Evidence mapPaperPMID 41964402Full record

ArticleJournal of internal medicine2026

Factors associated with potentially inappropriate medication use, medication underuse and overuse in older adults in the German National Cohort.

Miriam Degen, Ulrike Haug, Oliver H F Scholle, Yaw Awuku-Larbi, Sigrid Carlsson, Nina Ebert, Volker Harth, Anja M Hauri, Margit Heier, Anne Herrmann and 9 more

Abstract read
In one paragraph

Article in Journal of internal medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

19 authors.

Miriam DegenDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Ulrike HaugDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Oliver H F ScholleDepartment of Clinical Epidemiology, Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany.
Yaw Awuku-LarbiDepartment of Epidemiology, Helmholtz Centre for Infections Research, Braunschweig, Germany.
Sigrid CarlssonDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.
Nina EbertInstitute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research at the Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
Volker HarthInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Anja M HauriDepartment of Epidemiology, Helmholtz Centre for Infections Research, Braunschweig, Germany.
Margit HeierInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Neuherberg, Germany.
Anne HerrmannInstitute of Epidemiology and Preventive Medicine/Medical Sociology, University of Regensburg, Regensburg, Germany.
Michael LeitzmannInstitute of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany.
Jakob LinseisenInstitute of Epidemiology, University of Augsburg, Augsburg, Germany.
Claudia Meinke-FranzeInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Nadia ObiInstitute for Occupational and Maritime Medicine (ZfAM), University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Phil PendtInstitute for Community Medicine, University Medicine Greifswald, Greifswald, Germany.
Thomas ReinholdInstitute for Social Medicine, Epidemiology and Health Economics, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Barbara ThorandInstitute of Epidemiology, Helmholtz Zentrum München, German Research Center for Environmental Health (GmbH), Neuherberg, Neuherberg, Germany.
Hermann BrennerCancer Prevention Graduate School, German Cancer Research Center (DKFZ), Heidelberg, Germany.ORCID https://orcid.org/0000-0002-6129-1572
Ben SchöttkerDivision of Clinical Epidemiology of Early Cancer Detection, German Cancer Research Center (DKFZ), Heidelberg, Germany.

Funding

Federal Ministry of Research, Technology and Space 01ER1301A/B/CFederal Ministry of Research, Technology and Space 01ER1511DFederal Ministry of Research, Technology and Space 01ER1801A/B/C/DFederal Ministry of Research, Technology and Space 01ER2301A/B/CFederal states of GermanyGerman Cancer Aid 70115079German National Cohort (NAKO) NAKO-960Helmholtz AssociationInstitutes of the Leibniz AssociationParticipating universities
6 · The paper itself

Abstract

backgroundEffectively identifying individuals exposed to drug underuse, overuse and potentially inappropriate medication (PIM) in older adults is essential for minimizing preventable drug-related harms.

methodsWe 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.

resultsThe 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).

conclusionPIM 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.

Indexed as

Inappropriate PrescribingPotentially Inappropriate Medication ListPrescription Drug OveruseAgedCohort StudiesFemaleGermanyHumansMaleMiddle AgedRisk Factorsgeriatricsinternal medicinemedication reviewpharmacoepidemiologyquality of healthcare

Identifiers

PMID41964402
PMCPMC13137406

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.