Abstract P136: The Association Between Socioeconomic Status And Use Of Potentially Inappropriate Medications In Older Adults

Abstract

Introduction: The use of potentially inappropriate medications (PIM), defined as medications for which the risk of adverse events outweighs the expected benefits, increases the risk of hospitalization, adverse drug events, and mortality in older adults. As socioeconomic status (SES) influences health care quality, the purpose of this study is to investigate whether PIM use differs by SES in older adults. Hypothesis: We hypothesized that low SES was independently associated with increased use of PIM. Methods: We studied participants (aged 66-90 years) who were on at least one medication at visit 5 (2011-2013) of the Atherosclerosis Risk in Communities (ARIC) Study. We created a cumulative SES score, based on neighborhood SES (area deprivation index [ADI]) as well as individual SES (education and income). Because PIM for older adults defined by the 2019 Beers Criteria was extremely common (31% of the population), we focused on the use of two or more PIM. We used multivariable logistic regression to examine the associations between SES and PIM use ≥2. Results: Among 4927 participants (mean age of 75.6 (SD 5.1) years, 19.6% Black, and 57.8% female), 6.9% were on two or more PIMs. Overall, compared with individuals with high cumulative SES, those with lower SES had higher odds of PIM use in a dose-dependent manner (odds ratio [OR]: 1.40 [95% confidence interval (CI), 1.06-1.83] for middle cumulative SES; 1.83 [1.18-2.86] for low cumulative SES, Table ), adjusting for demographics and insurance type. For each SES component, low neighborhood SES (i.e., high ADI) and low education was significantly associated with higher odds of PIM use, but not income. Conclusions: We found that lower SES was associated with greater use of PIM among older adults, suggesting that there exist disparities in quality of care by SES. Focused efforts targeting older adults with low SES to reduce PIM use may be needed to prevent adverse outcomes.