Potentially Inappropriate Medications and Risk of Hospitalization in Retirees

Albert, Steven; Colombi, Alberto M.; Hanlon, Joseph T.

doi:10.2165/11315990-000000000-00000

Cited by 84 publications

(69 citation statements)

References 22 publications

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“…Probably, severe ADRs that lead to hospitalization may be caused by idiosyncratic response or predisposition of older people to develop adverse reactions, not necessarily related to the type of drug used. [22] , after adjusting for the variables age, gender, presence of serious diseases and number of drugs prescribed, found that older people who had used PIM were 1.8 to 1.9 times more likely to be hospitalized. Our finding shows that gender and age was not a risk factor for the occurrence of ADR to PIM, and corroborates the results of studies performed by Gallagher et al (2008) [8] and Akazawa et al (2010) [11] , since age categories had no association with PIM use.…”

Section: Discussionmentioning

confidence: 97%

Safety Assessment of Potentially Inappropriate Medications Use in Older People and the Factors Associated with Hospital Admission

et al. 2011

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-Purpose: Potentially Inappropriate Medications (PIM) use in elderly people may be responsible for the development of Adverse Drug Reaction (ADR) which, when severe, leads to hospital admissions. Objectives: to estimate the prevalence of elderly who had used PIM before being admitted to hospital and to identify the risk factors and the hospitalizations related to ADR arising from PIM. Methods: A descriptive and cross-sectional study was performed in the internal medicine ward of a teaching hospital (Brazil), in 2008. With the aid of a validated form, patients aged ≥ 60 years, with length of hospital stay ≥ 24 hours, were interviewed about drugs taken prior to the hospital admission and the complaints/reasons for hospitalization. Results: 19.1% (59/308) of older patients had taken PIM before hospital admission and in 4.9%; there were a causal relation between the PIM taken and the complaint reported. PIM responsible for admissions were: amiodarone, amitriptyline, cimetidine, clonidine, diazepam, digoxin, estrogen, fluoxetine, lorazepam, short-acting nifedipine and propranolol. 47.0% of the clinical manifestations of PIM-related ADR were: dizziness, fatigue, digoxin toxicity and erythema. Only polypharmacy was detected as a risk factor for the occurrence of ADR of PIM (p = 0.02). Conclusion: PIM use in elderly people is not a risk factor for ADR-related hospital admission. Probably, severe ADR, which lead to hospitalizations of older people, can be explained by idiosyncratic response or the predisposition of these patients to develop adverse drug events, whether or not drugs are classed as PIM.

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Section: Discussionmentioning

confidence: 97%

Safety Assessment of Potentially Inappropriate Medications Use in Older People and the Factors Associated with Hospital Admission

et al. 2011

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“…Other researches show that the prevalence of institutionalized older people who take at least one PIM ranges from 27.6% to 46.2% (Ruggiero et al, 2010;Castellar et al, 2007;Azoulay et al, 2005). The prescription of PIM must follow judicious protocols, since their administration may double the odds of hospitalization of elderly people (Albert et al, 2010), as well as the demand for health services (Fick et al, 2008). It can also generate hospital expenses (Akazawa et al, 2010).…”

Section: Discussionmentioning

confidence: 99%

Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

Varallo

Ambiel

Nanci

et al. 2012

Braz. J. Pharm. Sci.

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The present study aimed to estimate the prevalence of elderly using potentially inappropriate medications (PIM) and with occurrence of potentially hazardous drug interactions (PHDI); to identify the risk factors for the prescription of PIM and to evaluate the impact of pharmaceutical intervention (PI) for the prescription of safer therapeutic alternatives. Therefore, a cross-sectional study was performed in a long-term care facility in São Paulo State, between December/2010 and January/2011. The medical records of the patients ≥60 years old who took any drugs were consulted to assess the pharmacotherapeutic safety of the medical prescriptions, in order to identify PIM and PHDI, according to the Beers (2003) and World Health Organization criteria, respectively. PI consisted of a guidance letter to the physician responsible for the institution, with the suggestions of safer equivalent therapeutics. Approximately 88% of the elderly took at least one drug, and for 30% of them the PIM had been prescribed. Most of the PIM identified (53.4%) act on the central nervous system. Among the 13 different DI detected, 6 are considered PHDI. Polypharmacy was detected as a risk factor for PIM prescription. After the PI there was no change in medical prescriptions of patients who had been prescribed PIM or PHDI. The data suggests that PI performed by letter, as the only interventional, method was ineffective. To contribute it a wide dissemination of PIM and PHDI among prescriber professionals is necessary for the selection of safer treatment for elderly. Additionally, a pharmacist should be part of the health care team in order to help promote rational use of medicines.Uniterms: Drugs/interactions. Elderly people/inappropriated use of medicines. Long-term care facility. Medication/errors. Safety management.O presente estudo teve como objetivos estimar a prevalência de idosos em uso de medicamentos potencialmente impróprios (MPI) e com ocorrência de interações medicamentosas potencialmente perigosas (IMPP); identificar os fatores de risco para a prescrição de MPI e avaliar o impacto de intervenção farmacêutica (IF) para a prescrição de alternativas terapêuticas mais seguras. Para tanto, realizou-se estudo transversal em instituição de longa permanência do interior de São Paulo, de dezembro/2010 a janeiro/ 2011. Os prontuários médicos dos pacientes ≥60 anos e que utilizavam pelo menos um medicamento foram consultados para avaliar a segurança farmacoterapêutica das prescrições médicas, identificando-se os MPI e as IMPP, segundo critérios de Beers (2003) e o critério da Organização Mundial da Saúde, respectivamente. A IF constou de carta de orientação ao médico da instituição, com sugestão de equivalentes terapêuticos mais seguros. Aproximadamente 88% dos idosos haviam utilizado pelo menos um medicamento e, para 30% deles, havia pelo menos um MPI prescrito. A maioria dos MPI identificados (53,4%) age no sistema nervoso central. Entre as 13 interações medicamentosas detectadas, 6 são consideradas IMPP. A polimedicação foi detectada c...

