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Potentially Inappropriate Medication Use among Underserved Older Latino Adults

Background: Previous studies identified alarming increases in medication use, polypharmacy, and the use of potentially inappropriate medications (PIMs) among minority older adults with multimorbidity. However, PIM use among underserved older Latino adults is still largely unknown. The main objective...

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Autores principales: King, Ebony, Bazargan, Mohsen, Entsuah, Nana, Tokumitsu, Sayaka W., Wisseh, Cheryl, Adinkrah, Edward K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179006/
https://www.ncbi.nlm.nih.gov/pubmed/37176508
http://dx.doi.org/10.3390/jcm12093067
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author King, Ebony
Bazargan, Mohsen
Entsuah, Nana
Tokumitsu, Sayaka W.
Wisseh, Cheryl
Adinkrah, Edward K.
author_facet King, Ebony
Bazargan, Mohsen
Entsuah, Nana
Tokumitsu, Sayaka W.
Wisseh, Cheryl
Adinkrah, Edward K.
author_sort King, Ebony
collection PubMed
description Background: Previous studies identified alarming increases in medication use, polypharmacy, and the use of potentially inappropriate medications (PIMs) among minority older adults with multimorbidity. However, PIM use among underserved older Latino adults is still largely unknown. The main objective of this study is to examine the prevalence of PIM use among underserved, community-dwelling older Latino adults. This study examines both the complexity of polypharmacy in this community and identifies associations between PIM and multimorbidity, polypharmacy, and access to medical care among this segment of our population. Methods: This community-based, cross-sectional study included 126 community-dwelling Latinos aged 65 years and older. The updated 2019 AGS Beers Criteria was used to identify participants using PIMs. We used multinomial logistic regression to examine the independent association of PIM with several independent variables including demographic characteristics, the number of chronic conditions, the number of prescription medications used, level of pain, and sleep difficulty. In addition, we present five cases in order to offer greater insight into PIM use among our sample. Results: One-third of participants had at least one use of PIM. Polypharmacy (≥5 medications) was observed in 55% of our sample. In addition, 46% took drugs to be used with caution (UWC). In total, 16% were taking between 9 and 24 medications, whereas 39% and 46% were taking 5 to 8 and 1 to 4 prescription medications, respectively. The multinomial logit regression analysis showed that (controlling for demographic variables) increased PIM use was associated with an increased number of prescription medications, number of chronic conditions, sleep difficulty, lack of access to primary care, financial strains, and poor self-rated health. Discussion: Both qualitative and quantitative analysis revealed recurrent themes in the missed identification of potential drug-related harm among underserved Latino older adults. Our data suggest that financial strain, lack of access to primary care, as well as an increased number of medications and co-morbidity are inter-connected. Lack of continuity of care often leads to fragmented care, putting vulnerable patients at risk of polypharmacy and drug–drug interactions as clinicians lack access to a current and complete list of medications patients are using at any given time. Therefore, improving access to health care and thereby continuity of care among older Latino adults with multimorbidity has the potential to reduce both polypharmacy and PIM use. Programs that increase access to regular care and continuity of care should be prioritized among multimorbid, undeserved, Latino older adults in an effort toward improved health equity.
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spelling pubmed-101790062023-05-13 Potentially Inappropriate Medication Use among Underserved Older Latino Adults King, Ebony Bazargan, Mohsen Entsuah, Nana Tokumitsu, Sayaka W. Wisseh, Cheryl Adinkrah, Edward K. J Clin Med Article Background: Previous studies identified alarming increases in medication use, polypharmacy, and the use of potentially inappropriate medications (PIMs) among minority older adults with multimorbidity. However, PIM use among underserved older Latino adults is still largely unknown. The main objective of this study is to examine the prevalence of PIM use among underserved, community-dwelling older Latino adults. This study examines both the complexity of polypharmacy in this community and identifies associations between PIM and multimorbidity, polypharmacy, and access to medical care among this segment of our population. Methods: This community-based, cross-sectional study included 126 community-dwelling Latinos aged 65 years and older. The updated 2019 AGS Beers Criteria was used to identify participants using PIMs. We used multinomial logistic regression to examine the independent association of PIM with several independent variables including demographic characteristics, the number of chronic conditions, the number of prescription medications used, level of pain, and sleep difficulty. In addition, we present five cases in order to offer greater insight into PIM use among our sample. Results: One-third of participants had at least one use of PIM. Polypharmacy (≥5 medications) was observed in 55% of our sample. In addition, 46% took drugs to be used with caution (UWC). In total, 16% were taking between 9 and 24 medications, whereas 39% and 46% were taking 5 to 8 and 1 to 4 prescription medications, respectively. The multinomial logit regression analysis showed that (controlling for demographic variables) increased PIM use was associated with an increased number of prescription medications, number of chronic conditions, sleep difficulty, lack of access to primary care, financial strains, and poor self-rated health. Discussion: Both qualitative and quantitative analysis revealed recurrent themes in the missed identification of potential drug-related harm among underserved Latino older adults. Our data suggest that financial strain, lack of access to primary care, as well as an increased number of medications and co-morbidity are inter-connected. Lack of continuity of care often leads to fragmented care, putting vulnerable patients at risk of polypharmacy and drug–drug interactions as clinicians lack access to a current and complete list of medications patients are using at any given time. Therefore, improving access to health care and thereby continuity of care among older Latino adults with multimorbidity has the potential to reduce both polypharmacy and PIM use. Programs that increase access to regular care and continuity of care should be prioritized among multimorbid, undeserved, Latino older adults in an effort toward improved health equity. MDPI 2023-04-23 /pmc/articles/PMC10179006/ /pubmed/37176508 http://dx.doi.org/10.3390/jcm12093067 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
King, Ebony
Bazargan, Mohsen
Entsuah, Nana
Tokumitsu, Sayaka W.
Wisseh, Cheryl
Adinkrah, Edward K.
Potentially Inappropriate Medication Use among Underserved Older Latino Adults
title Potentially Inappropriate Medication Use among Underserved Older Latino Adults
title_full Potentially Inappropriate Medication Use among Underserved Older Latino Adults
title_fullStr Potentially Inappropriate Medication Use among Underserved Older Latino Adults
title_full_unstemmed Potentially Inappropriate Medication Use among Underserved Older Latino Adults
title_short Potentially Inappropriate Medication Use among Underserved Older Latino Adults
title_sort potentially inappropriate medication use among underserved older latino adults
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10179006/
https://www.ncbi.nlm.nih.gov/pubmed/37176508
http://dx.doi.org/10.3390/jcm12093067
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