NSAID use among residents in 68 residential aged care facilities 2014 to 2017: an analysis of duration, concomitant medication use, and high-risk comorbidities

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Abstract

Purpose: People in residential aged care are at increased risk of adverse events from nonsteroidal anti‐inflammatory drugs (NSAIDs) due to their age and health status, but little is known about use of NSAIDs in this setting. We aimed to estimate the prevalence of NSAID use by route, differences by high‐risk conditions, prevalence of concurrent proton pump inhibitor (PPI) use, and prevalence of the “triple whammy” combination (oral NSAID, diuretic, and angiotensin‐converting‐enzyme inhibitor or angiotensin receptor antagonist).

Methods: We conducted a dynamic cohort study using medication administration data from 68 residential aged care facilities (RACFs) during 2014 to 2017. Descriptive statistics and regression were used to estimate the proportion of residents who used NSAIDs, NSAIDs long term, NSAIDs with PPIs, and the triple whammy combination.

Results: Ten thousand three hundred sixty‐seven residents were included. Two thousand four hundred fourteen (23.3%) used at least one NSAID: 756 (7.3%) used only oral, 1326 (12.8%) used only topical, and 332 (3.2%) used both topical and oral NSAIDs. One thousand five hundred forty two (14.8%) used an NSAID long term, a majority of which only used topical NSAIDs 933/1542 (60.5%). Age, sex, and health status were associated with greater variation in long‐term topical use relative to oral NSAID use. A majority of oral NSAID users concomitantly used a PPI, which varied according to age, sex, and health status. Among residents with any oral NSAID use, 182/1088 (16.7%) had triple whammy medication use.

Conclusions: Targeted interventions to reduce NSAID use among RACF residents, to reduce triple whammy medication use, and increase PPI use for long‐term oral NSAID users are warranted.
LanguageEnglish
Pages1480-1488
Number of pages9
JournalPharmacoepidemiology and Drug Safety
Volume28
Issue number11
Early online date6 Aug 2019
DOIs
Publication statusPublished - Nov 2019

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Comorbidity
Anti-Inflammatory Agents
Pharmaceutical Preparations
Proton Pump Inhibitors
Health Status
Drug Users
Angiotensin Receptor Antagonists
Angiotensin-Converting Enzyme Inhibitors
Diuretics
Cohort Studies

Keywords

  • long‐term care
  • nonsteroidal anti‐inflammatory drugs
  • NSAID
  • pharmacoepidemiology
  • triple whammy

Cite this

@article{81b136ec6fba43d8a662f6ba91784711,
title = "NSAID use among residents in 68 residential aged care facilities 2014 to 2017: an analysis of duration, concomitant medication use, and high-risk comorbidities",
abstract = "Purpose: People in residential aged care are at increased risk of adverse events from nonsteroidal anti‐inflammatory drugs (NSAIDs) due to their age and health status, but little is known about use of NSAIDs in this setting. We aimed to estimate the prevalence of NSAID use by route, differences by high‐risk conditions, prevalence of concurrent proton pump inhibitor (PPI) use, and prevalence of the “triple whammy” combination (oral NSAID, diuretic, and angiotensin‐converting‐enzyme inhibitor or angiotensin receptor antagonist). Methods: We conducted a dynamic cohort study using medication administration data from 68 residential aged care facilities (RACFs) during 2014 to 2017. Descriptive statistics and regression were used to estimate the proportion of residents who used NSAIDs, NSAIDs long term, NSAIDs with PPIs, and the triple whammy combination. Results: Ten thousand three hundred sixty‐seven residents were included. Two thousand four hundred fourteen (23.3{\%}) used at least one NSAID: 756 (7.3{\%}) used only oral, 1326 (12.8{\%}) used only topical, and 332 (3.2{\%}) used both topical and oral NSAIDs. One thousand five hundred forty two (14.8{\%}) used an NSAID long term, a majority of which only used topical NSAIDs 933/1542 (60.5{\%}). Age, sex, and health status were associated with greater variation in long‐term topical use relative to oral NSAID use. A majority of oral NSAID users concomitantly used a PPI, which varied according to age, sex, and health status. Among residents with any oral NSAID use, 182/1088 (16.7{\%}) had triple whammy medication use. Conclusions: Targeted interventions to reduce NSAID use among RACF residents, to reduce triple whammy medication use, and increase PPI use for long‐term oral NSAID users are warranted.",
keywords = "long‐term care, nonsteroidal anti‐inflammatory drugs, NSAID, pharmacoepidemiology, triple whammy",
author = "Lind, {Kimberly E.} and Raban, {Magdalena Z.} and Andrew Georgiou and Westbrook, {Johanna I.}",
year = "2019",
month = "11",
doi = "10.1002/pds.4866",
language = "English",
volume = "28",
pages = "1480--1488",
journal = "Pharmacoepidemiology and Drug Safety",
issn = "1053-8569",
publisher = "Wiley-Blackwell, Wiley",
number = "11",

}

TY - JOUR

T1 - NSAID use among residents in 68 residential aged care facilities 2014 to 2017

T2 - Pharmacoepidemiology and Drug Safety

AU - Lind, Kimberly E.

