Inappropriate drug use and mortality in community-dwelling elderly with impaired kidney function--the Three-City population-based study

Détails

ID Serval
serval:BIB_14D529C395E7
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Inappropriate drug use and mortality in community-dwelling elderly with impaired kidney function--the Three-City population-based study
Périodique
Nephrol Dial Transplant
Auteur(s)
Breton G., Froissart M., Janus N., Launay-Vacher V., Berr C., Tzourio C., Helmer C., Stengel B.
ISSN
1460-2385 (Electronic)
ISSN-L
0931-0509
Statut éditorial
Publié
Date de publication
2011
Volume
26
Numéro
9
Pages
2852-9
Langue
anglais
Notes
Breton, Gaelle
Froissart, Marc
Janus, Nicolas
Launay-Vacher, Vincent
Berr, Claudine
Tzourio, Christophe
Helmer, Catherine
Stengel, Benedicte
eng
Multicenter Study
Research Support, Non-U.S. Gov't
England
2011/02/05 06:00
Nephrol Dial Transplant. 2011 Sep;26(9):2852-9. doi: 10.1093/ndt/gfq827. Epub 2011 Feb 3.
Résumé
BACKGROUND: Glomerular filtration rate (GFR) decline with age increases the risk of inappropriate dosing of drugs. We investigated the determinants and the mortality associated with the use of drugs that are contraindicated or require dose adjustment according to kidney function among the community-dwelling elderly. METHODS: The Three-City population-based study included 8701 participants >/=65 years from 1999 to 2001. Exposure to the risk of inappropriate drug dosage was defined as reported use of either a contraindicated drug or one requiring dose adjustment according to the individual baseline glomerular filtration rate estimated (eGFR) with the Modification of Diet in Renal disease study equation. Six-year mortality was analysed using Cox models adjusted for several sociodemographic, biologic and clinical risk factors. RESULTS: The overall percentage of exposure to the risk of inappropriate drug use was 13.3% (contraindication, 0.8%): it was 52.5% (4.5%) in those with an eGFR of 30-59 and 96% (48%) in those <30 mL/min/1.73 m(2). Antihypertensive agents, fibrates and psycholeptics accounted for most of the drugs with dosing recommendations and antidiabetic agents and antihistamines for those contraindicated. Individuals at risk were more likely to be men, older, and under treatment for hypertension or hypercholesterolemia. Exposure to either risk was independently related to higher all-cause mortality (hazard ratio 1.4, 95% confidence interval 1.0-1.9) in participants with eGFR <60 mL/min/1.73 m(2). CONCLUSIONS: Contraindicated drug prescription was uncommon but >10% of the population took drugs requiring renal dosing adjustments. Regular monitoring of eGFR may prevent excess mortality associated with inappropriate drug prescription in the elderly.
Mots-clé
Aged, Cohort Studies, Community Health Planning, *Drug-Related Side Effects and Adverse Reactions, Female, Follow-Up Studies, France/epidemiology, Glomerular Filtration Rate, Humans, Inappropriate Prescribing/*adverse effects, Kidney/*physiopathology, Kidney Failure, Chronic/epidemiology/*mortality/*pathology, Kidney Function Tests, Longitudinal Studies, Male, Prognosis, Prospective Studies, Risk Factors, Survival Rate
Pubmed
Open Access
Oui
Création de la notice
03/03/2016 16:49
Dernière modification de la notice
21/08/2019 5:35
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