Impact of Hospitalisation in an Acute Medical Geriatric Unit on Potentially Inappropriate Medication Use

Abstract

Hospitalisation in geriatric services results in a reduction in potentially inappropriate medication use. Improved pharmacological education of practitioners, especially with regard to drug adverse effects, is desirable to improve management of geriatric patients.

Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients

“…The prevalence of PIM use also decreased, from 66% (95% CI 63.8-68.0) on admission to 44% (95% CI 41.3-45.9) at discharge. 1 Although the current study concurred with these results in terms of a statistically significant reduction in PIMs, this change may not be considered clinically significant. The proportion of patients with an overall change in PIMs during the hospital stay may be more clinically relevant.…”

“…12 We believe that admission to hospital provides an opportunity to make changes in the type of drugs and the total number of PIMs prescribed. 1 The goal of this study was to determine the influence of hospital admission on the use of medications known to increase the risk of falls in older adults (as defined by the 2012 Beers criteria) among patients admitted to the authors' tertiary care facility after experiencing a fall. The primary objective was to determine the proportion of patients over the age of 65 years who were admitted to hospital with a diagnosis of falls and at least one PIM identified on a best possible medication history (BPMH) at the time of admission who had a change in the total number or dosage of PIMs upon discharge.…”

“…Several studies investigating use of PIMs by geriatric patients have been based on the criteria for determining inappropriate medication use developed by Beers and others. 1 The original criteria were developed in 1991 using a modified Delphi method to create a list of PIMs for nursing home residents. The criteria were revised and expanded in 1997 and again in 2003 to encompass all geriatric care settings.…”

Does hospital admission provide an opportunity for improving pharmacotherapy among elderly inpatients?

“…According to Vonbach et al (2008), 47% of all pDDI at hospital discharge were the result of medication changes during hospitalization. However, Laroche et al (2006) demonstrated that the prescription of anticholinergic and inappropriate drugs among geriatric inpatients decreased at discharge, showing that hospitalization could provide an opportunity to reassess pharmacological treatment.…”

Problemas relacionados a medicamentos e intervenções farmacêuticas em idosos internados na clínica médica do Hospital Universitário da Universidade de São Paulo.

“…Curiosamente, já houve observação documentada de que a hospitalização de pacientes geriátricos pode resultar em atenuação na prescrição de MPIs, constituindo uma oportunidade de rever o tratamento farmacológico (LAROCHE et al, 2006). PRMs, além de representarem um sério risco à saúde do paciente, também estão diretamente associados ao aumento de custos nos serviços de saúde.…”