Patricia Dominguez Castro1,2, Ciara Reynolds1,2, Maria Gabriella Bizzaro1,2, Sharon Kennelly3, Barbara Clyne4, Gerard Bury5, Catriona Bradley6, Karen Finnigan7, Laura McCullagh7, Celine Murrin1,2, Carla Perrotta1,2, Eileen R Gibney2,8, Clare A Corish9,2. 1. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland. 2. UCD Institute of Food and Health, University College Dublin, Dublin, Republic of Ireland. 3. National Primary Care Division, Community Funded Schemes Service Improvement, Mountmellick Primary Care Building, Co. Laois, Republic of Ireland. 4. HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. 5. School of Medicine, University College Dublin, Belfield, Dublin, Republic of Ireland. 6. Royal College of Surgeons in Ireland, Dublin, Republic of Ireland. 7. Department of Pharmacology and Therapeutics, Trinity Centre for Health Sciences, St James's Hospital, Dublin, Republic of Ireland. 8. School of Agriculture and Food Science, University College Dublin, Dublin, Republic of Ireland. 9. School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Republic of Ireland clare.corish@ucd.ie.
Abstract
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.
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.
Authors: K Jyväkorpi Satu; H Suominen Merja; E Strandberg Timo; Karoliina Salminen; T Niskanen Riikka; Hanna-Maria Roitto; K T Saarela Riitta; H Pitkälä Kaisu Journal: BMC Nutr Date: 2022-04-12
Authors: Aisling A Geraghty; Laura McBean; Sarah Browne; Patricia Dominguez Castro; Ciara M E Reynolds; David Hanlon; Gerard Bury; Margaret O'Neill; Sarah Clarke; Barbara Clyne; Karen Finnigan; Laura McCullagh; Sharon Kennelly; Clare A Corish Journal: Nutrients Date: 2022-01-14 Impact factor: 5.717