Potentially inappropriate medication prescribing among elderly patients with cardiovascular diseases

Abstract

Background/Aim: The purpose of the conducted study was to show the frequencies of PIM in the elderly population with cardiovascular diseases and to describe factors with significant impact on PIM present in the elderly population. Methods: The study was performed as a retrospective, cross-sectional study. The research was performed during 2018 , the relevant data collected during the period from January 2016 to December 2017. Study sample included 1500 patients over 65 years with cardiovasculares disease who had medical records at the Institute for Gerontology and Palliative Care, Belgrade. Assessment of PIM was done by standard international criteria American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. Results: PIM frequency in elderly population was 70, 3%. In relation to gender, it was more frequent in female elders. Mean number of prescribed drugs was similar for 2016 and 2017, respectively 7, 2 and 7, 3. The most common were: medium acting benzodiazepines (70, 9%), central ? blockers (23, 98%), and antipsychotics (typical and atypical) (20,94%). The most common comorbidity was noted in a group labelled with the international disease classification I00-I99 which inlcudes heart and blood vessel diseases (n=2658; 36.9%). The most common diagnoses belonged to the subgroup I10-I15 hypertensive diseases (n=1298; 18%), I20-I25 ischemic heart diseases (n= 542; 7.5%), I30-I52, other forms of heart disease (n=705; 9.8%), I60-I69 cerebrovascular diseases (n =94; 1.3%), and I80- I89 diseases of veins, lymph vessels and lymph nodes (n=12; 0.17%). Predictor for PIM were numerous: polypharmacy, gender, nicotine use, cognitive status, nutrition state and number of diseases registered at study sample. Conclusion: Cardiovascular diseases in the elderly population are associated with a high prevalence of potentially inappropriate drug prescribing. Creating health recommendations for prescribing drugs in the elderly that would emphasize these factors could reduce the prevalence of PIM in this population

Gender Differences in Potentially Inappropriate Medication Use among Older Adults

“…In the current investigation, after controlling for several patient-level characteristics, the most important common predictors for PIM use among older men and women were diabetes, ischemic heart disease, anxiety, and polypharmacy. Comorbidities have been cited as contributing factors to using PIM in several published studies [ 30 , 31 , 32 , 33 , 34 , 35 , 36 ]. In addition to specific medical conditions, the present study identified a significant association between polypharmacy and higher rates of PIM use.…”

Evaluation of potentially inappropriate medication in older patients with cardiovascular diseases—STOPP/START-based study

“…The results showed that the PIM frequency in the older population was 70.3%, more frequent in female elders. Several risk factors were pointed out as polypharmacy, gender, nicotine use, cognitive status, nutrition state, as well as the number of diseases in the study sample ( 35 ). Ubeda et al conducted a review of the medication and clinical records of 81 residents in nursing home in Spain, using Beers and STOPP/START criteria, v01.…”

“…The results showed that the PIM frequency in the older population was 70.3%, more frequent in female elders. Several risk factors were pointed out as polypharmacy, gender, nicotine use, cognitive status, nutrition state, as well as the number of diseases in the study sample (35). Ubeda Calcium-vitamin D supplementation in osteoporosis was the most frequent rule (15%), but omissions corresponding to the cardiovascular system implied 23% of patients (36).…”

Potentially Inappropriate Medications Use among Older Adults with Dyslipidaemia

“…There are no studies that have examined PIM usage in older persons with dyslipidemia, despite research among older adults showing a high prevalence of PIM use [ 10 ]. The majority of research [ 13 , 14 , 22 , 23 , 24 , 25 ] involved older persons with cardiovascular illnesses and did not focus specifically on older adults with a cardiovascular risk factor such as dyslipidemia. Recently published articles have emphasized the link between PIM use and cardiovascular diseases [ 13 , 14 , 22 , 23 , 24 , 25 ].…”

“…The majority of research [ 13 , 14 , 22 , 23 , 24 , 25 ] involved older persons with cardiovascular illnesses and did not focus specifically on older adults with a cardiovascular risk factor such as dyslipidemia. Recently published articles have emphasized the link between PIM use and cardiovascular diseases [ 13 , 14 , 22 , 23 , 24 , 25 ]. An analysis of 404 patients’ retrospective charts who had a history of cardiovascular illness and were admitted to the cardiology program revealed that 20% of all drugs recorded were PIMs [ 23 ].…”