Potentially inappropriate medication use and frailty phenotype among community‐dwelling older adults: A population‐based study

Bolina, Alisson Fernandes; Gomes, Nayara Cândida; Marchiori, Gianna Fiori; Pegorari, Maycon Sousa; Tavares, Darlene Mara dos Santos

doi:10.1111/jocn.14976

Cited by 13 publications

(19 citation statements)

References 37 publications

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“…As has been established, functional decline is closely associated with frailty [ 4 ]. Higher levels of medication risk were associated with higher risks of being overall frail and physically, psychologically and socially frail, which has been confirmed by other studies [ 71 , 72 ]. Ageing is associated with an increased prevalence of non-communicable diseases and an increased need for various medications.…”

Section: Discussionsupporting

confidence: 82%

Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE)

Elstgeest

Zhang

et al. 2021

BMC Geriatr

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Background Frailty is an age-related condition resulting in a state of increased vulnerability regarding functioning across multiple systems. It is a multidimensional concept referring to physical, psychological and social domains. The purpose of this study is to identify factors (demographic characteristics, lifestyle factors and health indicators) associated with overall frailty and physical, psychological and social frailty in community-dwelling older people from five European countries. Methods This cross-sectional study used baseline data from 2289 participants of the Urban Health Center European project in five European countries. Multivariable logistic regression models were used to assess associations of the factors with overall frailty and the three frailty domains. Results The mean age was 79.7 (SD = 5.7). Participants who were older, were female, had secondary or equivalent education, lived alone, not at risk of alcohol use, were less physically active, had multi-morbidity, were malnourished or with a higher level of medication risk, had higher odds of overall frailty (all P < 0.05). Age was not associated with psychological and social frailty; sex was not associated with social frailty; smoking and migration background was not associated with overall frailty or any of its domains. There existed an interaction effect between sex and household composition regarding social frailty (P < 0.0003). Conclusions The present study contributed new insights into the risk factors for frailty and its three domains (physical, psychological and social frailty). Nurses, physicians, public health professionals and policymakers should be aware of the risk factors of each type of frailty. Furthermore, examine these risk factors more comprehensively and consider overall frailty as well as its three domains in order to further contribute to decision-making more precisely on the prevention and management of frailty. Trial registration The intervention of the UHCE project was registered in the ISRCTN registry as ISRCTN52788952. The date of registration is 13/03/2017.

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Section: Discussionsupporting

confidence: 82%

Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE)

Elstgeest

Zhang

et al. 2021

BMC Geriatr

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“…The reported prevalence of PIMs prescribing in community-dwelling elderly patients ranged from 9.6% to 45.8% in international studies (13). In China, research on PIMs has mainly focused on their use in general hospitals and there are still few studies related to PIMs prescribing in community-dwelling populations.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Li¹,

Hu²,

Gao³

et al. 2021

Ann Palliat Med

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Background: To assess the prevalence and associated risk of potentially inappropriate medications (PIMs) prescribing in community-dwelling elderly patients in China and to examine the most frequently used PIMs. This will provide a reference for the formulation of medication manuals for the community-dwelling elderly and further standardize the use of medications in elderly patients.Methods: We conducted a cross-sectional retrospective study from April 1, 2020 to April 30, 2020. Data from elderly patients aged ≥65 years were collected from the Hengjie (N=2,294), Loujiang (N=3,972), and Tongxing communities (N=1,969) in Suzhou. The frequency of PIMs was detected using the 2019 Beers criteria and the 2017 Chinese criteria. Chi-square (for categorical variables), ANOVA (for continuous variables as applicable), and logistic regression were used to describe and identify potential predictors of PIMs.Results: A total of 8,235 elderly patients were examined. Using the Chinese criteria, the prevalence of PIMs was 37.07%, which was slightly higher than that found using the 2019 Beers criteria (32.16%).The most prescribed PIMs were estazolam (21.53%) and insulin (4.60%) based on the Chinese criteria.Logistic regression analysis showed that advanced age, polypharmacy, and comorbid disease of patients were associated with a high risk of PIMs. Furthermore, the educational background and professional title of physicians were also associated with PIMs.Conclusions: Given the high prevalence of PIMs in the Chinese community-dwelling elderly population, the implementation of evidence-based interventions to promote rational clinical drug use could improve their quality of life.

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“…Several factors have been associated with PIM prescription in older adults. These include increasing age [15], polypharmacy [1,10,16,17], female gender [1,9,17,18], dependence on instrumental activities of daily living [19], and frailty and cognitive impairments [20]. Other factors also include certain chronic comorbidities such as hypertension, diabetes mellitus, cardiovascular disease, and mental health conditions [11].…”

Section: Introductionmentioning

confidence: 99%

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

Al-Dahshan

Kehyayan

2020

Drugs - Real World Outcomes

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Background Potentially inappropriate medications (PIMs) often lead to sub-optimal or poor health outcomes in older adults. Objective The objective of this study was to determine the prevalence and predictors of PIM prescription among older adults in Qatar. Patients and Methods This was a cross-sectional, retrospective study using data from the electronic medical records of Qatari patients (age ≥ 65 years) attending the 23 primary healthcare (PHC) centers in Qatar from April 1, 2017 to September 30, 2017. PIMs were identified based on the Beers 2015 criteria: (1) medications to avoid for many or most older adults, and (2) medications to be used with caution in older adults. Descriptive statistics were used to estimate the prevalence of PIM prescription; multivariable logistic regression analysis was performed to identify predictors of PIM prescription among the study population. Results 5639 older adults were included with a mean age of 72.8 (± 6.5) years; 53.8% were females. The prevalence of PIMs that should be avoided was 60.7%, with the most prevalent ones being gastrointestinal (84.2%), pain (49.9%), and central nervous system (10.4%) drugs. Most patients (61.1%) were prescribed one PIM, 26.9% two PIMs, and 12.0% three or more PIMs. The prevalence of PIMs that should be used with caution was 40.6%, with diuretics (83.1%), antidepressants (25.7%), and antiplatelets (18.3%) as the most prevalent drug classes. Multivariable logistic regression showed female gender, polypharmacy, and certain comorbidities to be significant predictors of PIM prescription. Conclusions Older adults attending Qatar’s 23 PHC centers are prescribed a high number of PIMs. Because of the high risk of PIM prescription, the practice of medication reconciliation should be strengthened and reinforced. Electronic supplementary material The online version of this article (10.1007/s40801-020-00220-9) contains supplementary material, which is available to authorized users.

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Potentially inappropriate medication use and frailty phenotype among community‐dwelling older adults: A population‐based study

Cited by 13 publications

References 37 publications

Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE)

Factors associated with physical, psychological and social frailty among community-dwelling older persons in Europe: a cross-sectional study of Urban Health Centres Europe (UHCE)

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Prevalence and Predictors of Potentially Inappropriate Medication Prescription Among Older Adults: A Cross-Sectional Study in the State of Qatar

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