Multicompartment compliance aids in the community: the prevalence of potentially inappropriate medications.

Counter, David; Stewart, Derek; MacLeod, Joan; McLay, James S.

Abstract

The aim of this study was to assess the prevalence of potentially inappropriate medications (PIMs) use in a population of community-based multicompartment compliance aid (MCA) users in north-east Scotland. The research recorded data for MCAs dispensed by 48 of the 50 community pharmacies in Aberdeen City, between 1st June to 31st October 2014, together with concurrently prescribed medications, patient demographics and Carstairs index of social deprivation. Drug-specific quality indicators for PIMs from the Swedish National Board of Health and Welfare were applied, and bivariate logistic regression analysis was used to investigate associations with demographic variables. The median age was 82 years (range 12-105 years, 59% female). A total of 1977 PIMs were identified, affecting 57.8% of patients. A quarter of patients were prescribed >10 medications and 43% had a prescription containing at least one clinically significant drug-drug interaction (DDI). Ten drug groups accounted for 76% of all DDIs. A significant increase in the risk for at least one PIM was associated with female sex (for all indicators of PIM use), age < 80 years (three or more psychotropic medicines [OR 5.88, 2.96-11.70, P < 0.001]) and lower socioeconomic status (prescription of >10 medications [OR: 1.43, 95% CI: 1.16-1.78], prescription of a long-acting benzodiazepine [OR: 1.84, CI: 1.14-2.98]). The study concluded that MCA use is associated with a significant incidence of PIMs, particularly affecting those younger than 80 years and those living in deprived areas. Our findings indicate the need for a more aggressive multidisciplinary approach to the review of the medications prescribed to MCA users.

Citation

COUNTER, D., STEWART, D., MACLEOD, J. and MCLAY, J.S. 2017. Multicompartment compliance aids in the community: the prevalence of potentially inappropriate medications. British journal of clinical pharmacology [online], 83(7), pages 1515-1520. Available from: https://doi.org/10.1111/bcp.13220

• Journal Article Type: Article
• Acceptance Date: Dec 12, 2016
• Online Publication Date: Dec 23, 2016
• Publication Date: Jul 31, 2017
• Deposit Date: Jun 23, 2017
• Publicly Available Date: Dec 24, 2017
• Journal: British journal of clinical pharmacology
• Print ISSN: 0306-5251
• Electronic ISSN: 1365-2125
• Publisher: Wiley
• Peer Reviewed: Peer Reviewed
• Volume: 83
• Issue: 7
• Pages: 1515-1520
• DOI: https://doi.org/10.1111/bcp.13220
• Keywords: Drug interactions; Multi compartment compliance aids; Potentially inappropriate medications; Prescription drugs; Social class
• Public URL: http://hdl.handle.net/10059/2389