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COPD patients at heightened risk of drug side effects linked to polypharmacy

More likely to have other long-term conditions and to be co-prescribed several drugs

Caroline White

Wednesday, 17 January 2018

People with chronic obstructive pulmonary disease (COPD) and a cluster of other long-term conditions are at heightened risk of developing a range of side effects to the medicines they are prescribed, suggests research* published in the online journal BMJ Open.

The researchers found that patients with COPD are more likely to be prescribed several different drugs, which increases their risk of falls and bleeding, among other things.

They base their findings on a comparative UK Biobank study of 8317 people with COPD and 494,323 people free of the condition.

They found that people with COPD were more than three times as likely to have other long-term conditions (17% vs 4%) and significantly more likely to be prescribed five or more drugs with similar potential side-effects at the same time (52% vs 18%).

Many of the medications contributing to the risks of side effects were used to treat the other long-term conditions, rather than the COPD itself. Having several of these was associated with a greater risk of potential adverse drug reactions.

After taking account of potentially influential factors, those with COPD were significantly more likely to be prescribed three or more drugs contributing to falls, constipation, urinary retention, drowsiness, bleeding, and kidney damage.

Underlying cardiovascular disease was associated with the greatest risk of taking three or more drugs associated with falls/kidney damage while mental health conditions were most strongly associated with drugs linked with drowsiness/urinary retention/bleeding.

Lead author Peter Hanlon said: “Our work shows that co-prescription of drugs with the potential for various adverse drug reactions is common.”

Corresponding author Frances Mair, professor of General Practice at the Institute of Health and Wellbeing, added: “Our findings are important because it highlights the need for future research to examine the effects of this on healthcare outcomes.

“Going forward, clinical guidelines need to start emphasising the importance of the assessment of multimorbidity and adverse drug reaction risk.”

*Hanlon P, Nicholl BI, Jani BD, et al. Examining patterns of multimorbidity, polypharmacy and risk of adverse drug reactions in chronic obstructive pulmonary disease: a cross-sectional UK Biobank study. BMJ Open 2018;8:e018404. doi: 10.1136/bmjopen-2017-018404.

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