Polypharmacy in adults over 50 in Ireland: Opportunities for cost saving and improved healthcare
Abstract
What is TILDA?TILDA is a longitudinal study of ageing representative of the community-dwelling over 50 year olds in Ireland.In its first wave TILDA recruited a stratified clustered sample of 8,175 individuals with each participant undergoing an extensive in home face-to-face interview, completing a self-reported questionnaire as well as being invited for a health assessment.The overall response rate was 62%.A description of the sample and preliminary findings are available elsewhere (Barrett et al., 2011).What is polypharmacy?The proportion of the population aged over 65 years in Ireland is expected to double over the next 35 years from 11% in 2006 to 22% in 2041.Those over 65 years also consume the greatest proportion of medications in Western populations (Families USA, 2000), and in Ireland account for around half of the prescription medications dispensed within the Health Service Executive's Primary Care Reimbursement Service (HSE PCRS).Increasing life expectancy and associated greater multimorbidity, as well as new drug treatments and indications, all contribute to the development of multiple medication use as people age.However, as older people and those with multimorbidity are often excluded from drug trials there is a lack of high-quality evidence to guide prescribing in the elderly (Hilmer and Gnjidic, 2008).The definition of polypharmacy varies in the literature, making international comparisons difficult, but it is most commonly defined as the concurrent use of…
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