Potential Therapeutic Competition in Community-Living Older Adults in the U.S.: Use of Medications That May Adversely Affect a Coexisting Condition
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{"title"=>"Potential therapeutic competition in community-living older adults in the U.S.: Use of medications that may adversely affect a coexisting condition", "type"=>"journal", "authors"=>[{"first_name"=>"Songprod Jonathan", "last_name"=>"Lorgunpai", "scopus_author_id"=>"56067200300"}, {"first_name"=>"Marianthe", "last_name"=>"Grammas", "scopus_author_id"=>"13609475900"}, {"first_name"=>"David S H", "last_name"=>"Lee", "scopus_author_id"=>"55367979400"}, {"first_name"=>"Gail", "last_name"=>"McAvay", "scopus_author_id"=>"6701618906"}, {"first_name"=>"Peter", "last_name"=>"Charpentier", "scopus_author_id"=>"7102915079"}, {"first_name"=>"Mary E.", "last_name"=>"Tinetti", "scopus_author_id"=>"7005368767"}], "year"=>2014, "source"=>"PLoS ONE", "identifiers"=>{"scopus"=>"2-s2.0-84896091134", "sgr"=>"84896091134", "issn"=>"19326203", "doi"=>"10.1371/journal.pone.0089447", "pmid"=>"24586786", "isbn"=>"1932-6203", "pui"=>"372599245"}, "id"=>"196a7b54-98d5-3705-8991-0e2077c8ef06", "abstract"=>"OBJECTIVE: The 75% of older adults with multiple chronic conditions are at risk of therapeutic competition (i.e. treatment for one condition may adversely affect a coexisting condition). The objective was to determine the prevalence of potential therapeutic competition in community-living older adults.\\n\\nMETHODS: Cross-sectional descriptive study of a representative sample of 5,815 community-living adults 65 and older in the U.S, enrolled 2007-2009. The 14 most common chronic conditions treated with at least one medication were ascertained from Medicare claims. Medication classes recommended in national disease guidelines for these conditions and used by ≥ 2% of participants were identified from in-person interviews conducted 2008-2010. Criteria for potential therapeutic competition included: 1), well-acknowledged adverse medication effect; 2) mention in disease guidelines; or 3) report in a systematic review or two studies published since 2000. Outcomes included prevalence of situations of potential therapeutic competition and frequency of use of the medication in individuals with and without the competing condition.\\n\\nRESULTS: Of 27 medication classes, 15 (55.5%) recommended for one study condition may adversely affect other study conditions. Among 91 possible pairs of study chronic conditions, 25 (27.5%) have at least one potential therapeutic competition. Among participants, 1,313 (22.6%) received at least one medication that may worsen a coexisting condition; 753 (13%) had multiple pairs of such competing conditions. For example, among 846 participants with hypertension and COPD, 16.2% used a nonselective beta-blocker. In only 6 of 37 cases (16.2%) of potential therapeutic competition were those with the competing condition less likely to receive the medication than those without the competing condition.\\n\\nCONCLUSIONS: One fifth of older Americans receive medications that may adversely affect coexisting conditions. Determining clinical outcomes in these situations is a research and clinical priority. Effects on coexisting conditions should be considered when prescribing medications.", "link"=>"http://www.mendeley.com/research/potential-therapeutic-competition-communityliving-older-adults-medications-adversely-affect-coexisti-3", "reader_count"=>21, "reader_count_by_academic_status"=>{"Unspecified"=>1, "Librarian"=>1, "Researcher"=>4, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>2, "Student > Master"=>6, "Other"=>3, "Student > Bachelor"=>2, "Professor"=>1}, "reader_count_by_user_role"=>{"Unspecified"=>1, "Librarian"=>1, "Researcher"=>4, "Student > Doctoral Student"=>1, "Student > Ph. D. Student"=>2, "Student > Master"=>6, "Other"=>3, "Student > Bachelor"=>2, "Professor"=>1}, "reader_count_by_subject_area"=>{"Unspecified"=>3, "Medicine and Dentistry"=>10, "Pharmacology, Toxicology and Pharmaceutical Science"=>5, "Business, Management and Accounting"=>1, "Social Sciences"=>1, "Computer Science"=>1}, "reader_count_by_subdiscipline"=>{"Medicine