Potentially Inappropriate Drug Duplication in a Cohort of Older Adults with Dementia

Shanna C. Trenaman; Susan K. Bowles; Susan A. Kirkland; Melissa K. Andrew

doi:10.1016/j.curtheres.2021.100644

Potentially Inappropriate Drug Duplication in a Cohort of Older Adults with Dementia

Shanna C. Trenaman, Susan K. Bowles, Susan A. Kirkland, Melissa K. Andrew

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Resumen

Background: Concurrent use of 2 nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, loop diuretics, angiotensin-converting enzyme inhibitors, or anticoagulants is considered potentially inappropriate by Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment criteria. Objective: The objective was to examine drug duplication in a cohort of older adults with dementia. Methods: Cohort entry for Nova Scotia Seniors’ Pharmacare Program beneficiaries was the date an International Classification of Diseases ninth edition or 10th edition code for dementia was recorded in accessed databases between March 1, 2005, and March 31, 2015. Medication dispensation and sociodemographic data were captured from the Nova Scotia Seniors’ Pharmacare Program database between April 1, 2010, and March 31, 2015. Duplication was considered when 2 drugs from the same class were dispensed such that the supply in the patient's possession could overlap for more than 30 days. We reported number of cases of duplication and duration of overlap. Sex differences in drug duplication were assessed with bivariate logistic regression. Results: In the cohort of 28,953 Nova Scotia Seniors’ Pharmacare Program beneficiaries with dementia, we documented concurrent use in 101 (1.7%) nonsteroidal anti-inflammatory drugs users (mean duration = 75.6 days), 95 (1.0%) selective serotonin reuptake inhibitors users (mean duration = 146.6 days), 5 (0.07%) loop diuretic users (mean duration = 530.6 days), 183 (2.0%) angiotensin-converting enzyme inhibitor users (mean duration = 123.9 days), and 160 (3.5%) anticoagulant users (mean duration = 63.6 days). Nonsteroidal anti-inflammatory drug pairs were most commonly celecoxib with naproxen or diclofenac. Selective serotonin reuptake inhibitors duplication was most commonly sertraline with citalopram. No sex differences in risk for drug duplication were identified. Conclusions: Drug duplication was identified in a cohort of older adults with dementia and is a feasible target for intervention. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX)

Idioma original	English
Número de artículo	100644
Publicación	Current Therapeutic Research - Clinical and Experimental
Volumen	95
DOI	https://doi.org/10.1016/j.curtheres.2021.100644
Estado	Published - ene. 2021

Nota bibliográfica

Funding Information:
The data used in this report were made available by Health Data Nova Scotia of Dalhousie University. Although this research is based on data obtained from the Nova Scotia Department of Health and Wellness, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness. Funding for the data access for this study was awarded via a Canadian Society of Hospital Pharmacists Foundation grant and the corresponding author received salary support from the Canadian Consortium on Neurodegeneration in Aging (CCNA) under Team 14 (PI: Melissa Andrew), which investigates how multimorbidity modifies the risk of dementia and the patterns of disease expression. The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations (www.ccna-ccnv.ca). Neither of the funders had any say or input in any aspect of the research conducted. S. Trenaman completed proposal writing, data analysis, and manuscript writing. S. Kirkland, S. Bowles, and M. Andrew all provided support, advice, and editing during all stages of research and writing.

Funding Information:
Funding for the data access for this study was awarded via a Canadian Society of Hospital Pharmacists Foundation grant and the corresponding author received salary support from the Canadian Consortium on Neurodegeneration in Aging (CCNA) under Team 14 (PI: Melissa Andrew), which investigates how multimorbidity modifies the risk of dementia and the patterns of disease expression. The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations ( www.ccna-ccnv.ca ). Neither of the funders had any say or input in any aspect of the research conducted.

