abstract: 'Background: Prior work has identified disparities in the quality and

  outcomes of healthcare across socioeconomic subgroups. Medication use

  may be subject to similar disparities.

  Objective: To assess the association between demographic and

  socioeconomic factors (gender, age, race, income, education, and rural

  or urban residence) and appropriateness of medication use.

  Methods: US adults aged >= 45 years (n = 26,798) from the REasons for

  Geographic And Racial Differences in Stroke (REGARDS) study were

  included in the analyses, of which 13,623 participants aged >= 65 years

  (recruited 2003-2007). Potentially inappropriate medication (PIM) use in

  older adults and drug-drug interactions (DDIs) were identified through

  2015 Beers Criteria and clinically significant drug interactions list by

  Ament et al., respectively as measures of medication appropriateness.

  Multivariable logistic regression was used to assess the association of

  disparity parameters with PIM use and DDIs. Interactions between race

  and other disparity variables were investigated.

  Results: Approximately 87\% of the participants aged >= 65 years used at

  least one drug listed in the Beers Criteria, and 3.8\% of all

  participants used two or more drugs with DDIs. Significant gender-race

  interaction across prescription-only drug users revealed that white

  females compared with white males (OR = 1.33, 95\% CI 1.20-1.48) and

  black males compared with white males (OR = 1.60, 95\% CI 1.41-1.82)

  were more likely to receive PIM. Individuals with lower income and

  education also were more likely to use PIM in this sub-group. Females

  were less likely than males (female vs. male: OR = 0.55, 95\% CI

  0.48-0.63) and individuals resided in small rural areas as opposed to

  urban areas (small rural vs. urban: OR = 1.37, 95\% CI 1.07-1.76) were

  more likely to have DDIs.

  Conclusion: Demographic and socioeconomic disparities in PIM use and

  DDIs exist. Future studies should seek to better understand factors

  contributing to the disparities in order to guide development of

  interventions.'
affiliation: 'Rahman, M; Hansen, R (Corresponding Author), Auburn Univ, Harrison Sch
  Pharm, 2316 Walker Bldg, Auburn, AL 36849 USA.

  Rahman, Motiur; Qian, Jingjing; Garza, Kimberly; Hansen, Richard, Auburn Univ, Harrison
  Sch Pharm, Dept Hlth Outcomes Res \& Policy, Auburn, AL 36849 USA.

  Howard, George, Univ Alabama Birmingham, Dept Biostat, Ryals Sch Publ Hlth, Birmingham,
  AL 35294 USA.

  Abebe, Ash, Auburn Univ, Dept Math \& Stat, Auburn, AL 36849 USA.'
author: Rahman, Motiur and Howard, George and Qian, Jingjing and Garza, Kimberly and
  Abebe, Ash and Hansen, Richard
author-email: 'mzr0042@auburn.edu

  rah0019@auburn.edu'
author_list:
- family: Rahman
  given: Motiur
- family: Howard
  given: George
- family: Qian
  given: Jingjing
- family: Garza
  given: Kimberly
- family: Abebe
  given: Ash
- family: Hansen
  given: Richard
da: '2023-09-28'
doi: 10.1016/j.sapharm.2020.02.008
eissn: 1934-8150
files: []
issn: 1551-7411
journal: RESEARCH IN SOCIAL \& ADMINISTRATIVE PHARMACY
keywords: 'REGARDS; Potentially inappropriate medication; Drug-drug interaction;

  Socioeconomic disparity'
keywords-plus: 'POTENTIALLY INAPPROPRIATE MEDICATIONS; UPDATED BEERS CRITERIA;

  HEALTH-CARE; UNITED-STATES; DISEASE; DRUG; MORTALITY; BLACKS; WHITES;

  STOPP'
language: English
month: DEC
number: '12'
number-of-cited-references: '52'
orcid-numbers: Abebe, Ash/0000-0001-5759-2383
pages: 1702-1710
papis_id: e79570d817b824f7378d5e6ad26164fe
ref: Rahman2020disparitiesappropria
researcherid-numbers: Abebe, Ash/C-3681-2014
times-cited: '4'
title: 'Disparities in the appropriateness of medication use: Analysis of the REasons
  for Geographic And Racial Differences in Stroke (REGARDS) population-based cohort
  study'
type: Article
unique-id: WOS:000594634100010
usage-count-last-180-days: '0'
usage-count-since-2013: '0'
volume: '16'
web-of-science-categories: Public, Environmental \& Occupational Health; Pharmacology
  \& Pharmacy
year: '2020'