@article {11593, title = {A multidimensional measure of polypharmacy for older adults using the Health and Retirement Study.}, journal = {Scientific Reports}, volume = {11}, year = {2021}, pages = {8783}, abstract = {

Polypharmacy is commonly defined based on the number of medications taken concurrently using standard cut-offs, but several studies have highlighted the need for a multidimensional assessment. We developed a multidimensional measure of polypharmacy and compared with standard cut-offs. Data were extracted for 2141 respondents of the 2007 Prescription Drug Survey, a sub-study of the Health Retirement Study. Latent classes were identified based on multiple indicators of polypharmacy, including quantity, temporality and risk profile. A four-class model was selected based on fit statistics and clinical interpretability: {\textquoteright}High risk, long-term{\textquoteright} (Class 1), {\textquoteright}Low risk, long-term{\textquoteright} (Class 2), {\textquoteright}High risk, short-term{\textquoteright} (Class 3), and {\textquoteright}High risk for drug interactions, medium-term, regular{\textquoteright} (Class 4). Classes differed regarding sex, cohabitation, disability and multimorbidity. Participants in the {\textquoteright}low risk{\textquoteright} class tended to be male, cohabitating, and reported fewer health conditions, compared to {\textquoteright}high risk{\textquoteright} classes. Polypharmacy classes were compared to standard cut-offs (5+ or 9+ medications) in terms of overlap and mortality risk. The three {\textquoteright}high risk{\textquoteright} classes overlapped with the groups concurrently taking 5+ and 9+ medications per month. However, the multidimensional measure further differentiated individuals in terms of risk profile and temporality of medication taking, thus offering a richer assessment of polypharmacy.

}, keywords = {Diseases, Health Care, Medical research, Risk Factors}, issn = {2045-2322}, doi = {10.1038/s41598-021-86331-x}, author = {Carr, Ewan and Federman, Alex and Dzahini, Olubanke and Dobson, Richard J and Bendayan, Rebecca} }