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A dataset quantifying polypharmacy in the United States.

ABSTRACT: Polypharmacy is increasingly common in the United States, and contributes to the substantial burden of drug-related morbidity. Yet real-world polypharmacy patterns remain poorly characterized. We have counted the incidence of multi-drug combinations observed in four billion patient-months of outpatient prescription drug claims from 2007-2014 in the Truven Health MarketScan® Databases. Prescriptions are grouped into discrete windows of concomitant drug exposure, which are used to count exposure incidences for combinations of up to five drug ingredients or ATC drug classes. Among patients taking any prescription drug, half are exposed to two or more drugs, and 5% are exposed to 8 or more. The most common multi-drug combinations treat manifestations of metabolic syndrome. Patients are exposed to unique drug combinations in 10% of all exposure windows. Our analysis of multi-drug exposure incidences provides a detailed summary of polypharmacy in a large US cohort, which can prioritize common drug combinations for future safety and efficacy studies.

SUBMITTER: Quinn KJ

PROVIDER: S-EPMC5663207 | biostudies-literature | 2017 Oct

REPOSITORIES: biostudies-literature

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A dataset quantifying polypharmacy in the United States.

Quinn Katie J KJ Shah Nigam H NH

Scientific data 20171031

Polypharmacy is increasingly common in the United States, and contributes to the substantial burden of drug-related morbidity. Yet real-world polypharmacy patterns remain poorly characterized. We have counted the incidence of multi-drug combinations observed in four billion patient-months of outpatient prescription drug claims from 2007-2014 in the Truven Health MarketScan® Databases. Prescriptions are grouped into discrete windows of concomitant drug exposure, which are used to count exposure i ...[more]

PMID: 29087369

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Project description:Background/objectivesWith an aging population suffering from increased prevalence of chronic conditions in the United States (U.S.), a large portion of these patients are on multiple medications. High-risk medications can increase the risk for drug-drug interactions and medication nonadherence. This study aims to describe the prevalence of polypharmacy and high-risk medication prescribing in U.S. physician offices.MethodsThis was a cross-sectional study of the Centers for Disease Control and Prevention's National Ambulatory Medical Care Survey from 2009 to 2016. All patients over 65 years old were included. Polypharmacy was categorized as no polypharmacy (< 2 medications), minor polypharmacy (2-3 medications), moderate polypharmacy (4-5 medications), and major polypharmacy (>5 medications). Medications were further categorized into high-risk medication categories (anticholinergics, cardiovascular agents, central nervous system (CNS) medications, pain medications, and other). Comparisons between the degrees of polypharmacy were performed utilizing chi-square or Wilcoxon rank-sum tests with JMP Pro 14® (SAS Institute, Cary, NC).ResultsOver 2 billion patient visits were included. Overall, Polypharmacy was common (65.1%): minor polypharmacy (16.2%), moderate polypharmacy (12.1%), and major polypharmacy (36.8%). Patients with major polypharmacy were older compared to those with moderate or minor polypharmacy (75 vs. 73 years, respectively) and were most frequently prescribed pain medications (477.3 per 1,000 total visits). NSAIDs were the most frequently prescribed, with 232.4 per 1,000 total visits resulting in one high-risk NSAID prescription, while 21.9 per 1,000 total visits resulted in two or more high-risk NSAIDs.ConclusionMost patients over 65 years experienced some degree of polypharmacy, with many experiencing major polypharmacy. This indicates an increased need for expanded pharmacist roles through medication therapy management and safety monitoring in this patient population.

Dataset Information

A dataset quantifying polypharmacy in the United States.

Publications

A dataset quantifying polypharmacy in the United States.

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