Publisher Copyright:
© 2021 The Author(s)

ASJC Scopus Subject Areas

Pharmacology
Pharmacology (medical)

PubMed: MeSH publication types

Journal Article

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title = "Potentially Inappropriate Drug Duplication in a Cohort of Older Adults with Dementia",

abstract = "Background: Concurrent use of 2 nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, loop diuretics, angiotensin-converting enzyme inhibitors, or anticoagulants is considered potentially inappropriate by Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment criteria. Objective: The objective was to examine drug duplication in a cohort of older adults with dementia. Methods: Cohort entry for Nova Scotia Seniors{\textquoteright} Pharmacare Program beneficiaries was the date an International Classification of Diseases ninth edition or 10th edition code for dementia was recorded in accessed databases between March 1, 2005, and March 31, 2015. Medication dispensation and sociodemographic data were captured from the Nova Scotia Seniors{\textquoteright} Pharmacare Program database between April 1, 2010, and March 31, 2015. Duplication was considered when 2 drugs from the same class were dispensed such that the supply in the patient's possession could overlap for more than 30 days. We reported number of cases of duplication and duration of overlap. Sex differences in drug duplication were assessed with bivariate logistic regression. Results: In the cohort of 28,953 Nova Scotia Seniors{\textquoteright} Pharmacare Program beneficiaries with dementia, we documented concurrent use in 101 (1.7%) nonsteroidal anti-inflammatory drugs users (mean duration = 75.6 days), 95 (1.0%) selective serotonin reuptake inhibitors users (mean duration = 146.6 days), 5 (0.07%) loop diuretic users (mean duration = 530.6 days), 183 (2.0%) angiotensin-converting enzyme inhibitor users (mean duration = 123.9 days), and 160 (3.5%) anticoagulant users (mean duration = 63.6 days). Nonsteroidal anti-inflammatory drug pairs were most commonly celecoxib with naproxen or diclofenac. Selective serotonin reuptake inhibitors duplication was most commonly sertraline with citalopram. No sex differences in risk for drug duplication were identified. Conclusions: Drug duplication was identified in a cohort of older adults with dementia and is a feasible target for intervention. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX)",

author = "Trenaman, {Shanna C.} and Bowles, {Susan K.} and Kirkland, {Susan A.} and Andrew, {Melissa K.}",

note = "Funding Information: The data used in this report were made available by Health Data Nova Scotia of Dalhousie University. Although this research is based on data obtained from the Nova Scotia Department of Health and Wellness, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness. Funding for the data access for this study was awarded via a Canadian Society of Hospital Pharmacists Foundation grant and the corresponding author received salary support from the Canadian Consortium on Neurodegeneration in Aging (CCNA) under Team 14 (PI: Melissa Andrew), which investigates how multimorbidity modifies the risk of dementia and the patterns of disease expression. The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations (www.ccna-ccnv.ca). Neither of the funders had any say or input in any aspect of the research conducted. S. Trenaman completed proposal writing, data analysis, and manuscript writing. S. Kirkland, S. Bowles, and M. Andrew all provided support, advice, and editing during all stages of research and writing. Funding Information: Funding for the data access for this study was awarded via a Canadian Society of Hospital Pharmacists Foundation grant and the corresponding author received salary support from the Canadian Consortium on Neurodegeneration in Aging (CCNA) under Team 14 (PI: Melissa Andrew), which investigates how multimorbidity modifies the risk of dementia and the patterns of disease expression. The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations ( www.ccna-ccnv.ca ). Neither of the funders had any say or input in any aspect of the research conducted. Publisher Copyright: {\textcopyright} 2021 The Author(s)",

year = "2021",

month = jan,

doi = "10.1016/j.curtheres.2021.100644",

language = "English",

volume = "95",

journal = "Current Therapeutic Research - Clinical and Experimental",

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AU - Trenaman, Shanna C.

AU - Bowles, Susan K.

AU - Kirkland, Susan A.

AU - Andrew, Melissa K.

N1 - Funding Information: The data used in this report were made available by Health Data Nova Scotia of Dalhousie University. Although this research is based on data obtained from the Nova Scotia Department of Health and Wellness, the observations and opinions expressed are those of the authors and do not represent those of either Health Data Nova Scotia or the Department of Health and Wellness. Funding for the data access for this study was awarded via a Canadian Society of Hospital Pharmacists Foundation grant and the corresponding author received salary support from the Canadian Consortium on Neurodegeneration in Aging (CCNA) under Team 14 (PI: Melissa Andrew), which investigates how multimorbidity modifies the risk of dementia and the patterns of disease expression. The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations (www.ccna-ccnv.ca). Neither of the funders had any say or input in any aspect of the research conducted. S. Trenaman completed proposal writing, data analysis, and manuscript writing. S. Kirkland, S. Bowles, and M. Andrew all provided support, advice, and editing during all stages of research and writing. Funding Information: Funding for the data access for this study was awarded via a Canadian Society of Hospital Pharmacists Foundation grant and the corresponding author received salary support from the Canadian Consortium on Neurodegeneration in Aging (CCNA) under Team 14 (PI: Melissa Andrew), which investigates how multimorbidity modifies the risk of dementia and the patterns of disease expression. The CCNA receives funding from the Canadian Institutes of Health Research (CNA-137794) and partner organizations ( www.ccna-ccnv.ca ). Neither of the funders had any say or input in any aspect of the research conducted. Publisher Copyright: © 2021 The Author(s)

