Association between Potentially Inappropriate Medication Use and Chronic Diseases in the Elderly

Wang, Tzu-Chueh; Ku, Pou-Jen; Lu, Hai‐Lin; Hsu, Kung-Chuan; Trezise, Damien; Wang, Hue-Yu

doi:10.3390/ijerph16122189

Cited by 26 publications

(29 citation statements)

References 42 publications

(53 reference statements)

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“…As the prevalence of chronic morbidity increases with age, so does the risk of multiple comorbidities [ 31 ]. Multiple comorbidities potentially increase PIM prescriptions, which may lead to adverse events in older adults [ 33 , 34 ]. However, the association of age with PIM prescriptions has been inconsistently reported across studies [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

Al-Dahshan

Kehyayan

2020

Drugs - Real World Outcomes

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Background Potentially inappropriate medications (PIMs) often lead to sub-optimal or poor health outcomes in older adults. Objective The objective of this study was to determine the prevalence and predictors of PIM prescription among older adults in Qatar. Patients and Methods This was a cross-sectional, retrospective study using data from the electronic medical records of Qatari patients (age ≥ 65 years) attending the 23 primary healthcare (PHC) centers in Qatar from April 1, 2017 to September 30, 2017. PIMs were identified based on the Beers 2015 criteria: (1) medications to avoid for many or most older adults, and (2) medications to be used with caution in older adults. Descriptive statistics were used to estimate the prevalence of PIM prescription; multivariable logistic regression analysis was performed to identify predictors of PIM prescription among the study population. Results 5639 older adults were included with a mean age of 72.8 (± 6.5) years; 53.8% were females. The prevalence of PIMs that should be avoided was 60.7%, with the most prevalent ones being gastrointestinal (84.2%), pain (49.9%), and central nervous system (10.4%) drugs. Most patients (61.1%) were prescribed one PIM, 26.9% two PIMs, and 12.0% three or more PIMs. The prevalence of PIMs that should be used with caution was 40.6%, with diuretics (83.1%), antidepressants (25.7%), and antiplatelets (18.3%) as the most prevalent drug classes. Multivariable logistic regression showed female gender, polypharmacy, and certain comorbidities to be significant predictors of PIM prescription. Conclusions Older adults attending Qatar’s 23 PHC centers are prescribed a high number of PIMs. Because of the high risk of PIM prescription, the practice of medication reconciliation should be strengthened and reinforced. Electronic supplementary material The online version of this article (10.1007/s40801-020-00220-9) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

Al-Dahshan

Kehyayan

2020

Drugs - Real World Outcomes

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“…In 2015, the Japan Geriatric Society (JGS) updated the "Guidelines for Medical Treatment and its Safety in the Elderly" and proposed medication lists regarding PIMs, "Screening Tool for Older Persons' Appropriate Prescriptions for Japanese" (STOPP-J), to contribute to improving prescription quality [30,31]. PIMs, similar to PP, are associated with an increased risk of ADEs [27,[32][33][34][35], which increases with age [23].…”

Section: Introductionmentioning

confidence: 99%

Association of Self-Reported Medication Adherence with Potentially Inappropriate Medications in Elderly Patients: A Cross-Sectional Pilot Study

Miyazaki

Uchiyama

Nakamura

et al. 2020

IJERPH

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Background: Polypharmacy (PP) and potentially inappropriate medications (PIMs) cause problematic drug-related issues in elderly patients; however, little is known about the association between medication adherence and PP and PIMs. This study evaluated the association of self-reported medication adherence with PP and PIMs in elderly patients. Methods: A cross-sectional pilot study was conducted using data collected from electronic medical records of 142 self-administering patients aged ≥65 years, excluding emergency hospitalization cases. Self-reported medication adherence was assessed using the visual analogue scale (VAS). Results: Of the 142 patients, 91 (64.1%) had PP and 80 (56.3%) used at least one PIM. In univariate analysis, patients with a VAS score of 100% had a significantly higher number of female patients and ≥1 PIM use compared to other patients. We found no association between the VAS score and PP. In multivariable analysis, the use of PIMs was significantly associated with a VAS score of 100% (odds ratio = 2.32; 95% confidence interval = 1.16–4.72; p = 0.017). Conclusions: Use of PIMs by elderly patients is significantly associated with self-reported medication adherence. Pharmacists should pay more attention to prescribed medications of self-administering elderly patients in order to improve their prescribing quality.

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“…In Sweden, PIMs such as NSAIDs, hypnotic and sedative drugs, and apixaban were commonly prescribed [ 33 ]. One should note that results from previous studies conducted worldwide vary due to the variations in methods, data collection, differently defined study population, and patient characteristics [ 34 , 35 ].…”

Section: Discussionmentioning

confidence: 99%

Utilization of potentially inappropriate medication and risk of adverse drug events among older adults with chronic renal insufficiency: a population-wide cohort study

et al. 2021

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Background The use of potentially inappropriate medication (PIM) in population of older adults may result in adverse drug events (ADE) already after short term exposure, especially when it is prescribed to patients with chronic kidney disease (CKD). In order to limit ADE in the treatment of older adults PIM lists have been constructed as a source of information for healthcare professionals. The aim of this study was to estimate the utilization of PIM and incidence of ADE in older adults (≥70 years) with CKD. Methods We conducted a retrospective population-wide cohort study including patients from Lower Austria who were 70 years or older and diagnosed with CKD in the period from 2008 to 2011. Utilization of PIM was estimated from prescriptions filled by target population. We estimated risks of hospitalization due to ADE within 30 days after incident PIM prescription and compared them to a PIM-free control group by using marginal structural models (MSM). Results We identified 11,547 patients (women: 50.6%, median age in 2008: 78 years) who fulfilled the inclusion criteria. In total 24.7 and 8.1% of all prescriptions from that period contained a medication with a substance listed in the EU (7)-PIM and AT-PIM list, respectively. Proton pump inhibitors and Ginkgo biloba were the most often prescribed PIMs in this population. 94.6 and 79.3% patients filled at least one EU(7)-PIM and AT-PIM prescription, respectively. Despite the relatively high utilization of PIM there was only a low incidence of clinically relevant ADE. No event type exceeded the threshold level of 1% in the analysis of risks of ADE after filling a prescription for PIM. Nevertheless, MSM analysis showed an increased risk for 11 drugs and reduced risk for 4 drugs. Conclusions PIM prescription was common among older adults with CKD, however, only a small number of these drugs eventually led to hospitalization due to ADE within 30 days after incident PIM was filled. In the absence of a clinically important PIM-related increase in risk, an assessment of potential ADE severity to a PIM list by using a warning score system seems prudent.

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Association between Potentially Inappropriate Medication Use and Chronic Diseases in the Elderly

Cited by 26 publications

References 42 publications

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

Association of Self-Reported Medication Adherence with Potentially Inappropriate Medications in Elderly Patients: A Cross-Sectional Pilot Study

Utilization of potentially inappropriate medication and risk of adverse drug events among older adults with chronic renal insufficiency: a population-wide cohort study

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