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Journal of The Royal New Zealand College of General Practitioners
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RESEARCH ARTICLE (Open Access)
Online Early

Medicines use and polypharmacy in retirement village residents in Aotearoa New Zealand: a point prevalence observational study

Joanna Hikaka https://orcid.org/0000-0001-6792-6607 1 2 * , Zhenqiang Wu 3 , Michal Boyd 3 4 , Martin J. Connolly 1 3 , Joanna B. Broad 3 , Cheryl Calvert 3 5 , Annie Tatton 1 , Kathy Peri 4 , Katherine Bloomfield https://orcid.org/0000-0001-6679-1763 1 3
+ Author Affiliations
- Author Affiliations

1 Waitematā District Health Board, Auckland, New Zealand.

2 Te Kupenga Hauora Māori, University of Auckland, Auckland, New Zealand.

3 Department of Geriatric Medicine, University of Auckland, Auckland, New Zealand.

4 School of Nursing, University of Auckland, Auckland, New Zealand.

5 Auckland District Health Board, Auckland, New Zealand.

* Correspondence to: j.hikaka@auckland.ac.nz

Handling Editor: Felicity Goodyear-Smith

Journal of Primary Health Care https://doi.org/10.1071/HC24038
Submitted: 8 March 2024  Accepted: 22 April 2024  Published: 6 May 2024

© 2024 The Author(s) (or their employer(s)). Published by CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners. This is an open access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY-NC-ND)

Abstract

Introduction

Polypharmacy increases the risk of medicines-related harm, including falls, in older adults. Falls have a significant impact on quality of life and health system resources. Little is known about medicine use in retirement village (RV) residents in Aotearoa New Zealand (NZ).

Aim

Our study aimed to describe medicine use and the point prevalence of polypharmacy among a cohort of RV residents in Auckland, NZ.

Methods

Data collection occurred from July 2016 to June 2018. Eligible participants (those residing permanently in a RV) were recruited from RVs in Auckland, New Zealand. Medicines use data were collected using an interRAI assessment tool. Descriptive statistics, t-tests and Chi-squared tests were used for analysis.

Results

A total of 578 residents were recruited from 33 RVs and the median age was 81.6 years. Participants took a mean of 4.8 regular medicines (standard deviation = 2.9) and 0.7 ‘as required’ medicines. Anti-hypertensives (68.5%), lipid-lowering medicines (45.2%), antacids (39.4%) and antiplatelet agents (37.9%) were the most prescribed medicine classes. Polypharmacy (five-plus medicines; 51.8%) was common and hyperpolypharmacy (10-plus medicines; 5.7%) occurred infrequently.

Discussion

This study provides insight into medicines use by RV residents in Auckland, NZ. Medicines used for primary and secondary prevention of cardiovascular disease were used most commonly and polypharmacy was common. Active review of RV residents’ medicines is warranted, based on these findings and increasing evidence regarding the use of medicines, including those for primary prevention of cardiovascular disease.

Trial registration

Australia and New Zealand Clinical Trials Registry: CTRN12616000685415. Registered 25.5.2016. Universal Trial Number (UTN): U111–1173-6083.

Keywords: adverse drug reaction, aged, assisted living facilities, cardiovascular disease, frailty, medication review, pharmacoepidemiology, polypharmacy.

References

1  Masnoon N, Shakib S, Kalisch-Ellett L, et al. What is polypharmacy? A systematic review of definitions. BMC Geriatr 2017; 17: 230.
| Crossref | Google Scholar | PubMed |

2  Nishtala PS, Salahudeen MS. Temporal trends in polypharmacy and hyperpolypharmacy in older New Zealanders over a 9-year period: 2005-2013. Gerontology 2015; 61(3): 195-202.
| Crossref | Google Scholar | PubMed |

3  Zhang M, Holman CDJ, Preen DB, et al. Repeat adverse drug reactions causing hospitalization in older Australians: a population-based longitudinal study 1980–2003. Br J Clin Pharmacol 2007; 63(2): 163-170.
| Crossref | Google Scholar | PubMed |