PY - 2021/1

Y1 - 2021/1

N2 - Background: Concurrent use of 2 nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, loop diuretics, angiotensin-converting enzyme inhibitors, or anticoagulants is considered potentially inappropriate by Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment criteria. Objective: The objective was to examine drug duplication in a cohort of older adults with dementia. Methods: Cohort entry for Nova Scotia Seniors’ Pharmacare Program beneficiaries was the date an International Classification of Diseases ninth edition or 10th edition code for dementia was recorded in accessed databases between March 1, 2005, and March 31, 2015. Medication dispensation and sociodemographic data were captured from the Nova Scotia Seniors’ Pharmacare Program database between April 1, 2010, and March 31, 2015. Duplication was considered when 2 drugs from the same class were dispensed such that the supply in the patient's possession could overlap for more than 30 days. We reported number of cases of duplication and duration of overlap. Sex differences in drug duplication were assessed with bivariate logistic regression. Results: In the cohort of 28,953 Nova Scotia Seniors’ Pharmacare Program beneficiaries with dementia, we documented concurrent use in 101 (1.7%) nonsteroidal anti-inflammatory drugs users (mean duration = 75.6 days), 95 (1.0%) selective serotonin reuptake inhibitors users (mean duration = 146.6 days), 5 (0.07%) loop diuretic users (mean duration = 530.6 days), 183 (2.0%) angiotensin-converting enzyme inhibitor users (mean duration = 123.9 days), and 160 (3.5%) anticoagulant users (mean duration = 63.6 days). Nonsteroidal anti-inflammatory drug pairs were most commonly celecoxib with naproxen or diclofenac. Selective serotonin reuptake inhibitors duplication was most commonly sertraline with citalopram. No sex differences in risk for drug duplication were identified. Conclusions: Drug duplication was identified in a cohort of older adults with dementia and is a feasible target for intervention. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX)

AB - Background: Concurrent use of 2 nonsteroidal anti-inflammatory drugs, selective serotonin reuptake inhibitors, loop diuretics, angiotensin-converting enzyme inhibitors, or anticoagulants is considered potentially inappropriate by Screening Tool of Older Persons' Prescriptions and Screening Tool to Alert to Right Treatment criteria. Objective: The objective was to examine drug duplication in a cohort of older adults with dementia. Methods: Cohort entry for Nova Scotia Seniors’ Pharmacare Program beneficiaries was the date an International Classification of Diseases ninth edition or 10th edition code for dementia was recorded in accessed databases between March 1, 2005, and March 31, 2015. Medication dispensation and sociodemographic data were captured from the Nova Scotia Seniors’ Pharmacare Program database between April 1, 2010, and March 31, 2015. Duplication was considered when 2 drugs from the same class were dispensed such that the supply in the patient's possession could overlap for more than 30 days. We reported number of cases of duplication and duration of overlap. Sex differences in drug duplication were assessed with bivariate logistic regression. Results: In the cohort of 28,953 Nova Scotia Seniors’ Pharmacare Program beneficiaries with dementia, we documented concurrent use in 101 (1.7%) nonsteroidal anti-inflammatory drugs users (mean duration = 75.6 days), 95 (1.0%) selective serotonin reuptake inhibitors users (mean duration = 146.6 days), 5 (0.07%) loop diuretic users (mean duration = 530.6 days), 183 (2.0%) angiotensin-converting enzyme inhibitor users (mean duration = 123.9 days), and 160 (3.5%) anticoagulant users (mean duration = 63.6 days). Nonsteroidal anti-inflammatory drug pairs were most commonly celecoxib with naproxen or diclofenac. Selective serotonin reuptake inhibitors duplication was most commonly sertraline with citalopram. No sex differences in risk for drug duplication were identified. Conclusions: Drug duplication was identified in a cohort of older adults with dementia and is a feasible target for intervention. (Curr Ther Res Clin Exp. 2021; 82:XXX–XXX)

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Potentially Inappropriate Drug Duplication in a Cohort of Older Adults with Dementia

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