Patterns of therapeutic prescription medication category use among community-dwelling homebound older adults.
OBJECTIVE
The measurement of prescription medication use is usually through a simple count of medications, which tends to ignore therapeutic categories. This research investigated prescription medication use among homebound older adults, by documenting the therapeutic prescription medication categories used by these individuals and identifying the factors associated with use of multiple therapeutic categories.


METHODS
Baseline Nutrition and Function Study (2000-2001) data from 326 homebound older persons who completed the medication review component (visual inspection of medications) of the baseline in-home interview and used > or =1 prescribed medication were included in this analysis.


RESULTS
More than 40% (n = 133) regularly took medications from three to four different therapeutic categories and 31.6% (n = 103) used > or =5 different therapeutic categories. The use of respiratory medications declined with increasing age, and more women than men used diuretic and thyroid replacement medications. Independent of other factors, increased use of multiple therapeutic categories was associated with sociodemographic characteristics (gender, age, living arrangement, marital status and medication coverage), medical conditions (diabetes, heart problems and lung disease) and inability to self-manage medications.


CONCLUSIONS
Our findings suggest that individual characteristics and medical conditions may help identify homebound elders at high risk for using prescription medications from an increased number of different therapeutic categories. This observation may help clinicians and community-based providers of services to older persons to be aware of differences in therapeutic medication use within an older population, and how patterns of use may alter service needs.
Sharkey
Joseph R
JR
Department of Social and Behavioral Health, School of Rural Public Health, Texas A&M University System Health Sciences Center, College Station, TX 77840, USA. sharkey@tamu.edu
Browne
Barry
B
Ory
Marcia G
MG
Wang
Suojin
S
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003920:Diabetes Mellitus / Q000188:drug therapy; D011307:Drug Prescriptions / Q000145:classification* / Q000706:statistics & numerical data; D005260:Female; D006331:Heart Diseases / Q000188:drug therapy; D018577:Homebound Persons / Q000706:statistics & numerical data; D006801:Humans; D008171:Lung Diseases / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D009657:North Carolina; D019338:Polypharmacy; D012737:Sex Factors; D012959:Socioeconomic Factors