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Physician factors associated with polypharmacy and potentially inappropriate medication use among family medicine residency practices

Ie, Kenya (2017) Physician factors associated with polypharmacy and potentially inappropriate medication use among family medicine residency practices. Master Essay, University of Pittsburgh.

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Abstract

Background: Despite accumulating evidence about the impact of polypharmacy on public health, few studies have investigated factors related to polypharmacy. The objective of this study was to explore factors related to physician prescribing behavior. Methods: We conducted a physician survey at five family medicine residency practices and a linked health record review of their patients 65 years or older. The determinants of physicians’ mean number of prescriptions and potentially inappropriate medications (PIMs) were examined using a generalized linear model. Results: A total of 61 physicians (38 residents and 23 fellows/faculty) completed the survey and 2,103 visits by 932 patients seen by these physicians were analyzed. The mean prescription and PIM numbers per visit per physician were 9.50 and 0.46, respectively. After controlling for patient race and age, low prescribers were more likely to consider number of medications (p=0.007) and benefit/risk information for deprescribing (p=0.017) in prescribing decisions. Low PIM prescribers also considered these two factors and the Beers list (p=0.05). Physicians’ sex, length of experience, and perceived confidence were not associated with prescribing patterns. Public Health Significance: Conscious consideration concerning the number of medications and benefit/risk information, as well as using the Beers list, were associated with less polypharmacy and PIMs use. Our results warrant further research and education to address prescription-related problems among older patients, especially with a focus on enhancing deprescribing to improve patient outcomes while reducing inappropriate healthcare utilization and costs.


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Details

Item Type: Other Thesis, Dissertation, or Long Paper (Master Essay)
Status: Unpublished
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Ie, Kenyakei9@pitt.eduKEI9
Contributors:
ContributionContributors NameEmailPitt UsernameORCID
Committee ChairFinegold, Daviddnf@pitt.eduUNSPECIFIEDUNSPECIFIED
Committee MemberAlbert, Stevensmalbert@pitt.eduUNSPECIFIEDUNSPECIFIED
Date: 1 April 2017
Date Type: Submission
Publisher: University of Pittsburgh
Institution: University of Pittsburgh
Schools and Programs: Graduate School of Public Health > Multidisciplinary MPH
Degree: MPH - Master of Public Health
Thesis Type: Master Essay
Refereed: No
Date Deposited: 28 Jul 2017 15:17
Last Modified: 10 Dec 2020 02:04
URI: http://d-scholarship.pitt.edu/id/eprint/31136

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