[en] PURPOSE: To explore differences in the prevalence and determinants of polypharmacy in the older general population in Belgium between self-reported and prescription based estimates and assess the relative merits of each data source.
METHODS: Data were used from participants aged ≥65 years of the Belgian national health survey 2013 (n = 1950). Detailed information was asked on the use of medicines in the past 24 h and linked with prescription data from the Belgian compulsory health insurance (BCHI). Agreement between polypharmacy (use or prescription ≥5 medicines) and excessive polypharmacy (≥10 medicines) between both sources was assessed with kappa statistics. Multinomial logistic regression was used to study determinants of moderate (5-9 medicines) and excessive polypharmacy (≥10 medicines) and over- and underestimation of prescription based compared to self-reported polypharmacy.
RESULTS: Self-reported and prescription based polypharmacy prevalence estimates were respectively 27% and 32%. Overall agreement was moderate, but better in men (kappa 0.60) than in women (0.45). Determinants of moderate polypharmacy did not vary substantially by source of outcome indicator, but restrictions in activities of daily living (ADL), living in an institution and a history of a hospital admission was associated with self-reported based excessive polypharmacy only.
CONCLUSIONS: Surveys and prescription data measure polypharmacy from a different perspective, but overall conclusions in terms of prevalence and determinants of polypharmacy do not differ substantially by data source. Linking survey data with prescription data can combine the strengths of both data sources resulting in a better tool to explore polypharmacy at population level.
Disciplines :
Public health, health care sciences & services
Author, co-author :
Van der Heyden, Johan; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Berete, Finaba ; Université de Liège - ULiège > Unité de recherche Santé publique, épidémiologie et économie de la santé (URSAPES) ; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Renard, Françoise; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
Devleesschauwer, Brecht; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium ; Department of Veterinary Public Health and Food Safety, Ghent University, Merelbeke, Belgium
De Ridder, Karin; Department of Epidemiology and Public Health, Sciensano, Brussels, Belgium
BRUYERE, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Assessing polypharmacy in the older population: Comparison of a self-reported and prescription based method.
INAMI - Institut National d'Assurance Maladie-Invalidité
Funding text :
This work did not receive any specific grant from funding agencies in the public, commercial, or not‐for‐profit sectors. The Belgian Health Interview Survey (BHIS) is financed by the Federal and Inter‐Federated Belgian Public Health authorities. The linkage between BHIS data and the Belgian Compulsory Health Insurance data is financed by the National Institute for Health and Disability Insurance.
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