Inappropriate Medication Use as a Risk Factor for Self-Reported Adverse Drug Effects in Older Adults
Article first published online: 21 MAY 2009
© 2009, Copyright the Authors. Journal compilation © 2009, The American Geriatrics Society
Journal of the American Geriatrics Society
Volume 57, Issue 6, pages 1000–1006, June 2009
How to Cite
Chrischilles, E. A., VanGilder, R., Wright, K., Kelly, M. and Wallace, R. B. (2009), Inappropriate Medication Use as a Risk Factor for Self-Reported Adverse Drug Effects in Older Adults. Journal of the American Geriatrics Society, 57: 1000–1006. doi: 10.1111/j.1532-5415.2009.02269.x
- Issue published online: 29 MAY 2009
- Article first published online: 21 MAY 2009
- adverse drug effects
OBJECTIVES: To determine the association between inappropriate medication use and self-reported adverse drug effects (ADEs).
DESIGN: Prospective cohort study with three annual mailed surveys.
SETTING: Population-based sample of Iowa Medicare beneficiaries.
PARTICIPANTS: Cohort members (n=626) with established mobility disability and complete pharmacy dispensing records, continuous Medicare eligibility, and survey data.
MEASUREMENTS: The number of unique drug ingredients dispensed and inappropriate use were assessed for the year before the ADE survey. Inappropriate medication use was defined according to published criteria: contraindicated drugs for elderly people, drug–disease interactions (constructed from linked Medicare claims), drug–drug interactions, and therapeutic duplications. An ADE was defined from the following question: “In the past 12 months, have you experienced an unwanted effect or side effect of a medication?”
RESULTS: Of respondents to the ADE survey, 22.0% reported having experienced an ADE in the past year, and 322 (51.4%) received at least one potential inappropriate medication. Factors associated univariately with ADE self-report were number of medications, number of mobility limitations, any inappropriate medication use, and each of the individual domain appropriateness indicators, as well as number of different domains of inappropriate use. The adjusted odds ratio for developing an ADE was 2.14 (95% confidence interval=1.26–3.65) for those with inappropriate use versus no inappropriate use.
CONCLUSION: Efforts to reduce ADEs by reducing medication inappropriateness should be encouraged as a complement to efforts focused on reducing the number of medications prescribed.