Kara Suvada1, Laura Plantinga2, Camille P Vaughan3, Alayne D Markland4, Anna Mirk3, Kathryn L Burgio4, Susanne M Erni5, Mohammed K Ali6, Ike Okosun7, Henry Young8, Patricia S Goode4, Theodore M Johnson9. 1. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 2. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA. 3. Division of Geriatrics and Gerontology, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Brookhaven, GA, USA. 4. Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Birmingham, AL, USA; Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Alabama at Birmingham, Birmingham, AL, USA. 5. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA. 6. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA. 7. Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA. 8. College of Pharmacy, University of Georgia, Athens, GA, USA. 9. Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Brookhaven, GA, USA; Department of Family and Preventive Medicine, School of Medicine, Emory University, Atlanta, GA, USA; Division of General Internal Medicine, Department of Medicine, School of Medicine, Emory University, Atlanta, GA, USA. Electronic address: tmjohns@emory.edu.
Abstract
PURPOSE: The goal of this study was to determine if the US adult population with nocturia (waking from sleep at night to void) can easily take medications (desmopressin acetate) approved by the US Food and Drug Administration for nocturia. The study examined: (1) the prevalence of comorbid conditions, laboratory abnormalities, and concomitant medications that increase risk of desmopressin use; and (2) whether these factors are associated with age or nocturia frequency. METHODS: Using a cross-sectional analysis of four US National Health and Nutrition Examination Survey (NHANES) waves (2005-2012), a total of 4111 participants aged ≥50 years who reported ≥2 nightly episodes of nocturia were identified. The main outcome was frequency of contraindications and drug interactions as described in US Food and Drug Administration-approved prescribing information. These prescribing concerns were matched to examination findings, medical conditions, concomitant medications, and laboratory results of NHANES participants. The associations between prescribing concerns and nocturia severity and age groups were examined. FINDINGS: The mean participant age was 65.7 years (95% CI, 65.3-66.1), and 45.5% were male. Desmopressin prescribing concerns were present in 80.5% (95% CI, 78.0-82.9) of those ≥50 years of age with nocturia; 50.0% (95% CI, 47.0-53.0) had contraindications, and 41.6% (95% CI, 39.3-44.0) took a concomitant drug that could increase risk of low serum sodium. Desmopressin contraindications were higher with older age (P < 0.001) and present in 73.2% (95% CI, 69.3-77.1) of those ≥80 years of age. IMPLICATIONS: Using NHANES data, this study showed that older US adults with nocturia have a high prevalence of medical conditions, concomitant medications, and baseline laboratory abnormalities that likely increase the risk of potentially severe adverse side effects from desmopressin use. A medication designed and approved for a clinical symptom that is most common in older adults could not be taken by most of the older adults with the symptom. Published by Elsevier Inc.
PURPOSE: The goal of this study was to determine if the US adult population with nocturia (waking from sleep at night to void) can easily take medications (desmopressin acetate) approved by the US Food and Drug Administration for nocturia. The study examined: (1) the prevalence of comorbid conditions, laboratory abnormalities, and concomitant medications that increase risk of desmopressin use; and (2) whether these factors are associated with age or nocturia frequency. METHODS: Using a cross-sectional analysis of four US National Health and Nutrition Examination Survey (NHANES) waves (2005-2012), a total of 4111 participants aged ≥50 years who reported ≥2 nightly episodes of nocturia were identified. The main outcome was frequency of contraindications and drug interactions as described in US Food and Drug Administration-approved prescribing information. These prescribing concerns were matched to examination findings, medical conditions, concomitant medications, and laboratory results of NHANES participants. The associations between prescribing concerns and nocturia severity and age groups were examined. FINDINGS: The mean participant age was 65.7 years (95% CI, 65.3-66.1), and 45.5% were male. Desmopressin prescribing concerns were present in 80.5% (95% CI, 78.0-82.9) of those ≥50 years of age with nocturia; 50.0% (95% CI, 47.0-53.0) had contraindications, and 41.6% (95% CI, 39.3-44.0) took a concomitant drug that could increase risk of low serum sodium. Desmopressin contraindications were higher with older age (P < 0.001) and present in 73.2% (95% CI, 69.3-77.1) of those ≥80 years of age. IMPLICATIONS: Using NHANES data, this study showed that older US adults with nocturia have a high prevalence of medical conditions, concomitant medications, and baseline laboratory abnormalities that likely increase the risk of potentially severe adverse side effects from desmopressin use. A medication designed and approved for a clinical symptom that is most common in older adults could not be taken by most of the older adults with the symptom. Published by Elsevier Inc.
Entities:
Keywords:
aged or elderly; comorbidity; medications; polypharmacy; risk factors; safety
Authors: Jeffrey P Weiss; Alan J Wein; Philip van Kerrebroeck; Roger Dmochowski; Marypat Fitzgerald; Kari A O Tikkinen; Paul Abrams Journal: Neurourol Urodyn Date: 2011-06 Impact factor: 2.696
Authors: Alayne D Markland; Camille P Vaughan; Theodore M Johnson; Patricia S Goode; David T Redden; Kathryn L Burgio Journal: J Urol Date: 2011-01-19 Impact factor: 7.450
Authors: Kathryn L Burgio; Theodore M Johnson; Patricia S Goode; Alayne D Markland; Holly E Richter; David L Roth; Patricia Sawyer; Richard M Allman Journal: J Am Geriatr Soc Date: 2010-04-14 Impact factor: 5.562
Authors: Theodore M Johnson; Camille P Vaughan; Patricia S Goode; Donald L Bliwise; Alayne D Markland; Carrie Huisingh; David T Redden; Gerald McGwin; Rina Eisenstein; Joseph G Ouslander; Muta Issa; Kathryn L Burgio Journal: Clin Ther Date: 2016-10-28 Impact factor: 3.393
Authors: Michael T Solotke; Sanket S Dhruva; Nicholas S Downing; Nilay D Shah; Joseph S Ross Journal: Expert Opin Drug Saf Date: 2017-12-17 Impact factor: 4.250
Authors: Andrew S Levey; Lesley A Stevens; Christopher H Schmid; Yaping Lucy Zhang; Alejandro F Castro; Harold I Feldman; John W Kusek; Paul Eggers; Frederick Van Lente; Tom Greene; Josef Coresh Journal: Ann Intern Med Date: 2009-05-05 Impact factor: 25.391
Authors: Camille P Vaughan; Alayne D Markland; Alison J Huang; Cathy A Alessi; Andrew Guzman; Jennifer L Martin; Donald L Bliwise; Theodore M Johnson Ii; Kathryn L Burgio; Constance H Fung Journal: Age Ageing Date: 2022-02-02 Impact factor: 10.668