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Accepted (AM)Open Access (License Unspecified), Open
Journal article
Geographic region and racial variations in polypharmacy in the United States
Annals of epidemiology, v 25(6), pp 433-438
Jun 2015
PMID: 25908300
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Medications can have unintended effects. High medication use populations may benefit from increased regimen oversight. Limited knowledge exists concerning racial and regional polypharmacy variation. We estimated total medication distributions (excluding supplements) of American black and white adults and assessed racial and regional polypharmacy variation.
REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort data (n = 30,239 U.S. blacks and whites aged ≥45 years) were analyzed. Home pill bottle inspections assessed the last two weeks' medications. Polypharmacy (≥8 medications) was determined by summing prescription and/or over-the-counter ingredients. Population-weighted logistic regression assessed polypharmacy's association with census region, race, and sex.
The mean ingredient number was 4.12 (standard error = 0.039), with 15.7% of REGARDS using 8 ingredients or more. In crude comparisons, women used more medications than men, and blacks and whites reported similar mean ingredients. A cross-sectional, logistic model adjusting for demographics, socioeconomics, and comorbidities showed increased polypharmacy prevalence in whites versus blacks (OR [95% CI]: 0.63, [0.55–0.72]), women (1.94 [1.68–2.23]), and Southerners (broadly Southeasterners and Texans; 1.48 [1.17–1.87]) versus Northeasterners (broadly New England and upper Mid-Atlantic). Possible limitations include polypharmacy misclassification and model misspecification.
Polypharmacy is common. Race and geography are associated with polypharmacy variation. Further study of underlying factors explaining these differences is warranted.
•There is a high frequency of polypharmacy among American adults.•Polypharmacy is not equally distributed across racial groups and census regions.•Future research should investigate potential deleterious polypharmacy consequences.•However, polypharmacy is appropriate and the standard of care for some patients.•Higher Southern and white polypharmacy does not a priori indicate excessive use.
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Details
- Title
- Geographic region and racial variations in polypharmacy in the United States
- Creators
- Winn Cashion - Emory UniversityWilliam McClellan - Emory UniversityGeorge Howard - University of Alabama at BirminghamAbhinav Goyal - Emory UniversityDavid Kleinbaum - Emory UniversityMichael Goodman - Emory UniversityValerie Prince - Samford UniversityPaul Muntner - University of Alabama at BirminghamLeslie A. McClure - University of Alabama at BirminghamAnn McClellan - Emory UniversitySuzanne Judd - University of Alabama at Birmingham
- Publication Details
- Annals of epidemiology, v 25(6), pp 433-438
- Publisher
- Elsevier
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:000355021200008
- Scopus ID
- 2-s2.0-84929270986
- Other Identifier
- 991019231725504721
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- Collaboration types
- Domestic collaboration
- Web of Science research areas
- Public, Environmental & Occupational Health