Awareness of Beers criteria and potentially inappropriate medications among physicians and pharmacists in Palestine

Abukhalil, Abdallah Damin; Shaloudi, Abdelrazzaq Yahia; Shamasneh, Niveen Mohammad; Aljamal, Asil Maher

doi:10.1002/jppr.1728

Cited by 5 publications

(7 citation statements)

References 25 publications

(31 reference statements)

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“…Despite having poor knowledge and awareness about PIM screening tools, respondents showed a high degree of self-confidence in detecting PIMs in older adults. Our findings align with a similar study from Palestine, which showed that 34% of their participants had poor awareness of the PIM tool [ 38 ]. Surprisingly, half the participants were confident enough to identify PIMs by utilising the appropriate medication references.…”

Section: Discussionsupporting

confidence: 92%

Assessment of Knowledge, Attitude and Practices of the Hospital and Community Pharmacists in Saudi Arabia (Jeddah) towards Inappropriate Medication Use in Older Adults

Alfahmi

Curtain

Salahudeen

2023

IJERPH

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In Saudi Arabia, the older adult population is growing and is projected to increase three-fold by 2030. Potentially inappropriate medications (PIMs) are harmful to older adults’ and have a direct impact on clinical, health and economic outcomes. Pharmacists have a vital role in medication tailoring for older adults as multidisciplinary team members. However, there is also a paucity of research regarding pharmacists’ participation in detecting and avoiding PIMs use among older adults in Saudi Arabia. A cross-sectional, self-administered survey was conducted to assess the knowledge, practices, and attitude of pharmacists from seven hospitals and ten community pharmacies in Jeddah, Saudi Arabia. The survey comprised three sections; (i) identifying participants’ general characteristics, (ii) assessing their knowledge of PIMs use in older adults and (iii) examining the pharmacist’s attitude towards the procedures followed in dispensing for older adults. Inferential and descriptive statistics were used to analyse the survey data. A total of 157 community and hospital pharmacists participated in this study. Most of them dispensed medication weekly to older adults (85.4%), and 43.3% had relevant work experience of six to ten years. Though 44.6% of the participants were aware of PIMs that older adults should avoid, only 10.8% claimed adequate knowledge about PIMs. From the given three clinical case scenarios, a minority of pharmacists (21.7%) chose the correct answers, with a mean score of 2.38 ± 2.91 (95% CI 2.35–3.15). Participants who claimed to have knowledge of PIMs had a significantly higher mean score than those who did not, 4.59 ± 2.81 25 (95% CI 2.35–2.61). A minority of the pharmacists (14.7%) used screening tools such as STOPP, Beers criteria, or Medication Appropriateness Index (MAI) to detect PIMs in older adults. No statistically significant differences were detected when comparing the levels of knowledge of pharmacists with 1 to 5 years of practice to pharmacists with 6 to 15 and more years of experience (p = 0.431). Pharmacists’ knowledge, attitude and practices toward PIMs use in older adults in Saudi Arabia should be improved. The application of PIMs detection tools such as STOPP/START or Beers criteria currently has no place in day-to-day pharmacists’ roles in Saudi Arabia. Therefore, concerned stakeholders should develop educational programs to improve pharmacists’ knowledge of PIMs and promote the effective use of PIM screening tools such as Beers and STOPP criteria in their practice.

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Section: Discussionsupporting

confidence: 92%

Assessment of Knowledge, Attitude and Practices of the Hospital and Community Pharmacists in Saudi Arabia (Jeddah) towards Inappropriate Medication Use in Older Adults

Alfahmi

Curtain

Salahudeen

2023

IJERPH

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“…18 Therefore, educating and training geriatric health care providers and recruiting clinical pharmacists in hospitals will play a vital role in improving health care outcomes and reducing PIPs. 1 The use of multiple medications to treat chronic diseases, severe illnesses, and other health problems, known as polypharmacy, is more common among elderly patients because they have experienced multiple comorbidities and chronic and acute diseases that need to be treated by a variety of drugs. 20 Moreover, multiple medications increase drugdrug and drug-disease interactions, which may cause serious adverse events, especially among geriatric patients.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Age-related diseases account for 51.3% of the global disease burden among older adults, including cardiovascular diseases, neoplasms, chronic respiratory disorders, and sensory organ malfunctions related to advanced age and multimorbidity. 1 Elderly patients suffer more from multiple chronic conditions and are prone to polypharmacy, defined as using multiple medications (five or more medications). 2 More than 36% of patients older than 65 take more than five medications, about 90% take at least one prescription, and about 80% take at least two.…”

Section: Introductionmentioning

confidence: 99%

“…Elderly patients with polypharmacy are at a higher risk for medication errors than other patients, and it has been reported in 28–42% of polymedicated and elderly patients in various healthcare settings. 1 Medication errors arise from a lack of awareness of appropriate prescribing among physicians or a lack of patient education. These errors might result in significant damage requiring a new pharmaceutical treatment, hospitalization, comorbidities, kidney damage, or even death in certain situations.…”

