TY - JOUR
T1 - Prevalence and predictors of potentially inappropriate prescribing in middle-aged adults
T2 - A repeated cross-sectional study
AU - Redmond, Patrick
N1 - Funding Information:
Patrick Redmond is funded by the National Institute for Health Research (NIHR) as an Academic Clinical Lecturer. The views and opinions expressed by authors are those of the authors and do not necessarily reflect those of the UK National Institute for Health Research (NIHR) or the Department of Health and Social Care.
Publisher Copyright:
© 2021 Royal College of General Practitioners. All rights reserved.
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/7
Y1 - 2021/7
N2 - Background Potentially inappropriate prescribing (PIP) is common in older adults and known to be associated with polypharmacy and multimorbidity. Less is known about the prevalence and causes of PIP in middle-aged adults. Aim To determine the prevalence and predictors of PIP in middle-aged adults. Design and setting A repeated cross-sectional study was conducted using primary care data in London. Method PIP was defined using the PRescribing Optimally in Middle-aged People's Treatments (PROMPT) criteria. Prescribing and demographic data were extracted from Lambeth DataNet (LDN), a pseudonymised database of all patients registered at general practices in Lambeth, for those aged 45-64 years prescribed ≥1 medicines in each year from 2014-2019 (n = 46 633-52 582). Prevalence and trends over 6 years were investigated, including the association of PIP with polypharmacy, multimorbidity, deprivation, sex, and age. Results The prevalence of PIP decreased from 20% in 2014 to 18% in 2019. The most prevalent PROMPT criteria in 2019 were the use of ≥2 drugs from the same pharmacological class (7.6%), use of non-steroidal anti-inflammatory drugs for >3 months (7.1%) and use of proton pump inhibitors above recommended maintenance dosages for >8 weeks (3.1%). Over the study period, the prevalence of multimorbidity increased (47-52%) and polypharmacy remained stable (27%). Polypharmacy, multimorbidity, deprivation, and age were independently associated with PIP. Sex was the only variable not associated with PIP. Conclusion Almost one-fifth of middle-aged adults prescribed medicines are exposed to PIP, as defined by the PROMPT criteria. This is likely to be linked with exposure to avoidable adverse drug events. The PROMPT criteria may provide a useful aid in interventions to optimise prescribing.
AB - Background Potentially inappropriate prescribing (PIP) is common in older adults and known to be associated with polypharmacy and multimorbidity. Less is known about the prevalence and causes of PIP in middle-aged adults. Aim To determine the prevalence and predictors of PIP in middle-aged adults. Design and setting A repeated cross-sectional study was conducted using primary care data in London. Method PIP was defined using the PRescribing Optimally in Middle-aged People's Treatments (PROMPT) criteria. Prescribing and demographic data were extracted from Lambeth DataNet (LDN), a pseudonymised database of all patients registered at general practices in Lambeth, for those aged 45-64 years prescribed ≥1 medicines in each year from 2014-2019 (n = 46 633-52 582). Prevalence and trends over 6 years were investigated, including the association of PIP with polypharmacy, multimorbidity, deprivation, sex, and age. Results The prevalence of PIP decreased from 20% in 2014 to 18% in 2019. The most prevalent PROMPT criteria in 2019 were the use of ≥2 drugs from the same pharmacological class (7.6%), use of non-steroidal anti-inflammatory drugs for >3 months (7.1%) and use of proton pump inhibitors above recommended maintenance dosages for >8 weeks (3.1%). Over the study period, the prevalence of multimorbidity increased (47-52%) and polypharmacy remained stable (27%). Polypharmacy, multimorbidity, deprivation, and age were independently associated with PIP. Sex was the only variable not associated with PIP. Conclusion Almost one-fifth of middle-aged adults prescribed medicines are exposed to PIP, as defined by the PROMPT criteria. This is likely to be linked with exposure to avoidable adverse drug events. The PROMPT criteria may provide a useful aid in interventions to optimise prescribing.
UR - http://www.scopus.com/inward/record.url?scp=85108979719&partnerID=8YFLogxK
U2 - 10.3399/BJGP.2020.1048
DO - 10.3399/BJGP.2020.1048
M3 - Article
SN - 0960-1643
VL - 71
SP - E491-E497
JO - British Journal of General Practice
JF - British Journal of General Practice
IS - 708
ER -