Research Letter |

Cumulative Changes in the Use of Long-Term Medications: A Measure of Prescribing Complexity

Khoa D. Lam, MD1,2; Yinghui Miao, MPH2,3; Michael A. Steinman, MD1,2,3
[+] Author Affiliations
1Department of Medicine, University of California, San Francisco
2San Francisco VA Medical Center, San Francisco
3Division of Geriatrics, University of California, San Francisco
JAMA Intern Med. 2013;173(16):1546-1547. doi:10.1001/jamainternmed.2013.7060.
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Polypharmacy is a major concern in older adults, yet a simple cross-sectional count of medications does not capture the potential complications (and benefits) that occur when medications are started, stopped, and changed over time. The increased complexity that arises from multiple medication changes may lead to problems with adherence and confusion about proper medication use.1,2 In addition, because adverse drug reactions often occur relatively soon after a patient begins taking a medication, recent medication changes may involve increased risk of adverse drug events.3 In this study, we sought to longitudinally measure medication changes in a national sample of older veterans as a measure of prescribing complexity in older adults.

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