4  Gnjidic D, Le Couteur DG, Abernethy DR, et al. Drug Burden Index and Beers Criteria: impact on functional outcomes in older people living in self-care retirement villages. Br J Clin Pharmacol 2012; 52(2): 258-265.
| Crossref | Google Scholar | PubMed |

5  Jones Lang LaSalle. NZ Retirement Villages and Aged Care. Whitepaper. Jones Lang LaSalle Inc.; 2020.

6  Bekhet AK, Zauszniewski JA, Nakhla WE. Reasons for relocation to retirement communities: a qualitative study. West J Nurs Res 2009; 31(4): 462-479.
| Crossref | Google Scholar | PubMed |

7  Xue L, Boudreau RM, Donohue JM, et al. Persistent polypharmacy and fall injury risk: the Health, Aging and Body Composition Study. BMC Geriatr 2021; 21(1): 710.
| Crossref | Google Scholar | PubMed |

8  Jokanovic N, Tan ECK, Dooley MJ, et al. Prevalence and factors associated with polypharmacy in long-term care facilities: a systematic review. J Am Med Dir Assoc 2015; 16(6): 535.e1-535.e12.
| Crossref | Google Scholar | PubMed |

9  Peri K, Broad JB, Hikaka J, et al. Study protocol: older people in retirement villages. A survey and randomised trial of a multi-disciplinary invention designed to avoid adverse outcomes. BMC Geriatr 2020; 20: 247.
| Crossref | Google Scholar | PubMed |

10  von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Statement: guidelines for reporting observational studies. PLoS Med 2007; 4(10): e296.
| Crossref | Google Scholar | PubMed |

11  Broad JB, Wu Z, Bloomfield K, et al. Health profile of residents of retirement villages in Auckland, New Zealand: findings from a cross-sectional survey with health assessment. BMJ Open 2020; 10: e035876.
| Crossref | Google Scholar | PubMed |

12  Health Quality and Safety Committee. Polypharmacy in People Aged 65 and Over. 2019. Available at https://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/projects/atlas-of-healthcare-variation/polypharmacy/ [Accessed 14 March 2024].

13  Lee CY, George J, Elliott RA, et al. Prevalence of medication-related risk factors among retirement village residents: a cross-sectional survey. Age Ageing 2010; 39(5): 581-587.
| Crossref | Google Scholar | PubMed |

14  Lau SR, Waldorff F, Holm A, et al. Disentangling concepts of inappropriate polypharmacy in old age: a scoping review. BMC Public Health 2023; 23(1): 245.
| Crossref | Google Scholar | PubMed |

15  O’Mahony D, Cherubini A, Guiteras AR, et al. STOPP/START criteria for potentially inappropriate prescribing in older people: version 3. Eur Geriatr Med 2023; 14: 625-632.
| Crossref | Google Scholar | PubMed |

16  bpacNZ. Benzodiazepines and Zopiclone: Is Overuse Still an Issue? bpacNZ; 2021. Available at https://bpac.org.nz/2021/docs/benzo-zopiclone.pdf

17  Prieto-García L, Pericacho M, Sancho-Martínez SM, et al. Mechanisms of triple whammy acute kidney injury. Pharmacol Ther 2016; 167: 132-145.
| Crossref | Google Scholar | PubMed |

18  Maes ML, Fixen DR, Linnebur SA. Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence. Ther Adv Drug Saf 2017; 8(9): 273-297.
| Crossref | Google Scholar | PubMed |

19  Han BH, Sutin D, Williamson JD, et al. Effect of statin treatment vs usual care on primary cardiovascular prevention among older adults: the ALLHAT-LLT randomized clinical trial. JAMA Intern Med 2017; 177(7): 955-965.
| Crossref | Google Scholar | PubMed |

20  Marcellaud E, Jost J, Tchalla A, et al. Statins in primary prevention in people over 80 years. Am J Cardiol 2023; 187: 62-73.
| Crossref | Google Scholar | PubMed |

21  Bloomfield K, Hikaka J, Brookes J, et al. Changing the script: medicine optimisation recommendations made during proactive multidisciplinary meetings with older adults. N Z Med J 2024; 137(1593): 96-98.
| Crossref | Google Scholar | PubMed |