AU - Raban, Magdalena Z.

AU - Georgiou, Andrew

AU - Westbrook, Johanna I.

PY - 2019/11

Y1 - 2019/11

N2 - Purpose: People in residential aged care are at increased risk of adverse events from nonsteroidal anti‐inflammatory drugs (NSAIDs) due to their age and health status, but little is known about use of NSAIDs in this setting. We aimed to estimate the prevalence of NSAID use by route, differences by high‐risk conditions, prevalence of concurrent proton pump inhibitor (PPI) use, and prevalence of the “triple whammy” combination (oral NSAID, diuretic, and angiotensin‐converting‐enzyme inhibitor or angiotensin receptor antagonist). Methods: We conducted a dynamic cohort study using medication administration data from 68 residential aged care facilities (RACFs) during 2014 to 2017. Descriptive statistics and regression were used to estimate the proportion of residents who used NSAIDs, NSAIDs long term, NSAIDs with PPIs, and the triple whammy combination. Results: Ten thousand three hundred sixty‐seven residents were included. Two thousand four hundred fourteen (23.3%) used at least one NSAID: 756 (7.3%) used only oral, 1326 (12.8%) used only topical, and 332 (3.2%) used both topical and oral NSAIDs. One thousand five hundred forty two (14.8%) used an NSAID long term, a majority of which only used topical NSAIDs 933/1542 (60.5%). Age, sex, and health status were associated with greater variation in long‐term topical use relative to oral NSAID use. A majority of oral NSAID users concomitantly used a PPI, which varied according to age, sex, and health status. Among residents with any oral NSAID use, 182/1088 (16.7%) had triple whammy medication use. Conclusions: Targeted interventions to reduce NSAID use among RACF residents, to reduce triple whammy medication use, and increase PPI use for long‐term oral NSAID users are warranted.

AB - Purpose: People in residential aged care are at increased risk of adverse events from nonsteroidal anti‐inflammatory drugs (NSAIDs) due to their age and health status, but little is known about use of NSAIDs in this setting. We aimed to estimate the prevalence of NSAID use by route, differences by high‐risk conditions, prevalence of concurrent proton pump inhibitor (PPI) use, and prevalence of the “triple whammy” combination (oral NSAID, diuretic, and angiotensin‐converting‐enzyme inhibitor or angiotensin receptor antagonist). Methods: We conducted a dynamic cohort study using medication administration data from 68 residential aged care facilities (RACFs) during 2014 to 2017. Descriptive statistics and regression were used to estimate the proportion of residents who used NSAIDs, NSAIDs long term, NSAIDs with PPIs, and the triple whammy combination. Results: Ten thousand three hundred sixty‐seven residents were included. Two thousand four hundred fourteen (23.3%) used at least one NSAID: 756 (7.3%) used only oral, 1326 (12.8%) used only topical, and 332 (3.2%) used both topical and oral NSAIDs. One thousand five hundred forty two (14.8%) used an NSAID long term, a majority of which only used topical NSAIDs 933/1542 (60.5%). Age, sex, and health status were associated with greater variation in long‐term topical use relative to oral NSAID use. A majority of oral NSAID users concomitantly used a PPI, which varied according to age, sex, and health status. Among residents with any oral NSAID use, 182/1088 (16.7%) had triple whammy medication use. Conclusions: Targeted interventions to reduce NSAID use among RACF residents, to reduce triple whammy medication use, and increase PPI use for long‐term oral NSAID users are warranted.

KW - long‐term care

KW - nonsteroidal anti‐inflammatory drugs

KW - NSAID

KW - pharmacoepidemiology

KW - triple whammy

UR - http://purl.org/au-research/grants/nhmrc/1143941

UR - http://purl.org/au-research/grants/nhmrc/120200814

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U2 - 10.1002/pds.4866

DO - 10.1002/pds.4866

M3 - Article

VL - 28

SP - 1480

EP - 1488

JO - Pharmacoepidemiology and Drug Safety

JF - Pharmacoepidemiology and Drug Safety

SN - 1053-8569

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ER -