Contribution of Potentially Inappropriate Medications to Polypharmacy-Associated Risk of Mortality in Middle-Aged Patients: A National Cohort Study
| dc.rights.license | open | en_US |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | GUILLOT, Jordan | |
| dc.contributor.author | JUSTICE, Amy C | |
| dc.contributor.author | GORDON, Kirsha S | |
| dc.contributor.author | SKANDERSON, Melissa | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | PARIENTE, Antoine | |
| hal.structure.identifier | Bordeaux population health [BPH] | |
| dc.contributor.author | BEZIN, Julien
ORCID: 0000-0002-2568-1928 IDREF: 181595710 | |
| dc.contributor.author | RENTSCH, Christopher T | |
| dc.date.accessioned | 2024-08-22T08:26:35Z | |
| dc.date.available | 2024-08-22T08:26:35Z | |
| dc.date.issued | 2024-06-03 | |
| dc.identifier.issn | 1525-1497 | en_US |
| dc.identifier.uri | https://oskar-bordeaux.fr/handle/20.500.12278/201243 | |
| dc.description.abstractEn | BACKGROUND: The role of potentially inappropriate medications (PIMs) in mortality has been studied among those 65 years or older. While middle-aged individuals are believed to be less susceptible to the harms of polypharmacy, PIMs have not been as carefully studied in this group. OBJECTIVE: To estimate PIM-associated risk of mortality and evaluate the extent PIMs explain associations between polypharmacy and mortality in middle-aged patients, overall and by sex and race/ethnicity. DESIGN: Observational cohort study. SETTING: Department of Veterans Affairs (VA), the largest integrated healthcare system in the US. PARTICIPANTS: Patients aged 41 to 64 who received a chronic medication (continuous use of ≥ 90 days) between October 1, 2008, and September 30, 2017. MEASUREMENT: Patients were followed for 5 years until death or end of study period (September 30, 2019). Time-updated polypharmacy and hyperpolypharmacy were defined as 5-9 and ≥ 10 chronic medications, respectively. PIMs were identified using the Beers criteria (2015) and were time-updated. Cox models were adjusted for demographic, behavioral, and clinical characteristics. RESULTS: Of 733,728 patients, 676,935 (92.3%) were men, 479,377 (65.3%) were White, and 156,092 (21.3%) were Black. By the end of follow-up, 104,361 (14.2%) patients had polypharmacy, 15,485 (2.1%) had hyperpolypharmacy, and 129,992 (17.7%) were dispensed ≥ 1 PIM. PIMs were independently associated with mortality (HR 1.11, 95% CI 1.04-1.18). PIMs also modestly attenuated risk of mortality associated with polypharmacy (HR 1.07, 95% CI 1.03-1.11 before versus HR 1.05, 95% CI 1.01-1.09 after) and hyperpolypharmacy (HR 1.18, 95% CI 1.09-1.28 before versus HR 1.12, 95% CI 1.03-1.22 after). Patterns varied when stratified by sex and race/ethnicity. LIMITATIONS: The predominantly male VA patient population may not represent the general population. CONCLUSION: PIMs were independently associated with increased mortality, and partially explained polypharmacy-associated mortality in middle-aged people. Other mechanisms of injury from polypharmacy should also be studied. | |
| dc.language.iso | EN | en_US |
| dc.subject.en | Electronic health records | |
| dc.subject.en | Pharmacoepidemiology | |
| dc.subject.en | Polypharmacy | |
| dc.subject.en | Potentially inappropriate medications | |
| dc.subject.en | Veterans | |
| dc.title.en | Contribution of Potentially Inappropriate Medications to Polypharmacy-Associated Risk of Mortality in Middle-Aged Patients: A National Cohort Study | |
| dc.title.alternative | J Gen Intern Med | en_US |
| dc.type | Article de revue | en_US |
| dc.identifier.doi | 10.1007/s11606-024-08817-4 | en_US |
| dc.subject.hal | Sciences du Vivant [q-bio]/Santé publique et épidémiologie | en_US |
| dc.identifier.pubmed | 38831248 | en_US |
| bordeaux.journal | Journal of General Internal Medicine | en_US |
| bordeaux.hal.laboratories | Bordeaux Population Health Research Center (BPH) - UMR 1219 | en_US |
| bordeaux.institution | Université de Bordeaux | en_US |
| bordeaux.institution | INSERM | en_US |
| bordeaux.team | AHEAD_BPH | en_US |
| bordeaux.peerReviewed | oui | en_US |
| bordeaux.inpress | non | en_US |
| hal.identifier | hal-04675127 | |
| hal.version | 1 | |
| hal.date.transferred | 2024-08-22T08:26:38Z | |
| hal.popular | non | en_US |
| hal.audience | Internationale | en_US |
| hal.export | true | |
| dc.rights.cc | Pas de Licence CC | en_US |
| bordeaux.COinS | ctx_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.jtitle=Journal%20of%20General%20Internal%20Medicine&rft.date=2024-06-03&rft.eissn=1525-1497&rft.issn=1525-1497&rft.au=GUILLOT,%20Jordan&JUSTICE,%20Amy%20C&GORDON,%20Kirsha%20S&SKANDERSON,%20Melissa&PARIENTE,%20Antoine&rft.genre=article |
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