title: Medication profile and polypharmacy in adults with pediatric-onset spinal cord injury.
abstract: METHODS
  Cross-sectional survey.
  
  
  OBJECTIVE
  To describe the medications taken by individuals who had sustained a spinal cord injury (SCI) in childhood or adolescence (age <19 years) and to report the prevalence of polypharmacy and its association with demographic, injury-related and psychosocial factors.
  
  
  METHODS
  Community.
  
  
  METHODS
  Structured interviews of adults with pediatric-onset SCI. Routine medications and secondary health conditions (SHCs) experienced were recorded. Polypharmacy was defined as the concomitant use of five or more different types of medications. Bivariate analyses and multiple regression models were conducted to determine associations between polypharmacy and demographic factors, injury-related factors, number of SHCs and psychosocial outcomes (FIM, SF-12v2 Health Survey, CHART, PHQ-9).
  
  
  RESULTS
  A total of 159 participants (male, 63%; tetraplegia, 59%) with mean age 35.0±6.2 years (range, 26.7-50.9 years) were included. Most common routine medications were muscle relaxants (50.3%), bladder medications (48.5%), bowel agents (41.5%), analgesics (26.4%) and antidepressants (16.9%). Polypharmacy was present in 30.8% (n, 49) and was more prevalent in those with tetraplegia (40.2% vs 17.9%; P=0.003). Participants with polypharmacy were older, had lower FIM, CHART and SF-12v2 scores, and higher PHQ-9 scores. Regression models indicate the total number of SHCs, time since injury and tetraplegia to be significant positive predictors of polypharmacy.
  
  
  CONCLUSIONS
  Duration of SCI and SHCs are risk factors for polypharmacy in this population of adults with SCI. Measures should be taken to prevent the occurrence of SHCs throughout adulthood so as to prevent the potentially adverse physiological effects and psychosocial outcomes associated with polypharmacy.
authors.affiliation: Department of Research, Shriners Hospitals for Children, Chicago, IL, USA.
authors.forename: M
authors.initials: M
authors.lastname: Hwang
authors.affiliation: Department of Psychology, Shriners Hospitals for Children, Chicago, IL, USA.|Department of Psychology, Loyola University Chicago, Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Zebracki
authors.affiliation: Department of Pediatrics, Shriners Hospitals for Children, Chicago, IL, USA.|Department of Pediatrics, Rush Medical College, Chicago, IL, USA.
authors.forename: L C
authors.initials: LC
authors.lastname: Vogel
mesh_terms: D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D002648:Child; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D019338:Polypharmacy; D011782:Quadriplegia / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D012044:Regression Analysis; D013119:Spinal Cord Injuries / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology* / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome