RT Journal Article
SR Electronic
T1 Characteristics and determinants of high volume dispensing in long-term oral nutritional supplement users in primary care: a secondary analysis
JF BJGP Open
JO BJGP Open
FD Royal College of General Practitioners
SP BJGPO.2020.0131
DO 10.3399/BJGPO.2020.0131
A1 Patricia Dominguez Castro
A1 Ciara Reynolds
A1 Maria Gabriella Bizzaro
A1 Sharon Kennelly
A1 Barbara Clyne
A1 Gerard Bury
A1 Catriona Bradley
A1 Karen Finnigan
A1 Laura McCullagh
A1 Celine Murrin
A1 Carla Perrotta
A1 Eileen R Gibney
A1 Clare A Corish
YR 2021
UL http://bjgpopen.org/content/early/2021/03/16/BJGPO.2020.0131.abstract
AB Background Oral nutritional supplements (ONS) are recommended for patients who are malnourished or at risk of malnutrition. Appropriate ONS prescribing requires regular monitoring to assess its continued requirement. Previous research identified long-term ONS prescriptions (>6 months) without review, with 70% of these influenced by social factors.Aim To investigate the characteristics of long-term ONS users in Ireland and the determinants of larger volumes of ONS dispensing.Design & setting Secondary analysis of anonymous dispensed pharmacy claims data of patients dispensed standard ONS for 12 consecutive months in 2018 (n = 912).Method Factors showing significant (P<0.05) univariate associations with above the median consumption of ONS units were entered into a multivariable model.Results Median age was 76 (range 18 to 101) years, with 66.9% of the sample being ≥65 years. Almost 70% of the samples were on polypharmacy (45.6%; ≥5 medications) or excessive polypharmacy (21.5%; ≥10 medications). Younger age and being on polypharmacy for drugs having an effect on the central nervous system (CNS) were significantly associated with being dispensed more ONS units in univariate and multivariate analysis. Those patients in the age range 18 to 44 were 2.5 fold more likely to be prescribed more ONS units (odds ratio [OR] 2.5; 95% confidence interval [CI] 1.5 to 4.3; P<0.001). Patients using CNS drugs or on CNS polypharmacy were more likely to be prescribed more ONS units (ORs 1.2 and 2.4; 95% CI 0.9 to 1.4 and 1.3 to 4.4 respectively; P = 0.029). Conclusion Older age and polypharmacy characterise long-term ONS users in this study. Younger age and CNS medication polypharmacy are predictors of more ONS units prescribed over a year.