Factors associated with potentially inappropriate medication use, medication underuse and overuse in older adults in the German National Cohort.
Factors associated with potentially inappropriate medication use, medication underuse and overuse in older adults in the German National Cohort.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Heidelberg, DE · Author affiliation
Division of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.Location evidence
Bremen, DE · Author affiliation
Department of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.Location evidence
Braunschweig, DE · Author affiliation
Department of Epidemiology, Helmholtz Centre for Infections Research, Braunschweig, Germany.Location evidence
Lund, SE · Author affiliation
Department of Translational Medicine, Division of Urological Cancers, Lund University, Lund, Sweden.Location evidence
Düsseldorf, DE · Author affiliation
Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.Location evidence
Hamburg, DE · Author affiliation
Institute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.Location evidence
Munich, DE · Author affiliation
Institute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Neuherberg, Germany.Location evidence
Augsburg, DE · Author affiliation
KORA Study Centre, University Hospital of Augsburg, Augsburg, Germany.Location evidence
Regensburg, DE · Author affiliation
Institute of Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg, Regensburg, Germany.Location evidence
DE · Author affiliation · country only
Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.Location evidence
Berlin, DE · Author affiliation
Institute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.Location evidence
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Original abstract
BACKGROUND: Effectively identifying individuals exposed to drug underuse, overuse and potentially inappropriate medication (PIM) in older adults is essential for minimizing preventable drug-related harms. METHODS: We analysed data from 54,296 individuals aged 60-74 years from the German National Cohort (NAKO). We assessed the frequency of PIM, untreated conditions (medication and vaccination underuse) and medications without indication (overuse) utilizing the Fit fOR The Aged (FORTA) list. Factors associated with PIM, medication overuse and underuse were identified by multivariable logistic regression models. RESULTS: The frequency of PIM, underuse and overuse of medications was 26.1%, 19.1% and 23.6%, respectively. In participants with available vaccination information, 90.6% and 62.7% did not have the recommended pneumococcal and annual influenza virus vaccinations, respectively. Parkinson's disease, arterial hypertension, epilepsy and depression were strongly associated with PIM use, with 16.2-, 4.5-, 4.3- and 2.1-fold increased odds, respectively. Osteoporosis, atrial fibrillation, Parkinson's disease and chronic obstructive pulmonary disease were identified as particularly strongly associated with underuse, with 9.5-, 6.1-, 2.6- and 2.0-fold increased odds, respectively. Depression and epilepsy were the most prominent factors associated with overuse (1.6- and 1.5-fold increased odds). CONCLUSION: PIM and medication overuse, as well as drug and vaccine underuse, are very common among older German individuals. Comprehensive medication reviews are needed to improve medication quality. This work identifies people with specific characteristics who would benefit the most and could be prioritized for medication reviews.