Medication transitions and polypharmacy in older adults following acute care

Figures & data

Table 1 Cohort characteristics of 2,105 subjects over age 65 years with community-acquired pneumonia who were hospitalized or presented to the emergency room

Characteristics
Age, years, mean, SD	78	8
65–74 years, n	784	37%
75–85 years, n	886	42%
85 years and older, n	435	21%
Females, n	1,060	50%
Previous comorbidities, n
Cerebrovascular disease	278	13%
Heart disease	1,069	51%
Neoplasm	251	12%
Renal disease	205	10%
COPD	642	30%
Mental illness	278	13%
Pneumonia severity index, n
Class I and II	269	13%
Class III	619	29%
Class IV	932	44%
Class V	285	14%
Premorbid functional status, n
Independent mobility	1,918	91%
Wheelchair/prosthesis	122	6%
Bedridden	65	3%
Smoking status, n
Nonsmokers	1,169	56%
Former smoker	631	30%
Current smokers	305	14%
Nursing home residents, n	310	15%
Number of medications at baseline, mean, SD	4.5	2.8
Five or more medications, n	949	45%

Abbreviations: SD, standard deviation; COPD, chronic obstructive pulmonary disease.

Table 2 Prevalence of drug classes and number of medications utilized by 2,105 subjects over age 65 years with community-acquired pneumonia discharged from hospital or the emergency department

Anatomical therapeutic chemical class	Baseline, n		0–90 days’ follow-up, n		91–180 days’ follow-up, n		181–270 days’ follow-up, n		271–365 days’ follow-up, n
Cardiovascular system	1,322	63%	1,253	60%	1,217	58%	1,211	58%	1,218	58%
Renin–angiotensin system agents	499	24%	739	35%	734	35%	742	35%	757	36%
Beta-blockers	225	11%	330	16%	319	15%	314	15%	340	16%
Calcium-channel blockers	146	7%	371	18%	359	17%	365	17%	367	17%
Diuretics	625	30%	700	33%	619	29%	633	30%	636	30%
Nitrates	187	9%	213	10%	203	10%	199	9%	208	10%
Lipid-lowering agents	276	13%	317	15%	322	15%	323	15%	350	17%
Alimentary tract and metabolism	1,034	49%	924	44%	848	40%	851	40%	849	40%
Proton-pump inhibitors	314	15%	438	21%	427	20%	429	20%	446	21%
H2-receptor blockers	88	4%	88	4%	72	3%	77	4%	65	3%
Oral diabetes agents	261	12%	229	11%	230	11%	224	11%	224	11%
Nervous system	996	47%	935	44%	872	41%	843	40%	876	42%
Antipsychotics	47	2%	76	4%	72	3%	66	3%	76	4%
Antidepressants	328	16%	358	17%	350	17%	332	16%	351	17%
Anxiolytics	193	9%	304	14%	280	13%	266	13%	272	13%
Hypnotics/sedatives	241	11%	289	14%	252	12%	267	13%	265	13%
Respiratory system	803	38%	859	41%	697	33%	688	33%	660	31%
Inhaled	732	35%	721	34%	656	31%	642	30%	607	29%
Blood and blood-forming organs	632	30%	368	17%	341	16%	370	18%	375	18%
General anti-infectives for systemic use	435	21%	1,142	54%	500	24%	491	23%	534	25%
Systematic hormonal preparations, excluding sex hormones	397	19%	593	28%	490	23%	480	23%	500	24%
Musculoskeletal system	359	17%	524	25%	486	23%	496	24%	502	24%
NSAIDs	351	17%	293	14%	252	12%	249	12%	240	11%
Genitourinary system and sex hormones	124	6%	285	14%	263	12%	278	13%	257	12%
Dermatologicals	98	5%	193	9%	228	11%	219	10%	217	10%
Immunomodulating agents	13	1%	21	1%	20	1%	19	1%	18	1%
Mean number (SD) of medications	4.5 (2.8)		6.8 (4.0)		6.3 (3.8)		6.4 (3.9)		6.6 (4.0)
Subjects with polypharmacy (five or more unique medications)	949	45%	1,559	74%	1,502	71%	1,519	72%	1,540	73%

Abbreviations: NSAIDs, nonsteroidal anti-inflammatory drugs; SD, standard deviation.

Figure 1 Polypharmacy over time for 2,105 patients with community-acquired pneumonia, stratified by age.

Figure 2 Prevalence of drug dispensations over time for the most prevalent anatomic therapeutic chemical (ATC) level 1 classes at baseline.

Figure 3 Prevalence of antibiotic use.