PMID- 29267348
OWN - NLM
STAT- MEDLINE
DCOM- 20180116
LR  - 20220408
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 12
DP  - 2017
TI  - Analysis of polypharmacy effects in older patients using Japanese Adverse Drug 
      Event Report database.
PG  - e0190102
LID - 10.1371/journal.pone.0190102 [doi]
LID - e0190102
AB  - Population aging is a global phenomenon, and choosing appropriate medical care 
      for the elderly is critical. Polypharmacy is suspected to increase the risk of 
      adverse events (AEs) in older patients. We examined the AE profiles associated 
      with polypharmacy and aging using the Japanese Adverse Drug Event Report (JADER) 
      database. We attempted to mitigate the effect of patient-related factors using a 
      multiple-logistic regression technique and data subsetting. We selected case 
      reports for AEs as specified in the Medical Dictionary for Regulatory Activities 
      (MedDRA). The association between polypharmacy and "renal disorder" or "hepatic 
      disorder" was evaluated using reporting odds ratio (ROR) and adjusted for 
      covariates using multiple-logistic regression. For renal disorder, advanced 
      polypharmacy showed higher adjusted RORs, because the value of administered drugs 
      group [1.82 (1.76-1.88), >/= 10] was higher than that of the number of administered 
      drugs group [1.27 (1.24-1.31), 5-9]. The lower limit of the 95% confidence 
      interval (CI) of adjusted ROR for age (>/= 60 years) was > 1 for renal disorder. 
      For hepatic disorder, the adjusted RORs were as follows: 1.17 (1.14-1.20) for the 
      number of administered drugs group (5-9) and 1.14 (1.11-1.18) for the number of 
      administered drugs group (>/= 10). The adjusted RORs of hepatic disorder compared 
      to those of renal disorder had lower adjusted RORs related to the increase in the 
      number of administered drugs. Therefore, elderly individuals should be closely 
      monitored for the occurrence of renal disorder when they are subjected to 
      polypharmacy. This approach might apply to the simultaneous evaluation of the AE 
      risk of polypharmacy and aging.
FAU - Abe, Junko
AU  - Abe J
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
AD  - Medical Database Co., Ltd., Higashi, Shibuya-ku, Tokyo, Japan.
FAU - Umetsu, Ryogo
AU  - Umetsu R
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Uranishi, Hiroaki
AU  - Uranishi H
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Suzuki, Honami
AU  - Suzuki H
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Nishibata, Yuri
AU  - Nishibata Y
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Kato, Yamato
AU  - Kato Y
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Ueda, Natsumi
AU  - Ueda N
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Sasaoka, Sayaka
AU  - Sasaoka S
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Hatahira, Haruna
AU  - Hatahira H
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Motooka, Yumi
AU  - Motooka Y
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Masuta, Mayuko
AU  - Masuta M
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
FAU - Nakamura, Mitsuhiro
AU  - Nakamura M
AUID- ORCID: 0000-0002-5062-5522
AD  - Laboratory of Drug Informatics, Gifu Pharmaceutical University, Daigaku-nishi, 
      Gifu, Japan.
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20171221
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - *Adverse Drug Reaction Reporting Systems
MH  - Aged
MH  - Female
MH  - Humans
MH  - Japan
MH  - Male
MH  - *Polypharmacy
PMC - PMC5739473
COIS- Competing Interests: JA was an employee of Medical Database Co., LTD during the 
      time of the study and received a salary. RU is an employee of Micron Inc. The 
      specific roles of these authors are articulated in the 'author contributions' 
      section. The funders had no role in study design, data collection and analysis, 
      decision to publish, or preparation of the manuscript. There was no additional 
      external funding received for this study.
EDAT- 2017/12/22 06:00
MHDA- 2018/01/18 06:00
PMCR- 2017/12/21
CRDT- 2017/12/22 06:00
PHST- 2017/09/07 00:00 [received]
PHST- 2017/11/18 00:00 [accepted]
PHST- 2017/12/22 06:00 [entrez]
PHST- 2017/12/22 06:00 [pubmed]
PHST- 2018/01/18 06:00 [medline]
PHST- 2017/12/21 00:00 [pmc-release]
AID - PONE-D-17-32801 [pii]
AID - 10.1371/journal.pone.0190102 [doi]
PST - epublish
SO  - PLoS One. 2017 Dec 21;12(12):e0190102. doi: 10.1371/journal.pone.0190102. 
      eCollection 2017.