{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,14]],"date-time":"2026-11-14T10:54:12Z","timestamp":1794653652186,"version":"4.9.1"},"reference-count":39,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"unspecified","delay-in-days":24,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"crossref","award":["HRC\/2007\/1"],"award-info":[{"award-number":["HRC\/2007\/1"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100010414","name":"Health Research Board","doi-asserted-by":"crossref","award":["ECSA 2020"],"award-info":[{"award-number":["ECSA 2020"]}],"id":[{"id":"10.13039\/100010414","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2024,11,18]]},"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To describe the prevalence of sub-optimal monitoring for selected higher-risk medicines in older community-dwelling adults and to evaluate patient characteristics and outcomes associated with sub-optimal monitoring.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Study design<\/jats:title>\n                  <jats:p>Retrospective observational study (2011\u20132015) using historical general practice-based cohort data and linked dispensing data from a national pharmacy claims database.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Irish primary care.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>625 community-dwelling adults aged \u226570 years and prescribed at least one higher-risk medicine during the 5-year study period.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>The primary outcome was the prevalence of sub-optimal laboratory monitoring using a composite measure of published medication monitoring indicators, with a focus on commonly prescribed higher-risk medicines such as diuretics and anticoagulants. Poisson regression was used to assess the patient characteristics associated with sub-optimal monitoring and explanatory variables included the number of medicines, age, sex, deprivation and anxiety\/depression symptoms. Logistic regression was used to explore the association between baseline sub-optimal monitoring and the odds of adverse health outcomes (unplanned healthcare utilisation, adverse drug reactions and mortality).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Of 625 participants, the mean age was 77.7 years, 53% were female, the mean number of drugs was 7.3 (SD 3.3) and 499 (79.8%) had \u22651 unmonitored dispensing over 5\u2009years. The number of drugs, deprivation and anxiety\/depression symptoms were significantly associated with sub-optimal monitoring, with the strongest association seen for anxiety\/depression symptoms (incidence rate ratio: 1.33, 95% CI 1.05 to 1.68). There was a small but significant association between baseline sub-optimal monitoring and emergency department visits at follow-up, but no evidence of an association with unplanned hospital admissions, mortality or adverse drug reactions.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>The prevalence of sub-optimal medication monitoring was high, and number of drugs, deprivation and anxiety\/depression symptoms were significantly associated with sub-optimal monitoring. However, the public health impact of these findings remains uncertain, as there was no clear evidence of an association between sub-optimal monitoring and adverse health outcomes. Further research is needed to evaluate the effect of improved monitoring strategies and the optimal timing for drug monitoring of higher risk medications.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2024-086446","type":"journal-article","created":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T06:45:35Z","timestamp":1737787535000},"page":"e086446","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Prevalence and predictors of sub-optimal laboratory monitoring of selected higher risk medicines in Irish general practice: a 5-year retrospective cohort study of community-dwelling older adults"],"prefix":"10.1136","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2986-5994","authenticated-orcid":false,"given":"Caroline","family":"McCarthy","sequence":"first","affiliation":[{"name":"Department of General Practice, RSCI University of Medicine and Health Sciences, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9838-3625","authenticated-orcid":false,"given":"Frank","family":"Moriarty","sequence":"additional","affiliation":[{"name":"School of Pharmacy and Biomolecular Sciences, RSCI University of Medicine and Health Sciences, Dublin, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-1574","authenticated-orcid":false,"given":"Ann Sin\u00e9ad","family":"Doherty","sequence":"additional","affiliation":[{"name":"Department of General Practice, University College Cork, Cork, Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mark","family":"Feighery","sequence":"additional","affiliation":[{"name":"Department of General Practice, University College Cork, Cork, 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