Is age associated with the number or types of medications prescribed to renal transplant recipients?
OBJECTIVE
To determine whether age influences the number or types of medications prescribed to younger (aged 18-64) and elderly (aged > or =65) renal transplant recipients 3 years posttransplant.


METHODS
A cross-sectional study involving renal transplant recipients.


METHODS
Medical College of Georgia.


METHODS
A random sample of 100 elderly and 100 younger renal transplant recipients who received posttransplant care at the Medical College of Georgia, were on stable immunosuppressant therapy regimens, and were at least 3 years posttransplant.


METHODS
Medical and pharmacy data of recipients were evaluated for demographics; presence of a lipid-lowering agent; number of antihypertensives, immunosuppressants, antidiabetic agents, and total medications; number of rejections; dose per kilogram of immunosuppressant(s); infection-related hospitalizations; and measures of blood pressure, blood glucose, serum creatinine, serum tacrolimus/cyclosporine concentrations, total cholesterol, and triglycerides.


RESULTS
Elderly recipients were more likely to have diabetes mellitus before the transplant and to develop diabetes mellitus afterwards (P=.04) and were prescribed more total medications (12.40+/-3.72 vs 10.25+/-4.07, P<.001) and antidiabetic agents (0.89+/-0.93 vs 0.42+/-0.77, P<.001) 3 years posttransplant than younger recipients. Elderly recipients also had fewer chronic rejections, more infection-related hospitalizations, lower diastolic blood pressure, and greater fasting blood glucose levels 3 years posttransplant (P<.05) than younger recipients.


CONCLUSIONS
Future investigation should focus on deciphering the implications of the greater numbers of medications prescribed to elderly renal transplant recipients in terms of maximizing desired health outcomes (e.g., graft survival) and minimizing adverse drug-related experiences (e.g., infection).
Chisholm
Marie A
MA
University of Georgia College of Pharmacy, Athens, Georgia, USA. mchishol@mail.mcg.edu
Melroy
Joel
J
Johnson
Maribeth
M
Mulloy
Laura L
LL
Spivey
Christina A
CA
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000959:Antihypertensive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D001786:Blood Glucose / Q000378:metabolism; D002784:Cholesterol / Q000097:blood; D003404:Creatinine / Q000097:blood; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004359:Drug Therapy, Combination; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D005845:Georgia; D006084:Graft Rejection / Q000097:blood / Q000188:drug therapy / Q000453:epidemiology; D006785:Hospitals, University; D006801:Humans; D007004:Hypoglycemic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D007166:Immunosuppressive Agents / Q000493:pharmacokinetics / Q000627:therapeutic use; D016030:Kidney Transplantation / Q000502:physiology / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000097:blood / Q000453:epidemiology; D010359:Patient Readmission / Q000706:statistics & numerical data; D014280:Triglycerides / Q000097:blood
D000959:Antihypertensive Agents; D001786:Blood Glucose; D007004:Hypoglycemic Agents; D000960:Hypolipidemic Agents; D007166:Immunosuppressive Agents; D014280:Triglycerides; D002784:Cholesterol; D003404:Creatinine