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“…International research has shown that older age, low levels of physical performance (Dorr et al, 2006;Li, Chu, Sheu, & Huang, 2011), limitations in activities of daily living (Li, Chang, Wang, & Bai, 2011), comorbidity (Dorr et al, 2006;Landi et al, 2004), potentially inappropriate medications (Albert, Colombi, & Hanlon, 2010), and previous hospital admissions (Landi et al, 2004) are factors related to higher risk of hospitalization. In addition, hospitalization is related to community assistance (Nägga, Dong, Marcusson, Skoglund, & Wressle, 2012) and economic hardship (Landi et al, 2004) as well as psychosocial factors such as life satisfaction, loneliness (Jakobsson, Kristensson, Hallberg, & Midlöv, 2011), and selfrated health (Li, Chang, et al, 2011;Nägga et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA)

Hällgren

Fransson

Kåreholt

et al. 2016

Archives of Gerontology and Geriatrics

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PostprintThis is the accepted version of a paper published in Archives of gerontology and geriatrics (Print). This paper has been peer-reviewed but does not include the final publisher proof-corrections or journal pagination. Citation for the original published paper (version of record):Hallgren, J., Fransson, E I., Kåreholt, I., Reynolds, C A., Pedersen, N L. et al. (2016) Factors associated with hospitalization risk among community living older persons: results from the Swedish Adoption/TwinStudy of Aging (SATSA). Archives of gerontology and geriatrics (Print AbstractThe aims of the present study were to: (1) describe and compare individual characteristics of hospitalized and not hospitalized community living persons, and (2) to determine factors that are associated with hospitalization risk over time. We conducted a prospective study with a multifactorial approach based on the population-based longitudinal Swedish Adoption/Twin Study of Aging (SATSA). A total of 772 Swedes (mean age at baseline 69.7 years, range 46-103, 59.8% females) answered a postal questionnaire about physical and psychological health, personality and socioeconomic factors. During nine years of follow-up, information on hospitalizations and associated diagnoses were obtained from national registers. Results show that 484 persons (63%) had at least one hospital admission during the follow-up period. The most common causes of admission were cardiovascular diseases (25%) and tumors (22%). Cox proportional hazard regression models controlling for age, sex and dependency within twin pairs, showed that higher age (HR=1.02, p<0.001) and more support from relatives (HR=1.09, p=0.028) were associated with increased risk of hospitalization, while marital status (unmarried (HR=0.75, p=0.033) and widow/widower (HR=0.69, p<0.001)) and support from friends (HR=0.93, p=0.029) were associated with lower risk of hospitalization. Social factors were important for hospitalization risk even when medical factors were controlled for in the analyses. Number of diseases was not a risk in the final regression model. Hospitalization risk was also different for women and men and within different age groups. We believe that these results might be used in future interventions targeting health care utilization. Key wordsHospitalization, prospective design, older persons, marital status, social factors, friends support Highlights• While medical factors are important when predicting hospitalization, social factors matter as well.• Marital status significantly affects hospitalization risk.• Hospitalization risk differs between community-living men and women.• Different factors are associated with hospitalization risk in different age groups.3

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Potentially Inappropriate Medications and Risk of Hospitalization in Retirees

Cited by 84 publications

References 22 publications

Safety Assessment of Potentially Inappropriate Medications Use in Older People and the Factors Associated with Hospital Admission

Safety Assessment of Potentially Inappropriate Medications Use in Older People and the Factors Associated with Hospital Admission

Assessment of pharmacotherapeutic safety of medical prescriptions for elderly residents in a long-term care facility

Factors associated with hospitalization risk among community living middle aged and older persons: Results from the Swedish Adoption/Twin Study of Aging (SATSA)

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