Section: Introductionmentioning

confidence: 99%

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Evaluating Inappropriate Medication Prescribing Among Elderly Patients in Palestine Using the STOPP/ START Criteria

Abukhalil¹,

Al-Imam²,

Yaghmour³

et al. 2022

CIA

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Background: Elderly patients suffer from chronic diseases and are prone to polypharmacy and potentially inappropriate prescribing (PIP). This study aimed to identify potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) among elderly patients in a tertiary care hospital setting and to estimate the prevalence of polypharmacy. Methods: This multicenter retrospective observational study reviewed patient data from two major Palestinian hospitals. The collected data included patient demographics, comorbidities, and medications administered during hospitalization and discharge. The study included 247 patients aged ≥ 65 years hospitalized between January 2019 and December 2019. The STOPP/START criteria version 2 was used to identify the prevalence of PIMs and PPOs. Clinical pharmacists verified the data, and SPSS was used for data analysis. Descriptive statistics, one-tailed bivariate correlations, and Pearson's test were applied to the variables of interest to examine their association with the STOPP/START criteria. Results: A total of 247 patients were included in the study, and 50.2% were females. As a result, 165 (66.8%) participants were identified with PIPs, including 30 patients with PPOs, 91 with PIMs, and 44 with both. Furthermore, the prevalence of PIP during hospitalization and discharge was 56.29% and 64.39%, respectively. Polypharmacy (5-9 medications) was 44.5% and 52.1% during hospitalization and discharge, respectively, and excessive polypharmacy (ten medications or more) was 33.6% and 16.4% during hospitalization and discharge, respectively. Moreover, 47.3% of the patients had a comorbidity index of ≥ 5. Conclusion:This study identified a high prevalence of PIPs among elderly patients during hospital admission and discharge. In addition, more than half of the geriatric patients in this study had PIP and a high prevalence of polypharmacy. Therefore, this study emphasizes the importance of adapting evidence-based tools, such as the STOPP/START criteria, to optimize patient medication therapy and guide prescribers in identifying and resolving PIMs and PPOs.

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Potentially inappropriate medication uses and associated factors among elderly primary health care clinics attendees: A call to action

Samara,

Nazzal,

Naghnaghia

et al. 2023

PLoS ONE

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Background Polypharmacy is a significant risk factor for using potentially inappropriate medication (PIM), which is using drugs with more risks than benefits, especially for elders. This study aimed to estimate the prevalence of PIM using Beers Criteria, polypharmacy, and their related risk factors. Methods A descriptive cross-sectional study was conducted in West Bank primary health care clinics (PHC)from December 2021 to March 2022. Data were collected from PHC clinic attendees aged 65 and above via an interviewer-administered questionnaire and a review of their medical records. We used the Beers Criteria 2019 update to identify PIM and performed a multivariable analysis to determine its associated factors. Results The study included 421 older people (197 men and 224 women) with an average age of 73.6 years. The prevalence of polypharmacy was 75.1% (95%CI: 70.6%-79.1%), with an average of six medications dispensed per patient. On the other hand, PIM was identified among 36.8% of the study participants (CI:95%CI: 32.2%- 41.6%). Sulfonylureas were the most common (24.2%) reported PIM, followed by peripheral alpha-blockers (4.3%), non-steroidal anti-inflammatory drugs (3.1%), proton pump inhibitors (2.9%), and central nervous system medications (2.1%). Hyperpolypharmacy (> 10 drugs) [aOR = 4.1, 95%CI: 1.6–10.7], polypharmacy [aOR = 2.8, 95%CI: 1.4–5.4], and Diabetes [aOR = 3.5, 95%CI: 2.0–6.0] are the main associated factors of PIM. Conclusion This study found that over one-third of the older people attending PHC clinics have PIM, with polypharmacy and Diabetes being the main predicting variables. Improving physicians’ awareness of clear and specific PIM lists can reduce the number of PIM prescribed and decrease their impact.

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Awareness of Beers criteria and potentially inappropriate medications among physicians and pharmacists in Palestine

Cited by 5 publications

References 25 publications

Assessment of Knowledge, Attitude and Practices of the Hospital and Community Pharmacists in Saudi Arabia (Jeddah) towards Inappropriate Medication Use in Older Adults

Assessment of Knowledge, Attitude and Practices of the Hospital and Community Pharmacists in Saudi Arabia (Jeddah) towards Inappropriate Medication Use in Older Adults

Evaluating Inappropriate Medication Prescribing Among Elderly Patients in Palestine Using the STOPP/ START Criteria

Potentially inappropriate medication uses and associated factors among elderly primary health care clinics attendees: A call to action

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