November 1, 2001Epidemiology
Paradoxical Relations of Drug Treatment with Mortality in Older Persons
Why the study?
Does the use of common drug classes artifactually reduce mortality in observational studies of older persons?
Population
129,111 residents of New Jersey 65-99 years of age who had at least one hospitalization during 1991-1994 and…
Comparison
Use of 20 common classes of drugs during the 120… vs Non-users of the respective drug classes.
Design
Cohort
Follow-up
1 year after discharge
Authors
Discussion
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Implication
Caution against causal inference from apparent protective drug-mortality links in elderly cohorts; leaves open true effects without better confounding control.
Structured PICO
Does the use of common drug classes artifactually reduce mortality in observational studies of older persons?
P
Population
129,111 residents of New Jersey 65-99 years of age who had at least one hospitalization during 1991-1994 and filled prescriptions through Medicaid or Pharmacy Assistance for the Aged and Disabled program, plus a separate nonhospitalized cohort of 132,071 elderly persons.
I
Intervention
Use of 20 common classes of drugs during the 120 days before hospitalization.
C
Comparator
Non-users of the respective drug classes.
O
Outcome
Death in the hospital or during the year after discharge.hard clinical
Observational studies in high-risk elderly populations may show artifactual protective associations between drug use and mortality due to unmeasured confounding.
Limitations
- Selective under-use of drugs by elderly patients with potentially unmeasured comorbidity may lead to artifactual protective associations
Cite This Study
Glynn et al. (2001) studied this question.