Polypharmacy in spinal cord injury: Matched cohort analysis comparing drug classes, medical complications, and healthcare utilization metrics with 24-month follow-up.
J Spinal Cord Med
; : 1-10, 2024 Jul 22.
Article
in En
| MEDLINE
| ID: mdl-39037335
ABSTRACT
OBJECTIVE:
Polypharmacy in spinal cord injury (SCI) is common and predisposes patients to increased risk of adverse events. Evaluation of long-term health consequences and economic burden of polypharmacy in patients with SCI is explored.DESIGN:
Retrospective cohort.METHODS:
The IBM Marketscan Research Databases claims-based dataset was queried to search for adult patients with SCI with a 2-year follow-up.PARTICIPANTS:
Two matched cohorts were analyzed those with and without polypharmacy, analyzing index hospitalization, readmissions, payments, and health outcomes.RESULTS:
A total of 11 569 individuals with SCI were included, of which 7235 (63%) were in the polypharmacy group who took a median of 11 separate drugs over two years. Opioid analgesics were the most common medication, present in 57% of patients with SCI meeting the criteria of polypharmacy, followed by antidepressant medications (46%) and muscle relaxants (40%). Risk of pneumonia was increased for the polypharmacy group (58%) compared to the non-polypharmacy group (45%), as were urinary tract infection (79% versus 63%), wound infection (30% versus 21%), depression (76% versus 57%), and adverse drug events (24% versus 15%) at 2 years. Combined median healthcare payments were higher in polypharmacy at 2 years ($44 333 vs. $10 937, P < .0001).CONCLUSION:
Majority of individuals with SCI met the criteria for polypharmacy with nearly 60% of those prescribed opioids and taking drugs from high-risk side effect profiles. Polypharmacy in SCI was associated with a greater risk of pneumonia, depression, urinary tract infections, adverse drug events, and emergency room visits over two years with four times higher overall healthcare payments at 1-year post-injury.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Language:
En
Journal:
J Spinal Cord Med
/
J. spinal cord med
/
Journal of spinal cord medicine
Journal subject:
NEUROLOGIA
/
REABILITACAO
Year:
2024
Document type:
Article
Affiliation country:
Estados Unidos
Country of publication:
Reino Unido