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Using pharmacy dispensing data to predict falls in older individuals
AIMS: Associations between individual medication use and falling in older individuals are well‐documented. However, a comprehensive risk score that takes into account overall medication use and that can be used in daily pharmacy practice is lacking. We, therefore, aimed to determine whether pharmacy...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2020
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328421/ https://www.ncbi.nlm.nih.gov/pubmed/32737899 http://dx.doi.org/10.1111/bcp.14506 |
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author | Gemmeke, Marle Koster, Ellen S. Pajouheshnia, Romin Kruijtbosch, Martine Taxis, Katja Bouvy, Marcel L. |
author_facet | Gemmeke, Marle Koster, Ellen S. Pajouheshnia, Romin Kruijtbosch, Martine Taxis, Katja Bouvy, Marcel L. |
author_sort | Gemmeke, Marle |
collection | PubMed |
description | AIMS: Associations between individual medication use and falling in older individuals are well‐documented. However, a comprehensive risk score that takes into account overall medication use and that can be used in daily pharmacy practice is lacking. We, therefore, aimed to determine whether pharmacy dispensing records can be used to predict falls. METHODS: A retrospective cohort study was conducted using pharmacy dispensing data and self‐reported falls among 3454 Dutch individuals aged ≥65 years. Two different methods were used to classify medication exposure for each person: the drug burden index (DBI) for cumulative anticholinergic and sedative medication exposure as well as exposure to fall risk‐increasing drugs (FRIDs). Multinomial regression analyses, adjusted for age and sex, were conducted to investigate the association between medication exposure and falling classified as nonfalling, single falling and recurrent falling. The predictive performances of the DBI and FRIDs exposure were estimated by the polytomous discrimination index (PDI). RESULTS: There were 521 single fallers (15%) and 485 recurrent fallers (14%). We found significant associations between a DBI ≥1 and single falling (adjusted odds ratio: 1.30 [95% confidence interval {CI}: 1.02–1.66]) and recurrent falling (adjusted odds ratio: 1.60 [95%CI: 1.25–2.04]). The PDI of the DBI model was 0.41 (95%CI: 0.39–0.42) and the PDI of the FRIDs model was 0.45 (95%CI: 0.43–0.47), indicating poor discrimination between fallers and nonfallers. CONCLUSION: The study shows significant associations between medication use and falling. However, the medication‐based models were insufficient and other factors should be included to develop a risk score for pharmacy practice. |
format | Online Article Text |
id | pubmed-9328421 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-93284212022-07-30 Using pharmacy dispensing data to predict falls in older individuals Gemmeke, Marle Koster, Ellen S. Pajouheshnia, Romin Kruijtbosch, Martine Taxis, Katja Bouvy, Marcel L. Br J Clin Pharmacol Original Articles AIMS: Associations between individual medication use and falling in older individuals are well‐documented. However, a comprehensive risk score that takes into account overall medication use and that can be used in daily pharmacy practice is lacking. We, therefore, aimed to determine whether pharmacy dispensing records can be used to predict falls. METHODS: A retrospective cohort study was conducted using pharmacy dispensing data and self‐reported falls among 3454 Dutch individuals aged ≥65 years. Two different methods were used to classify medication exposure for each person: the drug burden index (DBI) for cumulative anticholinergic and sedative medication exposure as well as exposure to fall risk‐increasing drugs (FRIDs). Multinomial regression analyses, adjusted for age and sex, were conducted to investigate the association between medication exposure and falling classified as nonfalling, single falling and recurrent falling. The predictive performances of the DBI and FRIDs exposure were estimated by the polytomous discrimination index (PDI). RESULTS: There were 521 single fallers (15%) and 485 recurrent fallers (14%). We found significant associations between a DBI ≥1 and single falling (adjusted odds ratio: 1.30 [95% confidence interval {CI}: 1.02–1.66]) and recurrent falling (adjusted odds ratio: 1.60 [95%CI: 1.25–2.04]). The PDI of the DBI model was 0.41 (95%CI: 0.39–0.42) and the PDI of the FRIDs model was 0.45 (95%CI: 0.43–0.47), indicating poor discrimination between fallers and nonfallers. CONCLUSION: The study shows significant associations between medication use and falling. However, the medication‐based models were insufficient and other factors should be included to develop a risk score for pharmacy practice. John Wiley and Sons Inc. 2020-08-14 2021-03 /pmc/articles/PMC9328421/ /pubmed/32737899 http://dx.doi.org/10.1111/bcp.14506 Text en © 2020 The Authors. British Journal of Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of British Pharmacological Society https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Articles Gemmeke, Marle Koster, Ellen S. Pajouheshnia, Romin Kruijtbosch, Martine Taxis, Katja Bouvy, Marcel L. Using pharmacy dispensing data to predict falls in older individuals |
title | Using pharmacy dispensing data to predict falls in older individuals |
title_full | Using pharmacy dispensing data to predict falls in older individuals |
title_fullStr | Using pharmacy dispensing data to predict falls in older individuals |
title_full_unstemmed | Using pharmacy dispensing data to predict falls in older individuals |
title_short | Using pharmacy dispensing data to predict falls in older individuals |
title_sort | using pharmacy dispensing data to predict falls in older individuals |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9328421/ https://www.ncbi.nlm.nih.gov/pubmed/32737899 http://dx.doi.org/10.1111/bcp.14506 |
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