Table 2.
prevalences of most common potentially inappropriate medications (PIMs) defined by either combined Beers Laroche and prevalances of most common PIMs defined by PROMPT criteria in US veteran patients aged 49–70 years according to polypharmacy in 2016
| Birth cohort | 49 – 64 years old | 65 – 70 years old | ||||||||||
| N total | 2 748 705 | 1 499 586 | 1 249 119 | |||||||||
| N 0 – 4 medications | 1 914 269 | 1 116 351 | 797 918 | |||||||||
| N 5 – 9 medications (Polypharmacy) | 633 061 | 296 032 | 337 029 | |||||||||
| N ≥ 10 medications (Hyperpolypharmacy) | 201 375 | 87 203 | 114 172 | |||||||||
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| Beers Laroche | PROMPT | Beers Laroche | PROMPT | Beers Laroche | PROMPT | |||||||
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| Potentially inappropriate medications - Overall – n(%) | ||||||||||||
| 0 – 4 medications | 277 690 | (14.5) | 267 697 | (14.0) | 159 886 | (14.3) | 156 665 | (14.0) | 117 804 | (14.8) | 111 032 | (13.9) |
| 5 – 9 medications (Polypharmacy) | 389 499 | (61.5) | 377 738 | (59.7) | 187 556 | (63.4) | 184 248 | (62.2) | 201 943 | (59.9) | 193 490 | (57.4) |
| ≥ 10 medications (Hyperpolypharmacy) | 169 842 | (84.3) | 168 727 | (83.8) | 74 734 | (85.7) | 75 106 | (86.1) | 95 108 | (83.3) | 93 621 | (82.0) |
| Pump Proton Inhibitors – n(%) | ||||||||||||
| 0 – 4 medications | 121 209 | (6.3) | 125 541 | (6.6) | 66 336 | (5.9) | 69 151 | (6.2) | 54 873 | (6.9) | 56 390 | (7.1) |
| 5 – 9 medications (Polypharmacy) | 164 208 | (25.9) | 185 205 | (29.3) | 77 805 | (26.3) | 89 224 | (30.1) | 86 403 | (25.6) | 95 981 | (28.5) |
| ≥ 10 medications (Hyperpolypharmacy) | 68 155 | (33.8) | 93 347 | (46.4) | 30 158 | (34.6) | 42 307 | (48.5) | 37 997 | (33.3) | 51 040 | (44.7) |
| Sulfonylureas – n(%) | ||||||||||||
| 0 – 4 medications | 33 507 | (1.8) | 33 507 | (1.8) | 16 662 | (1.5) | 16 662 | (1.5) | 16 845 | (2.1) | 16 845 | (2.1) |
| 5 – 9 medications (Polypharmacy) | 90 115 | (14.2) | 90 115 | (14.2) | 36 610 | (12.4) | 36 610 | (12.4) | 53 505 | (15.9) | 53 505 | (15.9) |
| ≥ 10 medications (Hyperpolypharmacy) | 45 385 | (22.5) | 45 385 | (22.5) | 17 032 | (19.5) | 17 032 | (19.5) | 28 353 | (24.8) | 28 353 | (24.8) |
| Nonsteroidal anti-inflammatory drugs – n(%) | ||||||||||||
| 0 – 4 medications | 47 206 | (2.5) | 51 821 | (2.7) | 32 180 | (2.9) | 35 205 | (3.2) | 15 026 | (1.9) | 16 616 | (2.1) |
| 5 – 9 medications (Polypharmacy) | 58 667 | (9.3) | 75 420 | (11.9) | 34 237 | (11.6) | 43 846 | (14.8) | 24 430 | (7.3) | 31 574 | (9.4) |
| ≥ 10 medications (Hyperpolypharmacy) | 25 277 | (12.6) | 41 398 | (20.6) | 13 455 | (15.4) | 21 928 | (25.2) | 11 822 | (10.4) | 19 470 | (17.1) |
| Opioids without concurrent laxatives – n(%) | ||||||||||||
| 0 – 4 medications | - | 22 250 | (1.2) | - | 16 295 | (1.5) | - | 5 955 | (0.8) | |||
| 5 – 9 medications (Polypharmacy) | - | 33 187 | (5.2) | - | 21 425 | (7.2) | - | 11 762 | (3.5) | |||
| ≥ 10 medications (Hyperpolypharmacy) | - | 20 993 | (10.4) | - | 11 789 | (13.5) | - | 9 204 | (8.1) | |||
| Stimulant Laxatives – n(%) | ||||||||||||
| 0 – 4 medications | 9 415 | (0.5) | 8 752 | (0.5) | 5 654 | (0.5) | 5 221 | (0.5) | 3 761 | (0.5) | 3 531 | (0.4) |
| 5 – 9 medications (Polypharmacy) | 32 182 | (5.1) | 28 904 | (4.6) | 16 574 | (5.6) | 14 609 | (4.9) | 15 608 | (4.6) | 14 295 | (4.2) |
| ≥ 10 medications (Hyperpolypharmacy) | 39 982 | (19.9) | 34 634 | (17.2) | 18 564 | (21.3) | 15 658 | (18.0) | 21 418 | (18.8) | 18 976 | (16.6) |
| Insulin sliding scale – n(%) | ||||||||||||
