Original Research
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction: Hyperpolypharmacy is common among older adults, posing risks of adverse events, impacting quality of life and leading to increased costs. Less evidence is available regarding nationally representative trends over extended time periods for hyperpolypharmacy and related changes in prescription expenditures.
Research Question or Hypothesis: We hypothesize that the prevalence of hyperpolypharmacy and total prescription expenditures increased over the study period.
Study Design: This was a serial cross-sectional study utilizing U.S. nationally representative data from the 2002 to 2017 Medical Expenditure Panel Survey (MEPS).
Methods: Respondents aged =65 years were identified within MEPS dataset from 2002 to 2017. Hyperpolypharmacy exposure defined as use of =10 medications. Outcomes included the trends in hyperpolypharmacy and prescriptions expenditures. Data was grouped and segmented into four-year intervals, starting from 2002, for comparative analyses. Total prescription expenditures were standardized to U.S. 2017 dollars using consumer price indices. Trends were examined utilizing chi-squared and linear regression tests. Prescription expenditures were compared with t-tests. Survey weighted procedures were used to generate U.S. population estimates (SAS Version 9.4).
Results: In our sample of ~643 million patients, 15.1% exhibited hyperpolypharmacy. There was no linear trend in prevalence in hyperpolypharmacy over the study period (p-trend=0.16). Comparing the years 2002-2005 to 2014-2017, the prevalence of hyperpolypharmacy increased from 13.6% to 15.4% (p=0.002). Subgroup analysis revealed higher prevalence in White men (12.2% vs. 15.3%, p=0.001) and Black men (8.4% vs. 13.3%, p=0.007) when comparing the timeframes. The prevalence in White & Black men aged 65-74 also increased significantly over the timeframe (11.6% vs.14.1%, p=0.02; 6.9% vs. 14.4% p=0.001, respectively). The mean total prescription expenditures significantly increased when comparing the timeframes (Difference: $226; 95% CI: $19 - $434; p=0.03).
Conclusion: Both hyperpolypharmacy and prescription expenditures increased over the study period. Efforts to promote rational geriatric prescribing may help reduce hyperpolypharamcy and total prescription expenditures.
Presenting Author
Hang Lin BA, PharmD candidateUniversity at Buffalo School of Pharmacy and Pharmaceutical Sciences
Authors
David M. Jacobs PharmD, PhD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Aman Patel MSc, PharmD candidate
University at buffalo
Collin M. Clark PharmD, BCPS, BCGP
University at Buffalo Jacobs School of Medicine and Biomedical Sciences
Steven Feuerstein MS
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Amanda A. Foster PharmD, MPH
University at Buffalo School of Pharmacy and Pharmaceutical Sciences