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Polypharmacy and Psychological Distress May Be Associated in African American Adults

1
Department of Psychiatry, School of Medicine, University of Michigan, Ann Arbor, MI 48109-2029, USA
2
Center for Research on Ethnicity, Culture and Health, School of Public Health, University of Michigan, Ann Arbor, MI 48109-2029, USA
3
Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
4
Department of Family Medicine, University of California Los Angeles, Los Angeles, CA 90095, USA
5
Department of Family Medicine, Charles R. Drew University of Medicine and Sciences, Los Angeles, CA 90095, USA
*
Author to whom correspondence should be addressed.
Pharmacy 2019, 7(1), 14; https://doi.org/10.3390/pharmacy7010014
Received: 21 December 2018 / Revised: 21 January 2019 / Accepted: 22 January 2019 / Published: 24 January 2019
(This article belongs to the Special Issue The Burden of Medicines)
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PDF [238 KB, uploaded 24 January 2019]

Abstract

Background: Compared to Whites, African Americans are at a higher risk of multiple chronic conditions, which places them at a higher risk of polypharmacy. Few national studies, however, have tested whether polypharmacy is associated with psychological distress—the net of socioeconomic status, health status, and stress—in African Americans. Aims: In a national sample of African Americans in the US, this study investigated the association between polypharmacy and psychological distress. Methods: The National Survey of American Life (NSAL, 2003) included 3570 African American adults who were 18 years or over. This number was composed of 2299 women and 1271 men. Polypharmacy (using ≥ 5 medications) and hyper-polypharmacy (using ≥ 10 medications) were the independent variables. Psychological distress was the dependent variable. Age, gender, socioeconomic status (education attainment, income, employment, and marital status), health care access (insurance status and usual place of care), and health status (multimorbidity and psychiatric disorders) were the covariates. Linear multivariable regression was applied to perform the data analysis. Results: Both polypharmacy and hyper-polypharmacy were associated with psychological distress. This association was significant after controlling for all the covariates. Conclusions: African Americans with polypharmacy, particularly those with hyper-polypharmacy, are experiencing higher levels of psychological distress, which itself is a known risk factor for poor adherence to medications. There is a need for a comprehensive evaluation of medications as well as screening for psychopathology in African Americans with multiple medical conditions. View Full-Text
Keywords: race; ethnicity; Blacks; African Americans; polypharmacy; medications; psychological distress race; ethnicity; Blacks; African Americans; polypharmacy; medications; psychological distress
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).
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Assari, S.; Bazargan, M. Polypharmacy and Psychological Distress May Be Associated in African American Adults. Pharmacy 2019, 7, 14.

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