| アブストラクト | OBJECTIVES: To estimate the prevalence of potentially inappropriate prescribing (PIP) in UK middle-aged adults, identify patient-level factors associated with PIP and its associations with subsequent primary care utilisation and mortality. DESIGN: A prospective observational cohort study. SETTING: English routinely collected primary care electronic health record data from the Clinical Practice Research Datalink Aurum. The follow-up period was from 1 January 2018 to 7 February 2023. PARTICIPANTS: Randomly selected individuals (n=1 200 000) who were aged 45-64 years on 1 January 2018. EXPOSURE: Exposure was defined as at least one episode of PIP in the year 2018. PRIMARY AND SECONDARY OUTCOMES: The primary outcome was the rate of GP consultations in the year following exposure (2019). The secondary outcome was mortality between 2019 and 2023. RESULTS: 13.9% of participants experienced PIP in 2018. Factors significantly associated with PIP included polypharmacy (>/=10 medications: OR 6.93, 95% CI 6.61 to 7.27), multimorbidity (OR 2.47, 95% CI 2.45 to 2.50), female sex (OR 1.14, 95% CI 1.13 to 1.16), older age (OR 1.01 95% CI 1.01 to 1.02) and higher primary care consultation frequency (OR 1.04 95% CI 1.04 to 1.04). PIP was associated with increased primary care consultations the following year (IRR 1.03, 95% CI 1.02 to 1.03) but not mortality (HR 0.99, 95% CI 0.93 to 1.04). CONCLUSION: One in seven middle-aged adults were exposed to PIP and PIP resulted in higher subsequent primary care consultations; medicine optimisation strategies for PIP warrant evaluation in middle aged adults. |
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| ジャーナル名 | BMJ open |
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| Pubmed追加日 | 2026/7/28 |
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| 投稿者 | Naughton, Michael; Molokhia, Mariam; Redmond, Patrick; Douglas, Ian J; Mathur, Rohini |
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| 組織名 | The Clinical Effectiveness Group, The Wolfson Institute of Population Health,;Queen Mary University of London, London, UK m.naughton@qmul.ac.uk.;Faculty of Epidemiology and Population Health, London School of Hygiene &;Tropical Medicine, London, UK.;School of Population Health & Life Course Sciences, King's College London,;London, UK.;Department of General Practice, Royal College of Surgeons in Ireland, Dublin,;Leinster, Ireland.;Clinical Effectiveness Group, The Wolfson Institute of Population Health, Queen;Mary University of London, London, UK. |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/42509012/ |
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