and Dentistry"=>{"Medicine and Dentistry"=>10}, "Social Sciences"=>{"Social Sciences"=>1}, "Computer Science"=>{"Computer Science"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Unspecified"=>{"Unspecified"=>3}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>5}}, "reader_count_by_country"=>{"Netherlands"=>1}, "group_count"=>4}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1397546"], "description"=>"<p>Abbreviations: COPD, chronic obstructive pulmonary disease; GERD/PUD, gastroesophageal reflux disease or peptic ulcer disease;</p>a<p>The first chronic condition listed for a pair is the condition for which the medication is recommended by the national specialty organization guideline; the second chronic condition in a pair is the coexisting condition that may be worsened with the medication (i.e. competing condition).</p>b<p>The numerator is the number of participants with the indicated condition who received the recommended medication. The denominator is the number of participants who had the indicated condition who also had the competing condition.</p>c<p>The numerator is the number of participants with the indicated condition who received the recommended medication. The denominator is the number of participants who had the indicated condition but did not have the competing condition.</p>d<p>Numbers in brackets are the reference of the studies supporting the possible adverse effect of the medication class on the competing condition.</p>", "links"=>[], "tags"=>["biotechnology", "pharmacogenomics", "Drugs and devices", "Clinical pharmacology", "Drug interactions", "geriatrics", "Long-term care", "Global health", "Non-clinical medicine", "Health care policy", "Health education and awareness", "Health risk analysis", "Health statistics", "Health care providers", "Health services research", "Public health", "recommended", "competing", "community-living", "persons", "aged", "65", "older"], "article_id"=>943784, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Songprod Jonathan Lorgunpai", "Marianthe Grammas", "David S. H. Lee", "Gail McAvay", "Peter Charpentier", "Mary E. Tinetti"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0089447.t003", "stats"=>{"downloads"=>0, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Frequency_of_Use_of_a_Recommended_Medication_for_a_Chronic_Condition_According_to_Presence_of_Competing_Conditions_among_Community_living_Persons_in_the_U_S_Aged_65_and_Older_N_8202_8202_5815_/943784", "title"=>"Frequency of Use of a Recommended Medication for a Chronic Condition According to Presence of Competing Conditions among Community-living Persons in the U.S. Aged 65 and Older (N = 5815).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-02-25 02:57:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/1397544"], "description"=>"a<p>The number of pairs of the 14 most common coexisting chronic conditions experienced by the MCBS cohort for which there is at least one prescription medication recommended by the national specialty organization for most individuals with the conditions. Those with zero condition pairs had only one of the 14 chronic conditions.</p>b<p>Prescription medications given a GRADE A or B or equivalent level of recommendations by the national specialty organization guideline for one or more of the 14 chronic conditions. All medications recommended by a guideline are included if evidence grading not included in the guideline. Prescription medications used by at least 2% of study participants are included. For example, fibrates, nicotinic acid, and bile sequestrants are mentioned in guidelines for hyperlipidemia but the prevalence of use was low. Nonprescription medications (e.g. aspirin, nonsteroidal anti-inflammatory drugs, H<sub>2</sub> receptor antagonists) were not available.</p>c<p>Among the 2353 beta-blocker users, 1807 used a selective beta-blocker, 267 used a nonselective beta-blocker, and 279 used an alpha/beta-blocker.</p>d<p>Proton pump inhibitors are likely underestimated because does not include over the counter.