Identifying predictors of medication-related harm in older populations: a latent class analysis approach.

Background The aim of this study was to apply latent class analysis to identify underlying groupings of predictors, including drug classes and clinical predictors, co-occurring in older people at higher risk of medication-related harm. Method The Adverse Drug reactions in an Ageing PopulaTion cohort...

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Published in:Age & Ageing Vol. 54; no. 8; pp. 1 - 10
Main Authors: Brannigan, Ross, Frydenlund, Juliane, Williams, David J, Moriarty, Frank, Wallace, Emma, Kirke, Ciara, Bennett, Kathleen E, Cahir, Caitriona
Format: Article
Published: Oxford University Press / USA Aug2025
Online Access:View this record in EBSCOhost
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      dt: Aug2025
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      pub: Oxford University Press / USA
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        10.1093/ageing/afaf227
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        atl: Identifying predictors of medication-related harm in older populations: a latent class analysis approach.
      aug:
        au:
          Brannigan, Ross
          Frydenlund, Juliane
          Williams, David J
          Moriarty, Frank
          Wallace, Emma
          Kirke, Ciara
          Bennett, Kathleen E
          Cahir, Caitriona
        affil:
          Royal College of Surgeons in Ireland, School of Population Health, Dublin, Leinster, Ireland
          Department of Geriatric and Stroke Medicine, Royal College of Surgeons in Ireland, Dublin, Leinster, Ireland
          Royal College of Surgeons in Ireland, School of Pharmacy and Biomolecular Sciences, Dublin, Ireland
          Department of General Practice, University College Cork School of Medicine, Cork, Ireland
          National Quality and Patient Safety Directorate at Health Service Executive, Dublin, Ireland
      keyword:
        adverse drug reactions (ADR)
        adverse effects of medication
        aging
        anti-inflammatory agents
        antihypertensive agents
        calcium channel blockers
        comorbidity
        diuretics
        fibrinolytic agents
        frailty
        functional impairment
        geographic population
        health-related quality of life
        high risk drugs
        hospital admission
        hospitalisation
        latent class analysis
        latent class analysis (LCA)
        medication-related harm
        older adult
        older patients
        polypharmacy
        prescribing behavior
        quality of life
        renin-angiotensin-aldosterone system
        adverse drug reactions (ADR)
        adverse effects of medication
        aging
        anti-inflammatory agents
        antihypertensive agents
        calcium channel blockers
        comorbidity
        diuretics
        fibrinolytic agents
        frailty
        functional impairment
        geographic population
        health-related quality of life
        high risk drugs
        hospital admission
        hospitalisation
        latent class analysis
        latent class analysis (LCA)
        medication-related harm
        older adult
        older patients
        polypharmacy
        prescribing behavior
        quality of life
        renin-angiotensin-aldosterone system
      ab: Background The aim of this study was to apply latent class analysis to identify underlying groupings of predictors, including drug classes and clinical predictors, co-occurring in older people at higher risk of medication-related harm. Method The Adverse Drug reactions in an Ageing PopulaTion cohort was used (N  = 798 patients aged ≥65 years admitted acutely to hospital). Seven drug classes; antithrombotic agents, diuretics, renin-angiotensin-aldosterone system, calcium channel blockers, beta-blocking agents, psychoanaleptics, non-steroidal anti-inflammatory drugs, and comorbidity, frailty and significant polypharmacy (10+ different drug classes) were included as potential predictors of medication-related harm. Medication-related harm outcomes included adverse drug reactions (ADR)-related hospital admissions, health-related quality of life, functional impairment and emergency department visits. Determination of the best number of latent classes was based on standard comparison of fit statistics. Univariate and multivariable logistic, linear and Poisson regression models were used to examine the associations between the latent groups and the medication-related harm outcomes. Results A five class model was determined to fit best; (i) high-risk prescribing and polypharmacy group (N  = 245); (ii) low-risk group (n  = 138); (iii) high-risk prescribing only group (N  = 332); (iv) antihypertensive group (N  = 18); and (v) psychoanaleptics and polypharmacy group (N  = 65). Patients in both the high-risk prescribing and polypharmacy group (a.OR = 2.59, 95%CI = 1.51–4.44) and the high-risk prescribing only group (a.OR = 2.85, 95%CI = 1.57–5.20) were more likely to have an ADR-related hospital admission, with the high-risk prescribing and polypharmacy group also having statistically significant higher functional impairment (β = 1.21, 95% CI = 0.09, 2.33) compared to those in the low-risk group. Conclusion Identifying distinct subgroups of older people based on their medications may lead to more targeted and tailored interventions to reduce potential medication-related harm.
      pubtype: Academic Journal
      doctype: Article
      src: R
    language: English
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