{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T15:02:51Z","timestamp":1785164571971,"version":"3.55.0"},"reference-count":45,"publisher":"BMJ","issue":"7","license":[{"start":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T00:00:00Z","timestamp":1785110400000},"content-version":"unspecified","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000272","name":"National Institute for Health and Care Research","doi-asserted-by":"publisher","award":["NIHR303533"],"award-info":[{"award-number":["NIHR303533"]}],"id":[{"id":"10.13039\/501100000272","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015652","name":"Barts Charity","doi-asserted-by":"publisher","award":["MGU0504"],"award-info":[{"award-number":["MGU0504"]}],"id":[{"id":"10.13039\/100015652","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["WT\/201375\/Z\/16\/Z"],"award-info":[{"award-number":["WT\/201375\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2026,6,22]]},"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To estimate the prevalence of potentially inappropriate prescribing (PIP) in UK middle-aged adults, identify patient-level factors associated with PIP and its associations with subsequent primary care utilisation and mortality.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A prospective observational cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>English routinely collected primary care electronic health record data from the Clinical Practice Research Datalink Aurum. The follow-up period was from 1 January 2018 to 7 February 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Randomly selected individuals (n=1 200 000) who were aged 45\u201364 years on 1 January 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Exposure<\/jats:title>\n                    <jats:p>Exposure was defined as at least one episode of PIP in the year 2018.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcomes<\/jats:title>\n                    <jats:p>The primary outcome was the rate of GP consultations in the year following exposure (2019). The secondary outcome was mortality between 2019 and 2023.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>13.9% of participants experienced PIP in 2018. Factors significantly associated with PIP included polypharmacy (\u226510 medications: OR 6.93, 95%\u2009CI 6.61 to 7.27), multimorbidity (OR 2.47, 95%\u2009CI 2.45 to 2.50), female sex (OR 1.14, 95%\u2009CI 1.13 to 1.16), older age (OR 1.01 95%\u2009CI 1.01 to 1.02) and higher primary care consultation frequency (OR 1.04 95%\u2009CI 1.04 to 1.04). PIP was associated with increased primary care consultations the following year (IRR 1.03, 95%\u2009CI 1.02 to 1.03)\u2009but not mortality (HR 0.99, 95%\u2009CI 0.93 to 1.04).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>One in seven middle\u2010aged adults were exposed to PIP and PIP resulted in higher subsequent primary care consultations; medicine optimisation strategies for PIP warrant evaluation in middle aged adults.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2025-115606","type":"journal-article","created":{"date-parts":[[2026,7,27]],"date-time":"2026-07-27T14:35:21Z","timestamp":1785162921000},"page":"e115606","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Is potentially inappropriate prescribing in UK middle-aged adults associated with healthcare utilisation and mortality? 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