOI: 10.1007/s40801-023-00390-2
Popis: Abstract Background Safe and appropriate use of medicines is essential to improve health outcomes in cirrhosis. However, little is known about the number and type of medicines dispensed to people with cirrhosis in Australia, as this predominantly occurs in the community. We aimed to characterise the prescriptions dispensed to people with cirrhosis and explore changes in the use of medication groups over time. Methods Pharmaceutical Benefits Scheme data between 1 January 2016 and 30 June 2020 was extracted for consenting CirCare participants (multi-site, prospective, observational study). Prescriptions dispensed from cirrhosis diagnosis until liver transplant or death were included. Safety classifications for dispensed medicines were defined using published evidence-based recommendations. The pattern of medication use was analysed in 6-monthly time intervals. Generalised estimating equations models were used to estimate the change in consumption of medicines over time. Results Five hundred twenty-two patients (mean age 60 years, 70% male, 34% decompensated at recruitment) were dispensed 89,615 prescriptions during the follow-up period, representing a median of 136 [interquartile range (IQR) 62–237] prescriptions and a median of 16 (IQR 11–23) unique medicines per patient (total n = 9306 medicines). The most commonly used medicines were proton pump inhibitors (PPIs) (dispensed at least once to 73% of patients), opioids (68%) and antibiotics (89%). Polypharmacy was prevalent, with 59–69% of observed participants in each time period dispensed five or more unique medicines. Prescription medication use increased over time (p
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