Comparison of four criteria for potentially inappropriate medications in Brazilian community‐dwelling older adults

Novaes, Priscila Horta; Cruz, Danielle Teles da; Lucchetti, Alessandra Lamas Granero; Leite, Isabel Cristina Gonçalves; Lucchetti, Giancarlo

doi:10.1111/ggi.12944

Cited by 30 publications

(30 citation statements)

References 24 publications

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“…Findings from this study showed that around 57% of older adults with dental care visits were prescribed at least one Beers Criteria medication 39. Another study conducted in Brazil found that 50% of community-dwelling elderly patients were prescribed at least one PIM according to the 2015 update of AGS Beers Criteria 40. Accordingly, PIM prevalence in the current study (62.5%) is relatively comparable with available literature which investigated geriatric PIMs using the updated Beers Criteria in the outpatient settings.…”

Section: Discussionsupporting

confidence: 74%

Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study

Al-Azayzih¹,

AlAmoori²,

Altawalbeh³

2019

Pharm Pract (Granada)

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Background: Due to aging, along with its associated physiological changes, older adults are extremely vulnerable to be afflicted with multiple chronic conditions (multimorbidity). Accordingly, prescribing a large number of drugs to older adults would be inevitable. Resulted complex drug regimens can lead to prescribing of Potentially Inappropriate Medications (PIMs) with subsequent negative health and economic outcomes. Objectives: The main objective of this study is to investigate the prevalence and predictors of PIMs prescribing among Jordanian elderly outpatients, using the last updated version of the American Geriatrics Society (AGS) Beers Criteria (2015 version). Methods: A Unicenter, cross-sectional study were data was assessed using medical records of included study subjects conducted over three months period from beginning of October to the end of December 2016 at King Abdullah University Hospital, Al Ramtha, Jordan. Our study included patients aged 65 years or above who visited the outpatient clinics at King Abdullah University hospital (KAUH) and were prescribed at least one oral medication during the study period. PIMs were identified for these patients and further classified according to the 2015 AGS Beers Criteria. We measured the prevalence of PIMs prescribed among elderly outpatients in Jordan. Results: A total of 4622 eligible older adults were evaluated in this study, of whom 62.5% (n=2891) were found to have at least one PIM prescribed during the three months study period. 69% of identified PIMs were medications to be used with caution in elderly, 22% were medications to avoid in many or most older adults, 6.3% were medications to be avoided or have their dosage adjusted based on kidney function in older adults, 2.04% medications were to avoid in older adults with specific diseases/syndromes, and 1.6% were potentially clinically important non-anti-infective drug-drug interactions to be avoided in older adults. Female gender and polypharmacy were found to be significant predictors of PIMs use among elderly. Conclusions: Potentially Inappropriate Medication prescribing is common among Jordanian elderly outpatients. Female gender and polypharmacy are associated with more PIMs prescribing and so need further attention.

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Section: Discussionsupporting

confidence: 74%

Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study

Al-Azayzih¹,

AlAmoori²,

Altawalbeh³

2019

Pharm Pract (Granada)

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“…If apixaban and zopiclone were to be excluded, the prevalence of PIMs would decrease from 45 to 25% according to the EU (7)-PIM list. In accordance to the results of the present study, two previous studies comparing EU (7)-PIM and national PIM criteria found that the prevalence of PIMs according to EU (7)-PIM were higher than according to the national lists [7, 27]. Altogether, this raises the question about the pertinence of explicit criteria.…”

Section: Discussionsupporting

confidence: 91%

Assessment of potentially inappropriate medications using the EU (7)-PIM list and the Swedish quality indicators

2019

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Background Several tools to evaluate the appropriateness of prescriptions have been developed over the years. Objective To compare the prevalence of potentially inappropriate medication (PIM) among elderly, using the European Union (EU) (7)-PIM list and the Swedish quality indicators. Secondary objectives were to investigate factors associated with the use of PIMs using the two tools. Setting Medical ward in a hospital in Northern Sweden. Methods Medical records for patients aged ≥ 65 years admitted to the medical ward were reviewed by clinical pharmacists from September to November 2015 and from February to April 2016. PIMs were identified through the abovementioned identification tools. Main outcome measure Prevalence of PIMs. Results Of 93 patients, 18.3% had one PIM according to the Swedish quality indicators. The most common PIM class was non-steroidal anti-inflammatory drugs and diclofenac was one of the most commonly prescribed PIMs. According to the EU (7)-PIM list, 45.2% of the study population was prescribed one or more PIMs. The most common PIM class was hypnotic and sedative drugs, and the most frequently prescribed PIM was apixaban. No significant associations between PIMs and different factors were found using either identification tool. Conclusion The prevalence of PIMs was relatively low in the study sample according to the Swedish guidelines but high according to the EU (7)-PIM list. Different evaluation tools might give inconclusive results, but it is still important to continuously evaluate the need for PIMs in older patients in order to improve drug treatment and to decrease the risk of adverse drug reactions.

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“…The prolonged use in the elderly with Helicobacter pylori infection or with successful eradication is associated with an increased risk of developing gastric neoplasia. In addition, the use of PPI concomitantly with other drugs represents a high risk for DI, and these drugs should be prescribed with caution 8,12,13,29,30 .…”

Section: Discussionmentioning

confidence: 99%

“…It is important to note the high prevalence of PIM in the studied group, similar to that described in literature for elderly people in this health sector, with a prevalence ranging from 11.7 to 41.9% 20 ,21,27 . However, when assessing hospitalized or institutionalized elderly persons or only those in outpatient follow-up care, there is great variability in the prevalence of PIM (2.9% to 91.9%), 30,31 .…”

Section: Discussionmentioning

confidence: 99%

The iatrogenic triad in a group of elderly women contracted to a health plan

Oliveira

Manso

2019

Rev. bras. geriatr. gerontol.

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Objective: to study the main elements of the iatrogenic triad in a group of elderly women with a Chronic Non-Communicable Disease (CNCD) contracted to a health plan. Method: A cross-sectional and descriptive epidemiological study was carried out by analyzing 3,501 medical prescriptions of 725 elderly women aged ≥65 years. The medications were determined to be Potentially Inappropriate Medications (PIM) based on four instruments (AGS Beers 2015, PRISCUS List, EU(7)-PIM, Brazilian Consensus of PIM - CBPIM). In addition, the most prescribed drugs were assessed for possible Drug Interactions (DI) and classified according to degree of severity. Results: the present study revealed that 89.3% of the studied group used at least one element of the iatrogenic triad, and 44.9% of the sample were associated with the use of polypharmacy and PIM. A total of 48.0% were taking at least five continuous use medications. The main DI were omeprazole, simvastatin and levothyroxine, all of which are of significant severity and have potential drug-food interactions. A total of 35.1% of PIM were identified through the four criteria used, 26.6% were identified by the CBPIM, 25.8% by the EU(7)-PIM, and 24.6% and 6.6% by AGS Beers and PRISCUS, respectively. Conclusion: a high index of continuous use medications, PIM and potential DI were identified, mainly enzymatic inhibitors in a group of elderly women at risk due to their clinical characteristics. Old age was associated with the presence of all the elements of the iatrogenic triad. It was also noted that there were no significant differences between the criteria applied, except for the PRISCUS list.

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Comparison of four criteria for potentially inappropriate medications in Brazilian community‐dwelling older adults

Cited by 30 publications

References 24 publications

Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study

Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study

Assessment of potentially inappropriate medications using the EU (7)-PIM list and the Swedish quality indicators

The iatrogenic triad in a group of elderly women contracted to a health plan

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