Evaluation of the heterogeneity of studies estimating the association between risk factors and the use of potentially inappropriate drug therapy for the elderly: a systematic review with meta-analysis

Abstract

Twenty-nine articles (17 cross-sectional and 12 cohort) were included. The majority of the studies were conducted in Europe. Regarding the study durations, 3 to 18 months was necessary to perform the research. As for the sample characteristics, all the studies analyzed involved the older adults and included anywhere from 96 patients to 33,830,599 outpatient consultations. Of the variables analyzed, only polypharmacy presented a positive association with the use of PIDT. All meta-analysis studies showed high heterogeneity, indicating the lack of a methodological standardization of the studies included, among other factors.

Potentially Inappropriate Medications by Beers Criteria in Older Outpatients: Prevalence and Risk Factors

“…Second, as we used only the prescription record of the EMR, we did not have information on the general health status and co-morbidities of the patients. Thus, although PIMs have been associated with many chronic diseases,161820) we were unable to analyze associations with any disease in our study. Third, despite the widespread use of the Beers criteria for evaluating PIMs, there is considerable debate concerning the efficacy of the criteria.…”

“…Many studies have reported an increased risk of PIM with age, sex, multiple medications, and the number of co-morbidities 1011121415161819). In Brazil, PIM use in older patients increased with increasing age and female sex 19).…”

“…Therefore, although these previous studies are not consistent with regard to the association of PIM with some factors, there is a general consensus on the association between multiple medications and PIM use. Further evidence is available from a systemic meta-analysis demonstrating that only multiple medications were positively associated with PIM use in the elderly 18). However, in the US, older age, the presence of more chronic diseases, and a greater number of health care visits were associated with higher odds of using 1–4 medications or >5 medications, compared with no medications 16).…”

“…Several previous studies have evaluated the prevalence of potentially inappropriate medications (PIMs) and their association with sociodemographic and/or health status variables included in the Beers criteria 1011121314151617181920). However, in South Korea, except for one previous study on the prevalence of Beers criteria-based PIMs in a large medical center,13) there have been no reports on the risk factors of PIMs based on large-scale medical center data.…”

Potentially inappropriate psychotropic prescription at discharge is associated with lower functioning in the elderly psychiatric inpatients. A cross-sectional study

“…The use of a medication that is known to induce harmful effects through drug-drug or drug-disease interactions are also inappropriate, as well as the prescription of a high-dose medication during an excessive period of time (Lang et al 2010). Potentially inappropriate psychotropic (PIP) prescription in the elderly patients (≥65 years) has become an important concern in developed countries (Nishtala et al 2014;Santos et al 2015a). With the global increase of medication prescription, the increase of life expectancy and the improvement of screening strategies, the global medication rate has increased in the elderly (Santos et al 2015b).…”