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Data from: Associations between polypharmacy and treatment intensity for hypertension and diabetes: a cross-sectional study of nursing home patients in British Columbia, Canada

Citation

McCracken, Rita et al. (2017), Data from: Associations between polypharmacy and treatment intensity for hypertension and diabetes: a cross-sectional study of nursing home patients in British Columbia, Canada, Dryad, Dataset, https://doi.org/10.5061/dryad.c0375

Abstract

Objectives: Describe nursing home polypharmacy prevalence in the context of prescribing for diabetes and hypertension and determine possible associations between lower surrogate markers for treated hypertension and diabetes (over treatment) and polypharmacy. Design: Cross sectional study. Setting: 6 nursing homes in British Columbia, Canada. Participants: 214 patients, residing in one of selected facilities during data collection period. Primary and secondary outcome measures: Polypharmacy was defined as >=9 regular medications. Over treatment of diabetes was defined as being prescribed at least one hypoglycemic medication and a glycosylated hemoglobin (A1c) <=7.5%. Over treatment of hypertension required being prescribed at least one hypertension medication and having a systolic blood pressure (SBP) <=128 mmHg. Polypharmacy prescribing, independent of over treatment, was calculated by subtracting disease specific medications from total medications prescribed. Results: Data gathering was completed for 214 patients, 104 (48%) of whom were prescribed >=9 medications. All patients were very frail. Patients with polypharmacy were more likely to have a diagnosis of hypertension (p=.04) or congestive heart failure (p=.003) and less likely to have a diagnosis of dementia (p=.03). Patients with over treated hypertension were more likely to also experience polypharmacy (RR 1.77 (1.07-2.96), p=.027). Patients with over treated diabetes were prescribed more non-diabetic medications than those with a higher A1c (11.0 ±3.7 versus 7.2 ±3.1, p=.01). Conclusion: Over treated diabetes and hypertension may be quite prevalent in nursing home patients and the presence of polypharmacy is associated with more aggressive disease treatment. Further study of interventions designed to reduce over treatment of hypertension and diabetes is needed to fully understand the potential links between polypharmacy and potential of harms of disease-specific over treatment.

Usage Notes

Location

Canada
British Columbia