Around 9 million of the 17 million individuals aged ≥65 years in Germany potentially have an elevated risk for adverse drug reactions and 4.6 million potentially have a highly elevated risk.

Analyses were based on the first 5,000 participants of the Rhineland Study (mean age 55 years; 57% women). Of our participants, 66.0% reported the use of a drug
regularly, which increased to 87.4% in participants aged ≥65 years (n=1,301). The use of polypharmacy, potentially inappropriate medication, and pharmacogenomic drugs was 15.9%, 6.4%, and 20.5%, respectively. In participants <65 years, 16.0% (95%CI 14.8;17.3) had at least one risk factor. In participants aged ≥65 years, 54.1% (95%CI 51.4;56.8) had at least one, and 27.4% (95%CI 25.0;29.9) had at least two risk factors.
Extrapolating these numbers to the German population implies, that around 9 of the 17 million individuals aged 65 years or older are potentially at an elevated risk for adverse drug reactions, of which 4.6 million are at a potentially highly elevated risk for adverse drug reactions.
Conclusion: Our study shows that drug use is common and the individual risk for an adverse drug reaction in our population is high. This suggests room for improvement in general medication use.

Please cite this article as doi: 10.1111/bcp.14671 (article accepted for review)

Polypharmacy, potentially inappropriate medication, and pharmacogenomics drug exposure in the Rhineland Study.
Short running title: Suboptimal drug use and adverse effect risk

Folgerdiena M de Vries1, Julia C Stingl2, and Monique M B Breteler1,3
The authors confirm that the PI for this paper is Monique M. B. Breteler.
1. Population Health Sciences, German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
2. Institute of Clinical Pharmacology University Hospital of RWTH Aachen, Germany.
3. Institute for Medical Biometry, Informatics and Epidemiology (IMBIE), Faculty of Medicine,
University of Bonn, Bonn, Germany

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