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Multiple medicine use: factors of importance in different age groups
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Pharmacy, Department of Pharmacy. (Pharmaceutical Outcomes Research Group)
The Swedish Association of the Pharmaceutical Industry. (Pharmaceutical Outcomes Research Group)
Department of Clinical Sciences, Lund University.
Department of Public Health and Community Medicine/Primary Health Care, The Sahlgrenska Academy at Gothenburg University and The Skaraborg Institute.
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(English)Manuscript (preprint) (Other academic)
Abstract [en]

BACKGROUND: Multiple medicine use among elderly persons is likely to be the result of treatment regimens developed over a long time. By learning more about this development, it might be possible to increase quality in management of multiple medicine use across the adult lifespan.

OBJECTIVE: To describe patterns of multiple medicine use in a general population in association with sociodemographic factors, lifestyle, and health status.

METHODS: Data from a cross-sectional population health survey collected during 2001-2005 in 2,816 randomly selected Swedish residents (age 30-75 years; response rate 76%). Multiple medicine use was defined as the upper quartile in each age cohort.

RESULTS: The cut-offs defining multiple medicine use were: ≥2 for 30-49 year olds, ≥3 for 50-64 year olds, and ≥5 for 65-75 year olds. When drugs were classified into the second level of the ATC code, 76.3% of the 30-49 year olds, 97.9% of the 50-64 year olds, and 100% of the 65-75 year olds used a unique combination of drugs. The multivariate analyses showed that diabetes and poor self-rated health were associated with multiple medicine use in all age cohorts. Female gender and hypertension were associated with multiple medicine use among 30-49 and 50-64 year olds, ex-smoking among 50-64 year olds, and obesity among 65-75 year olds.

CONCLUSIONS: Different cut-offs should be used in defining multiple medicine use in different age groups. A vast majority of users of multiple medicines have a unique drug combination. Multiple medicine use is associated with morbidity and poor self-rated health across all age groups, suggesting that multiple medicine use is not due to drug over-consumption.

Keyword [en]
health status factors, lifestyle factors, multiple medicine use, polypharmacy, population survey, self-rated health, sociodemographic factors
National Category
Social and Clinical Pharmacy
Identifiers
URN: urn:nbn:se:uu:diva-106348OAI: oai:DiVA.org:uu-106348DiVA: diva2:224624
Available from: 2009-06-19 Created: 2009-06-19 Last updated: 2010-01-14Bibliographically approved
In thesis
1. Multiple Medicine Use: Patients’ and general practitioners’ perceptions and patterns of use in relation to age and other patient characteristics
Open this publication in new window or tab >>Multiple Medicine Use: Patients’ and general practitioners’ perceptions and patterns of use in relation to age and other patient characteristics
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

There are widespread concerns about the increasing use of multiple medicines. The aims of this thesis were to identify older patients' and general practitioners' (GPs) attitudes to and experiences of multiple medicine use, as well as to describe patterns of multiple medicine use in different age groups in association with patient-related factors. An additional aim was to contribute to scientific methodological development by providing an empirical example of the application of the Lehoux, Poland, & Daudelin template for the analysis of interaction in focus groups. Data were collected via qualitative focus group discussions and from a cross-sectional community-based population survey conducted during 2001-2005.

The patients revealed co-existing accounts of both immediate gratitude that medicines exist and problems with using multiple medicines such as worrying whether multiple medicine use is 'good' for the body. The patient-doctor relationship coloured their attitudes towards their treatment and care.

The GPs at times felt insecure, though surrounded by treatment guidelines. Lack of communication with hospital specialists was perceived to reduce treatment quality, while influence of patient pressure was thought to contribute to the development of multiple medicine use. An interaction analysis helped in appreciating and clarifying the contexts in which results from the content analysis were created. Further discussion is needed on how to best report these results.

Different cut-offs are useful in defining multiple medicine use in different age groups. Vast majorities of users of multiple medicines were found to have unique medicine combinations. Multiple medicine use was found to be associated with morbidity and poor self-rated health across all age groups.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 77 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Pharmacy, ISSN 1651-6192 ; 102
Keyword
Age groups, Focus group interaction analysis, General practitioners, Multiple medicine use, Patient-doctor communication, Patient-related factors, Polypharmacy
National Category
Social and Clinical Pharmacy
Research subject
Social Pharmacy
Identifiers
urn:nbn:se:uu:diva-106349 (URN)978-91-554-7564-2 (ISBN)
Public defence
2009-09-25, Auditorium Minus, Gustavianum, Akademigatan 3, Uppsala, 09:15 (English)
Opponent
Supervisors
Available from: 2009-09-02 Created: 2009-06-19 Last updated: 2009-09-02Bibliographically approved

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Moen, Janne

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