Association of suboptimal prescribing and change in lower extremity physical function over time

Mary Jo V Pugh, Raymond F. Palmer, Michael L. Parchman, Eric Mortensen, Kyriakos Markides, David V. Espino

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

Background: Previous studies have found inconsistent links between suboptimal prescribing and negative patient outcomes. While suboptimal prescribing consists of multiple components, e.g. drugs to avoid in the elderly (DAE), potential drug interactions (PDI) and polypharmacy, most research has focused on the impact of drugs to avoid. This study explores the relationship between suboptimal prescribing, comorbid disease, and change in lower extremity functional limitation (LEFL). Methods: This prospective cohort study used data from the Hispanic Established Population for the Epidemiologic Study of the Elderly. Baseline data collection occurred between 1993 and 1994 with three additional waves of data collected approximately every 2 years. Based on the disablement process model, the dependent variable was change in LEFL over the 7-year study period. Independent variables included suboptimal prescribing: DAE, PDI and polypharmacy. Measures of pathology included comorbid diseases (stroke, cancer, hypertension, cardiovascular disease, arthritis, and diabetes). Age, gender, education, smoking, cognitive status, depression, body mass index, marital status, and self-reported health were controlled in analyses. Results: Diabetes, stroke, and arthritis were associated with a decline in LEFL. Polypharmacy mediated the relationship between diabetes and LEFL, and polypharmacy was also significantly associated with decrements in LEFL. Conclusion: The effect of suboptimal prescribing on change in LEFL was limited to both direct and mediational effects of polypharmacy. Additional research exploring the association between suboptimal prescribing and a variety of quality measures using a diverse set of outcomes would improve our understanding of the impact of suboptimal prescribing more broadly defined.

Original languageEnglish (US)
Pages (from-to)445-453
Number of pages9
JournalGerontology
Volume53
Issue number6
DOIs
StatePublished - May 2008

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Polypharmacy
Lower Extremity
Drug Interactions
Arthritis
Stroke
Drug Prescriptions
Marital Status
Hispanic Americans
Research
Pharmaceutical Preparations
Epidemiologic Studies
Body Mass Index
Cohort Studies
Cardiovascular Diseases
Smoking
Prospective Studies
Depression
Pathology
Hypertension
Education

Keywords

  • Mexican Americans
  • Patient outcomes
  • Pharmacoepidemiology
  • Pharmacotherapy
  • Polypharmacy
  • Quality of care

ASJC Scopus subject areas

  • Aging

Cite this

Pugh, M. J. V., Palmer, R. F., Parchman, M. L., Mortensen, E., Markides, K., & Espino, D. V. (2008). Association of suboptimal prescribing and change in lower extremity physical function over time. Gerontology, 53(6), 445-453. https://doi.org/10.1159/000119460

Association of suboptimal prescribing and change in lower extremity physical function over time. / Pugh, Mary Jo V; Palmer, Raymond F.; Parchman, Michael L.; Mortensen, Eric; Markides, Kyriakos; Espino, David V.

In: Gerontology, Vol. 53, No. 6, 05.2008, p. 445-453.

Research output: Contribution to journalArticle

Pugh, MJV, Palmer, RF, Parchman, ML, Mortensen, E, Markides, K & Espino, DV 2008, 'Association of suboptimal prescribing and change in lower extremity physical function over time', Gerontology, vol. 53, no. 6, pp. 445-453. https://doi.org/10.1159/000119460
Pugh, Mary Jo V ; Palmer, Raymond F. ; Parchman, Michael L. ; Mortensen, Eric ; Markides, Kyriakos ; Espino, David V. / Association of suboptimal prescribing and change in lower extremity physical function over time. In: Gerontology. 2008 ; Vol. 53, No. 6. pp. 445-453.
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