| 0 – 4 medications | 16 369 | (0.9) | - | 8 482 | (0.8) | - | 7 887 | (1.0) | - | |||
| 5 – 9 medications (Polypharmacy) | 35 024 | (5.5) | - | 15 127 | (5.1) | - | 19 897 | (5.9) | - | |||
| ≥ 10 medications (Hyperpolypharmacy) | 23 431 | (11.6) | - | 9 125 | (10.5) | - | 14 306 | (12.5) | - | |||
| Antidepressants– n(%) | ||||||||||||
| 0 – 4 medications | 16 401 | (0.9) | - | 9 763 | (0.8) | - | 6 638 | (0.8) | ||||
| 5 – 9 medications (Polypharmacy) | 27 634 | (4.4) | - | 13 996 | (4.7) | - | 13 638 | (4.0) | ||||
| ≥ 10 medications (Hyperpolypharmacy) | 18 646 | (9.3) | - | 8 994 | (10.3) | - | 9 652 | (8.5) | ||||
| Benzodiazepines, Long and Intermediate/ short acting – n(%) | ||||||||||||
| 0 – 4 medications | 11 694 | (0.6) | 17 569 | (0.9) | 6 928 | (0.6) | 10 424 | (0.9) | 4 766 | (0.6) | 7 145 | (0.9) |
| 5 – 9 medications (Polypharmacy) | 20 059 | (3.2) | 29 460 | (4.7) | 10 772 | (3.6) | 15 937 | (5.4) | 9 287 | (2.8) | 13 523 | (4.0) |
| ≥ 10 medications (Hyperpolypharmacy) | 15 560 | (7.7) | 22 414 | (11.1) | 7 610 | (8.7) | 11 102 | (12.7) | 7 950 | (7.0) | 11 312 | (9.9) |
| Selective serotonin reuptake inhibitors (PIMs) used in combination with venlafaxine. – n(%) | ||||||||||||
| 0 – 4 medications | - | 13 025 | (0.7) | - | 8 361 | (0.8) | - | 4 664 | (0.6) | |||
| 5 – 9 medications (Polypharmacy) | - | 20 403 | (3.2) | - | 10 991 | (3.7) | - | 9 412 | (2.8) | |||
| ≥ 10 medications (Hyperpolypharmacy) | - | 13 825 | (6.9) | - | 6 678 | (7.7) | - | 7 147 | (6.3) | |||
| First-generation antihistamines– n(%) | ||||||||||||
| 0 – 4 medications | 8 788 | (0.5) | 8 788 | (0.5) | 5 609 | (0.5) | 5 609 | (0.5) | 3 179 | (0.4) | 3 179 | (0.4) |
| 5 – 9 medications (Polypharmacy) | 18 137 | (2.9) | 18 137 | (2.9) | 10 305 | (3.5) | 10 305 | (3.5) | 7 832 | (2.3) | 7 832 | (2.3) |
| ≥ 10 medications (Hyperpolypharmacy) | 17 231 | (8.6) | 17 231 | (8.6) | 9 024 | (10.4) | 9 024 | (10.4) | 8 207 | (7.2) | 8 207 | (7.2) |
| Skeletal muscle relaxants – n(%) | ||||||||||||
| 0 – 4 medications | 7 725 | (0.4) | - | 5 773 | (0.5) | - | 1 952 | (0.2) | - | |||
| 5 – 9 medications (Polypharmacy) | 18 493 | (2.9) | - | 12 381 | (4.2) | - | 6 112 | (1.8) | - | |||
| ≥ 10 medications (Hyperpolypharmacy) | 17 513 | (8.7) | - | 10 229 | (11.7) | - | 7 284 | (6.4) | - | |||
| Nonbenzodiazepine hypnotics (Z-drugs) – n(%) | ||||||||||||
| 0 – 4 medications | 8 543 | (0.5) | 8 543 | (0.5) | 4 990 | (0.5) | 4 990 | (0.5) | 3 553 | (0.5) | 3 553 | (0.5) |
| 5 – 9 medications (Polypharmacy) | 14 407 | (2.3) | 14 407 | (2.3) | 7 599 | (2.6) | 7 599 | (2.6) | 6 808 | (2.0) | 6 808 | (2.0) |
| ≥ 10 medications (Hyperpolypharmacy) | 10 236 | (5.1) | 10 236 | (5.1) | 5 170 | (5.9) | 5 170 | (5.9) | 5 066 | (4.4) | 5 066 | (4.4) |
| Corticoids without concomitant bisphosphonate – n(%) | ||||||||||||
| 0 – 4 medications | - | 3 586 | (0.2) | - | 1 815 | (0.2) | - | 1 771 | (0.2) | |||
| 5 – 9 medications (Polypharmacy) | - | 7 151 | (1.1) | - | 3 138 | (1.1) | - | 4 013 | (1.2) | |||
| ≥ 10 medications (Hyperpolypharmacy) | - | 6 141 | (3.1) | - | 2 593 | (3.0) | - | 3 548 | (3.1) | |||
| Cardio-selective calcium-channel blockers (verapamil or Diltiazem) used in combination with beta-adrenoceptor blocking drugs – n(%) | ||||||||||||
| 0 – 4 medications | - | 1 792 | (0.1) | - | 776 | (0.1) | - | 1 016 | (0.1) | |||
| 5 – 9 medications (Polypharmacy) | - | 7 541 | (1.2) | - | 2 860 | (1.0) | - | 4 681 | (1.4) | |||
| ≥ 10 medications (Hyperpolypharmacy) | - | 5 758 | (2.9) | - | 2 113 | (2.4) | - | 3 645 | (3.2) | |||