ArticleEuropean journal of clinical pharmacology2025
Association between socioeconomic status and dispensing of higher-risk drug classes and polypharmacy in older community-based populations: a nationwide cohort study.
Article in European journal of clinical pharmacology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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1 citing paper in PubMed.
- Evidence-based nursing to reduce polypharmacy risks in older cholecystectomy patients.World journal of gastrointestinal surgery · 2025Article
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8 authors.
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Abstract
backgroundHigher-risk medications are associated with increased risk of medication-related harm in older populations.
aimTo investigate the association between socioeconomic status (SES) and the prescribing of higher-risk drug classes and polypharmacy in older community-dwelling adults.
methodsThis prospective, population-based cohort study used linked data from the Irish Longitudinal Study on Ageing (TILDA, 2018), the Health Service Executive-Primary Care Reimbursement Service (HSE-PCRS), and the General Medical Services (GMS) scheme over a 2-year follow-up. SES was measured by education, income, and private health insurance. Higher-risk drugs included antithrombotic agents, beta-blockers, calcium channel blockers, diuretics, renin-angiotensin-aldosterone system (RAAS) inhibitors, psychoanaleptics, and NSAIDs. Polypharmacy was categorised as 0-4, 5-9, and 10 + drug classes. Multivariable logistic and ordinal regression models adjusted for age, sex, and multimorbidity were used.
resultsThe study included 1,401 individuals aged ≥ 70 years (median age 79; 43% male); 53% had ≥ 3 chronic conditions. 43% had primary/no education, 46% had below-median income, and 55% lacked private health insurance. Antithrombotics were the most prescribed higher-risk drug (38%), and 41% had 10 + different drug classes. Higher-risk prescribing and polypharmacy were more prevalent in those with lower SES. Participants with low SES were significantly more likely to be prescribed higher-risk drugs and experience polypharmacy. The greatest association was for psychoanaleptics: adjusted OR 1.97 [95% CI: 1.32;2.95] for primary/no formal education vs. third-level education, and 1.73 [95% CI: 1.30;2.30] for no vs. private health insurance.
conclusionSES-related disparities in higher-risk prescribing highlight the need for targeted interventions addressing social determinants of health in older populations.
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