| Title |
The “iatrogenic triad”: polypharmacy, drug–drug interactions, and potentially inappropriate medications in older adults
|
|---|---|
| Published in |
International Journal of Clinical Pharmacy, April 2017
|
| DOI | 10.1007/s11096-017-0470-2 |
| Pubmed ID | |
| Authors |
Priscila Horta Novaes, Danielle Teles da Cruz, Alessandra Lamas Granero Lucchetti, Isabel Cristina Gonçalves Leite, Giancarlo Lucchetti |
| Abstract |
Background The elderly population is often in continuous use of several medications and is more subject to the "iatrogenic triad" of polypharmacy, potentially inappropriate medication use and drug-drug interactions. However, few studies have investigated these three factors concomitantly. Purpose To assess the prevalence and inter-relationship of potentially inappropriate medication (PIM) use, polypharmacy and drug-drug interactions in older adults, together with their associated factors. Setting city of Juiz de Fora, Brazil. Methods a cross-sectional, observational and door-to-door epidemiologic study in community-dwelling older adults was conducted. Main outcome measure The primary outcomes were polypharmacy, inappropriate medication use (2012 Beers and 2015 STOPP criteria) and drug-drug interactions. Associated factors were also investigated using bivariate and multivariate analyses. Results a total of 368 (92%) older adults were in continuous use of at least one drug. There was a high prevalence of polypharmacy (44.6%), drug-drug interaction (72.3%) and PIMs by Beers (42.1%) and PIMs by STOPP (46.2%). Analysis of the inter-relationship of the criteria (polypharmacy, PIMs STOPP and drug-drug interactions) revealed that 108 (29.3%) of the older adults had all three criteria concomitantly and multivariate analysis showed that frailty and having a caregiver were associated with this "iatrogenic triad". Conclusion A high prevalence of iatrogenic effects from drugs was found in the older adults assessed. One in every three elderly participants of the study had all three iatrogenic criteria concomitantly, highlighting the major public health impact of this problem. The results of this study can serve to inform new preventive and educational strategies for health professionals. |
X Demographics
The data shown below were collected from the profiles of 122 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Spain | 56 | 46% |
| United States | 3 | 2% |
| Ireland | 2 | 2% |
| Argentina | 2 | 2% |
| Colombia | 1 | <1% |
| Peru | 1 | <1% |
| Brazil | 1 | <1% |
| Cabo Verde | 1 | <1% |
| Ecuador | 1 | <1% |
| Other | 4 | 3% |
| Unknown | 50 | 41% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 98 | 80% |
| Practitioners (doctors, other healthcare professionals) | 14 | 11% |
| Scientists | 9 | 7% |
| Science communicators (journalists, bloggers, editors) | 1 | <1% |
Mendeley readers
The data shown below were compiled from readership statistics for 148 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 148 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 24 | 16% |
| Student > Bachelor | 19 | 13% |
| Student > Ph. D. Student | 17 | 11% |
| Student > Postgraduate | 10 | 7% |
| Other | 9 | 6% |
| Other | 24 | 16% |
| Unknown | 45 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 38 | 26% |
| Pharmacology, Toxicology and Pharmaceutical Science | 26 | 18% |
| Nursing and Health Professions | 17 | 11% |
| Biochemistry, Genetics and Molecular Biology | 2 | 1% |
| Arts and Humanities | 2 | 1% |
| Other | 10 | 7% |
| Unknown | 53 | 36% |
Attention Score in Context
This research output has an Altmetric Attention Score of 76. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 05 December 2017.
All research outputs
#538,647
of 24,598,501 outputs
Outputs from International Journal of Clinical Pharmacy
#8
of 1,223 outputs
Outputs of similar age
#11,430
of 315,193 outputs
Outputs of similar age from International Journal of Clinical Pharmacy
#1
of 22 outputs
Altmetric has tracked 24,598,501 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 97th percentile: it's in the top 5% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 1,223 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 5.7. This one has done particularly well, scoring higher than 99% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 315,193 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 96% of its contemporaries.
We're also able to compare this research output to 22 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 99% of its contemporaries.