polypharmacy

This package analyse prescription drugs deliveries to calculate several indicators of polypharmacy corresponding to the various definitions found in the literature.

It is essential to know the concepts used to calculate the various polypharmacy indicators to adequately use this package.
The core of the package is the data_process() function that creates the data.table of pharmacists drug deliveries by restructuring the drug delivery records (usually extracted from a pharmacy or a health insurance information system) into continuous periods of drug availability, applying user-defined arguments such as the grace periods between renewals or the longest treatment duration that an individual may accumulate through the successive renewals.

Then, each polypharmacy indicator can be computed using the corresponding function (ind_simult(), ind_stdcumul(), ind_wcumul(), ind_stdcontinuous(), ind_ucontinuous()) or using the overall function indicators() and select all the desired indicator(s) to be calculated at once.

Prior to running data_process() the user may need to pre-process the table of original drug delivery records to break down combination drug into their individual components (drugs_bkdn()) and/or to overwrite the treatment duration of specified drugs with constant time periods (cst_trt_dur()).

Installation

install.packages("polypharmacy")

Development version

To get a bug fix or to use a feature from the development version, you can install the development version of polypharmacy from GitHub.

# install.packages("remotes")
remotes::install_github("guiboucher/polypharmacy")

References

• Bjerrum, L., Rosholm, J. U., Hallas, J., & Kragstrup, J. (1997). Methods for estimating the occurrence of polypharmacy by means of a prescription database. [journal article]. European Journal of Clinical Pharmacology, 53(1), 7-11. DOI: 10.1007/s002280050329
• Chan, D.-C., Hao, Y.-T., & Wu, S.-C. (2009a). Characteristics of outpatient prescriptions for frail Taiwanese elders with long-term care needs. Pharmacoepidemiology and Drug Safety, 18(4), 327-334. DOI: 10.1002/pds.1712
• Fincke, B. G., Snyder, K., Cantillon, C., Gaehde, S., Standring, P., Fiore, L., . . . Gagnon, D. R. (2005). Three complementary definitions of polypharmacy: methods, application and comparison of findings in a large prescription database. Pharmacoepidemiol Drug Saf, 14(2), 121-128. DOI: 10.1002/pds.966
• Hovstadius, B., Astrand, B., & Petersson, G. (2009). Dispensed drugs and multiple medications in the Swedish population: an individual-based register study.(Technical advance)(Report). BMC Clinical Pharmacology, 9(11), 11. DOI: 10.1186/1472-6904-9-11
• Hovstadius, B., Astrand, B., & Petersson, G. (2010). Assessment of regional variation in polypharmacy. Pharmacoepidemiology and Drug Safety, 19(4), 375-383. DOI: 10.1002/pds.1921
• Kennerfalk, A., Ruigómez, A., Wallander, M.-A., Wilhelmsen, L., & Johansson, S. (2002). Geriatric Drug Therapy and Healthcare Utilization in the United Kingdom. Annals of Pharmacotherapy, 36(5), 797-803. DOI: 10.1345/aph.1A226
• Masnoon, N., Shakib, S., Kalisch-Ellett, L., & Caughey, G. E. (2017). What is polypharmacy? A systematic review of definitions. BMC Geriatr, 17(1), 230. DOI: 10.1186/s12877-017-0621-2
• Narayan, S. W., & Nishtala, P. S. (2015). Associations of Potentially Inappropriate Medicine Use with Fall-Related Hospitalisations and Primary Care Visits in Older New Zealanders: A Population-Level Study Using the Updated 2012 Beers Criteria. [journal article]. Drugs - Real World Outcomes, 2(2), 137-141. DOI: 10.1007/s40801-015-0020-y
• Nishtala, P. S., & Salahudeen, M. S. (2015). Temporal Trends in Polypharmacy and Hyperpolypharmacy in Older New Zealanders over a 9-Year Period: 2005-2013. Gerontology, 61(3), 195-202. DOI: 10.1159/000368191
• Park, H. Y., Ryu, H. N., Shim, M. K., Sohn, H. S., & Kwon, J. W. (2016). Prescribed drugs and polypharmacy in healthcare service users in South Korea: an analysis based on National Health Insurance Claims data. Int J Clin Pharmacol Ther, 54(5), 369-377. DOI: 10.5414/cp202484
• Veehof, L., Stewart, R., Haaijer-Ruskamp, F., & Jong, B. M. (2000). The development of polypharmacy. A longitudinal study. Fam Pract, 17(3), 261-267. DOI: 10.1093/fampra/17.3.261