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Polypharmacy and drug-drug interactions among older and younger male prisoners in Switzerland

Beatrice Annaheim (Institute for Biomedical Ethics, University of Basel, Basel, Switzerland)
Tenzin Wangmo (Institute for Biomedical Ethics, University of Basel, Basel, Switzerland)
Wiebke Bretschneider (Institute for Biomedical Ethics, University of Basel, Basel, Switzerland)
Violet Handtke (Institute for Biomedical Ethics, University of Basel, Basel, Switzerland)
Bernice S. Elger (Institute for Biomedical Ethics, University of Basel, Basel, Switzerland)
Angelo Belardi (Division of Clinical Psychology and Epidemiology, Faculty of Psychology, University of Basel, Basel, Switzerland)
Andrea H. Meyer (Division of Clinical Psychology and Epidemiology, Faculty of Psychology, University of Basel, Basel, Switzerland)
Raphael Hösli (Pharmacy, Spitalzentrum Biel, Biel-Bienne, Switzerland)
Monika Lutters (Clinical Pharmacy, Cantonal Hospital Baden, Baden, Switzerland)

International Journal of Prisoner Health

ISSN: 1744-9200

Article publication date: 15 March 2019

Issue publication date: 22 July 2019

Abstract

Purpose

The purpose of this paper is to determine the prevalence of polypharmacy and drug–drug interactions (DDIs) in older and younger prisoners, and compared if age group is associated with risks of polypharmacy and DDIs.

Design/methodology/approach

For 380 prisoners from Switzerland (190 were 49 years and younger; 190 were 50 years and older), data concerning their medication use were gathered. MediQ identified if interactions of two or more substances could lead to potentially adverse DDI. Data were analysed using descriptive statistics and generalised linear mixed models.

Findings

On average, older prisoners took 3.8 medications, while younger prisoners took 2.1 medications. Number of medications taken on one reference day was higher by a factor of 2.4 for older prisoners when compared to younger prisoners (p = 0.002). The odds of polypharmacy was significantly higher for older than for younger prisoners (>=5 medications: odds ratio = 5.52, p = 0.035). Age group analysis indicated that for potentially adverse DDI there was no significant difference (odds ratio = 0.94; p = 0.879). However, when controlling for the number of medication, the risk of adverse DDI was higher in younger than older prisoners, but the result was not significant.

Originality/value

Older prisoners are at a higher risk of polypharmacy but their risk for potentially adverse DDI is not significantly different from that of younger prisoners. Special clinical attention must be given to older prisoners who are at risk for polypharmacy. Careful medication management is also important for younger prisoners who are at risk of very complex drug therapies.

Keywords

Acknowledgements

Ethics approval and consent to participate: ten cantonal ethics committees approved this study (EKBB Basel, Bern, Aargau, Luzern, St Gallen, Valais, Vaud, Fribourg, Zurich and Thurgau); EK 184/11. Anonymous data were collected from medical records requiring no consent from data subjects. The authors acknowledge the financial support of the Swiss National Science Foundation (SNSF) as well as the OPO Stiftung. The authors declare that they have no competing interests. The authors would like to thank the team of MediQ for their support. The authors are grateful to participating prisons that provided us access to the data and the many assistants for supporting us with data entry and data checking.

Citation

Annaheim, B., Wangmo, T., Bretschneider, W., Handtke, V., Elger, B.S., Belardi, A., Meyer, A.H., Hösli, R. and Lutters, M. (2019), "Polypharmacy and drug-drug interactions among older and younger male prisoners in Switzerland", International Journal of Prisoner Health, Vol. 15 No. 3, pp. 250-261. https://doi.org/10.1108/IJPH-07-2018-0040

Publisher

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Emerald Publishing Limited

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