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Polypharmacy and Potentially Inappropriate Medication Use in Older Adults With Systemic Lupus Erythematosus
Dale Jean-Guy Séguin1, Christine A Peschken1, Cassandra Dolovich1
1Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.
Arthritis Care & Research
|August 9, 2021
Summary
Older adults with systemic lupus erythematosus (SLE) experience higher rates of polypharmacy, defined as using multiple medications. This increased medication use is linked to potentially inappropriate prescriptions for benzodiazepines/Z-drugs and opioids.
Area of Science:
- Rheumatology
- Geriatrics
- Clinical Pharmacy
Background:
- Older adults with systemic lupus erythematosus (SLE) are at risk for polypharmacy.
- Potentially inappropriate medications (PIMs) like opioids and benzodiazepines/Z-drugs pose risks to this population.
- Understanding risk factors for polypharmacy and PIMs in SLE is crucial for patient safety.
Purpose of the Study:
- To determine the prevalence of polypharmacy in older adults with SLE.
- To identify risk factors associated with polypharmacy and PIMs (opioids, benzodiazepines/Z-drugs) in this cohort.
Main Methods:
- Retrospective chart review of 206 SLE patients aged ≥50 years.
- Prescription data from the Manitoba Drug Program Information Network.
- Logistic regression to analyze associations between clinical factors and polypharmacy/PIM use.
Main Results:
- 72% of patients used ≥5 medications, and 35% used ≥10 medications.
- Prednisone use, higher Charlson Comorbidity Index (CCI) scores, and rural residence were associated with polypharmacy.
- Polypharmacy significantly increased the odds of benzodiazepine/Z-drug and opioid use.
Conclusions:
- Polypharmacy is highly prevalent in older adults with SLE, exceeding general population rates.
- Polypharmacy serves as a key indicator for the use of potentially inappropriate medications, including opioids and benzodiazepines/Z-drugs.
- These findings highlight the need for careful medication management in older SLE patients.
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