White older adults and men have the highest risk of using a high-risk medication regularly, a new study finds.
A study published on Aug. 31 in the Journal of the American Geriatrics Society found that there were differences in risk based on types of medications, age, sex, and race.
The results suggest there’s a need to individualize medication optimization based on the factors affecting high-risk medication use risk.
Data came from administrative health claims for members of large commercial and Medicare Advantage health plans. The team looked at data from over 2.75 million older US adults (average age was 74) who started a high-risk medication between 2017 and 2022.
The researchers evaluated outcomes across 16 classes of high-risk medication. They defined chronic high-risk medication use as having a 90-day supply across two or more refills within 180 days of starting the drug.
Of all participants during the study, 15% became new chronic users of one or more high-risk medications. Asian, Black and Hispanic Americans had a lower risk of being a chronic high-risk medication user compared with white people. Men had a higher risk than women; and no age group was significantly linked with new chronic high-risk medication use.
Risks for long-term use differed based on different medication classes: Non-white older adults taking benzodiazepines, first-generation antihistamines and antimuscarinics had a higher risk of becoming chronic users.
More than 20% of older adults in the US regularly use at least one high-risk medication, and that figure is going up, the authors noted.
Of the 16 high-risk medication classes, chronic use was at 2% for pain medications, 3% for barbiturates and 50% for long-acting sulfonylureas.
The authors said that to boost the effectiveness of desprescribing interventions, it may be more helpful for clinicians to focus on individual sociodemographic groups who may be at the greatest risk of becoming long-term users of high-risk medication rather than on individual classes of drugs.
