Potentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study

López-Rodríguez, Juan A.; Rogero-Blanco, Eloisa; Aza-Pascual-Salcedo, Mercedes; López-Verde, Fernando; Pico-Soler, Victoria; Leiva-Fernández, Francisca; Prados-Torres, Juan Daniel; Prados‐Torres, Alexandra; Cura-González, Isabel del

doi:10.1371/journal.pone.0237186

Cited by 35 publications

(39 citation statements)

References 53 publications

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“…Moreover, the results show that T2DM is more prevalent among the 65–70 years age group. The results of our study are similar to the recent study that applied 2019 Beers Criteria on patients aged 65–74 years attending primary care centers in Spain and which reported a PIM prevalence of 68.8% [ 22 ]. Furthermore, another recent study by Sharma et al reported that nearly 62% of older patients aged 65–70 years received at least one PIM during hospitalization [ 23 ].…”

Section: Discussionsupporting

confidence: 90%

Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study

et al. 2020

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Background: Older patients with type 2 diabetes mellitus (T2DM) are at greater risk of receiving potentially inappropriate medications (PIM) during hospitalization which may result in adverse outcomes. Aim: To evaluate the extent of PIM use in the older population with T2DM during hospitalization in a tertiary care hospital in India. Methods: A cross-sectional study was carried out from August 2019 to January 2020 in a tertiary care teaching hospital among the older population (aged ≥ 65 years) hospitalized with T2DM. Medications prescribed during hospitalization were reviewed following Beers Criteria 2019 to identify the extent of polypharmacy and PIM use. Binary logistic regression was applied to determine the factors associated with PIM use. Results: The mean age of the 150 patients hospitalized with T2DM was 68.85 ± 5.51 years, most of whom were men (54.7%). The participants had at least four comorbidities and were receiving an average of nine medications per day; the median length of hospital stay was 8 days (interquartile range (IQR): 4–19 days). Overall, three quarters (74%) of the participants had at least one PIM prescribed during their hospitalization as per Beers Criteria. Significant factors associated with the use of PIM during hospitalization are patients taking a higher number of medications (odds ratio (OR): 7.85, 95% CI 1.49–41.10), lower creatinine clearance values (OR: 12.90, 95% CI 2.81–59.28) and female patients (OR: 2.29; 95% CI: 1.05–4.97). Conclusions: PIM use is frequently observed in older T2DM patients during hospitalization. Polypharmacy, reduced renal function and female gender are associated with higher PIM use. Engaging clinical pharmacists in evaluating medication appropriateness can improve the outcomes of older patients.

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Section: Discussionsupporting

confidence: 90%

Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study

et al. 2020

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“…Our results show that the most prescribed PIMs were PPIs and long-acting sulfonylureas. The use of PPIs coincides with other studies (Fralick et al 2020;Lopez-Rodriguez et al 2020;Roux et al 2020;He et al 2021). Overuse of PPIs is a problem worldwide (Forgacs and Loganayagam 2008;Voukelatou et al 2019) as it is in Jordan (Alqudah et al 2016) due to their relative superior efficacy and high safety compared to H2 receptor blockers.…”

Section: Discussionsupporting

confidence: 77%

“…In other studies conducted worldwide for the use of PIMs according to 2019 AGS Beers Criteria, the prevalence ranged from 34.1 to 68.8%. These studies were conducted in Lebanon (34.1%) (Chahine 2020), in USA (34.4%) (Clark et al 2020), in China (35.0%) (Huang et al 2020), in Switzerland (53%) (Achterhof et al 2020), and in Spain (68.8%) (Lopez-Rodriguez et al 2020). The difference in prevalence is predicted and comparing other studies should be made with caution due to differences in population studied, time of the study, source of patient information, healthcare setting, and medication availability and accessibility in different countries.…”

Section: Discussionmentioning

confidence: 99%

Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria

Khader¹,

Hasoun²,

Alsayed³

et al. 2021

PHAR

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The aims of this study were to estimate the prevalence of potentially inappropriate medications (PIMs) in a community-dwelling Jordanian population of geriatrics according to the 2019 American Geriatrics Society Beers Criteria, to identify the most used PIMs and factors independently associated with PIMs use. This was an observational, descriptive, cross-sectional study. The sample population included 386 participants. Data were collected by face-to-face interviews. A total of 2894 medications were evaluated. The prevalence of patients using at least one PIM was 49.2%. The most used PIMs were proton pump inhibitors (24.6%) and long-acting sulfonylurea (20.5%). Participants who had diabetes mellitus, peptic ulcer, or irritable bowel syndrome had significantly higher numbers of PIMs. The use of PIMs was high in Jordanian geriatric patients. The results of this study might help healthcare providers to detect high-risk patients and reconsider the necessity of using PIMs to decrease the risk of adverse drug events.

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“…Psychotropic polypharmacy remains problematic [65], and polypharmacy can be associated with certain classes of medications, particularly central nervous system (CNS) drugs, anticholinergics, sedatives, and proton pump inhibitors [66][67][68]. Several epidemiological studies have demonstrated that potentially inappropriate prescribing increases with polypharmacy [69][70][71][72][73]. Similar trends have been observed in care home populations and people with dementia [74,75].…”

Section: Prescribing In the Face Of Multimorbiditymentioning

confidence: 90%

An Update on Medication Use in Older Adults: a Narrative Review

Barry

Hughes

2021

Curr Epidemiol Rep

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Purpose of Review The global phenomenon of population aging is impacting the health and care needs of society. The use of medications by older adults is acknowledged to be the most common form of medical intervention for many acute and chronic conditions and prescribing in this population continues to increase. In this narrative review, we summarise the age-related factors that should be considered when prescribing for older adults, address some of the perennial challenges related to medicine use in older people, and highlight important emerging research in this area. Recent Findings A range of age-related factors should be considered when prescribing for older adults. However, the evidence base still lacks data pertaining to older adults due to their continued under-representation in clinical trials. Multimorbidity, polypharmacy, and inappropriate prescribing continue to remain prevalent among older adults, although recent research has been focused on the development and evaluation of complex interventions to address these challenges. Summary Further high-quality studies of interventions to improve and support medication use in older adults are needed, ensuring that older adults are well represented in such trials and consideration is given to the measurement of patient- and provider-focused outcomes.

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Potentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study

Cited by 35 publications

References 53 publications

Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study

Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study

Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria

An Update on Medication Use in Older Adults: a Narrative Review

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