</p>e<p>Among the 1375 calcium channel blocker users, 1142 used a dihydropyridine calcium channel blocker and 233 used a nondihydropyridine (primarily diltiazem; verapamil was used by <2% of the study population)</p>", "links"=>[], "tags"=>["biotechnology", "pharmacogenomics", "Drugs and devices", "Clinical pharmacology", "Drug interactions", "geriatrics", "Long-term care", "Global health", "Non-clinical medicine", "Health care policy", "Health education and awareness", "Health risk analysis", "Health statistics", "Health care providers", "Health services research", "Public health", "coexisting", "pairs"], "article_id"=>943782, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Songprod Jonathan Lorgunpai", "Marianthe Grammas", "David S. H. Lee", "Gail McAvay", "Peter Charpentier", "Mary E. Tinetti"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0089447.t001", "stats"=>{"downloads"=>2, "page_views"=>10, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_Participants_by_Number_of_Coexisting_Chronic_Condition_Pairs_N_8202_8202_5_815_/943782", "title"=>"Characteristics of Participants by Number of Coexisting Chronic Condition Pairs (N = 5,815).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-02-25 02:57:05"}
  • {"files"=>["https://ndownloader.figshare.com/files/1397545"], "description"=>"<p>Abbreviations: GERD/PUD, gastroesophageal reflux disease or peptic ulcer disease.</p>a<p>The most common pairs of coexisting chronic conditions listed in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0089447#pone-0089447-t001\" target=\"_blank\"><b>Table 1</b></a> for which there is at least one medication (listed in <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0089447#pone-0089447-t001\" target=\"_blank\"><b>Table 1</b></a>) recommended by the national specialty organization guidelines that may worsen the other condition in the pair (see <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0089447#s2\" target=\"_blank\">Methods</a> for how these competing medications were identified). Of the guideline recommended medications, only prescription medications used by at least 2% of the study sample are included.</p>b<p>Estimated number of persons in U.S. with the competing chronic conditions.</p>c<p>Percent of participants with the coexisting conditions who use the potentially competing medication, that is, a medication recommended for one chronic condition that may worsen the coexisting chronic condition. See <a href=\"http://www.plosone.org/article/info:doi/10.1371/journal.pone.0089447#s2\" target=\"_blank\">Methods</a> for selection criteria for competing medications.</p>d<p>Coronary artery disease includes history of myocardial infarction, acute coronary syndrome, or angina.</p>e<p>Manifestations of diabetic autonomic neuropathy, such as orthostasis, may be worsened by alpha/beta-blockers.</p>f<p>Proton pump inhibitors use is likely underestimated because nonprescription use of proton pump inhibitors not included in the dataset.</p>", "links"=>[], "tags"=>["biotechnology", "pharmacogenomics", "Drugs and devices", "Clinical pharmacology", "Drug interactions", "geriatrics", "Long-term care", "Global health", "Non-clinical medicine", "Health care policy", "Health education and awareness", "Health risk analysis", "Health statistics", "Health care providers", "Health services research", "Public health", "therapeutic", "co-existing", "chronicconditions", "community-living", "persons", "aged", "65", "older"], "article_id"=>943783, "categories"=>["Biological Sciences", "Medicine"], "users"=>["Songprod Jonathan Lorgunpai", "Marianthe Grammas", "David S. H. Lee", "Gail McAvay", "Peter Charpentier", "Mary E. Tinetti"], "doi"=>"https://dx.doi.org/10.1371/journal.pone.0089447.t002", "stats"=>{"downloads"=>0, "page_views"=>14, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Prevalence_of_Potential_Therapeutic_Competition_in_Common_Co_existing_ChronicConditions_among_Community_living_Persons_in_the_U_S_Aged_65_and_Older_N_8202_8202_5815_/943783", "title"=>"Prevalence of Potential Therapeutic Competition in Common Co-existing ChronicConditions among Community-living Persons in the U.S. Aged 65 and Older (N = 5815).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-02-25 02:57:05"}

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