Prescribing of potentially inappropriate medications among the elderly population in an ambulatory care setting in a Saudi military hospital: Trend and cost

Al-Omar, Hussain Abdulrahman; Alsultan, Mohammed S.; Abu-Auda, Hisham S

doi:10.1111/j.1447-0594.2012.00951.x

Cited by 30 publications

(49 citation statements)

References 25 publications

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“…[182021] Use of PIMs has been recently reported from South India using Beers 2003 criteria where 4.1% of total drugs could be considered as potentially inappropriate as compared to 2.9% in our study. This difference could be due to difference in study population.…”

Section: Discussionmentioning

confidence: 60%

Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: A comparison between Beers 2003 and 2012 criteria

et al. 2013

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Objectives:To detect the prevalence and pattern of use of Potentially inappropriate medications (PIMs) in hospitalized elderly patients of a tertiary care teaching hospital using Beers 2012 criteria and to compare the same with Beers 2003 criteria.Materials and Methods:Prescriptions of the elderly patients aged 65 years and above were collected from the medicine ward and analyzed. PIMs were identified with help of Beers 2003 and Beers 2012 criteria and comparison was made between the two criteria. Predictors associated with use of PIM were identified using bivariate and multivariate logistic regression analysis.Results:A total of 210 patients received 2,267 drugs. According to Beers 2003 criteria, 60 (28.57%) elderly patients received at least one PIM and 2.9% drugs were prescribed inappropriately. According to Beers 2012 criteria, 84 (40%) elderly received at least one PIM while 22 (10.47%) received multiple PIMs and about 5% drugs were prescribed inappropriately. The most commonly prescribed PIM was mineral oil-liquid paraffin (30, 14.3%) followed by spironolactone (25, 11.9%), digoxin (19, 9%), and benzodiazepines (14, 6.7%). There was a significant association between the number of patients receiving more than six drugs and the use of PIMs (P < 0.01). Use of more than 10 drugs was a significant predictor for use of PIMs in the elderly.Conclusion:The study shows high prevalence of prescribing PIMs in hospitalized elderly patients. Beers 2012 criteria are more effective in identifying PIMs than Beers 2003 criteria.

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Section: Discussionmentioning

confidence: 60%

Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: A comparison between Beers 2003 and 2012 criteria

et al. 2013

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“…7,12,14,18 Previous studies conducted in Saudi Arabia showed PIMs rates of 52.5% 7 and 2.1%-2.5%. 19 Differences in the tested populations of these studies may have contributed to the discrepancy between the reported results from previous studies and those obtained herein, since the present study was conducted in a family medicine setting; in Al Odhayani et al, 7 798 older patients were arbitrarily selected from Prince Sultan Medical Military City through the patient register from the family medicine chronic disease clinics in the Home Health Care programme; in Al-Omar et al, 19 the authors conducted a retrospective cross-sectional study of outpatient pharmacy prescription records of older patients at Riyadh Military Hospital.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

Potentially inappropriate medications in older patients based on Beers criteria: a cross-sectional study of a family medicine practice in Saudi Arabia

et al. 2020

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BackgroundThe use of potentially inappropriate medications (PIMs) is an important issue in older patients who are at risk of adverse drug events.AimTo determine the prevalence of PIM use, according to Beers criteria, among an older population (aged ≥65 years) in a large family medicine setting, and to identify the associated risks.Design & settingA prospective cross-sectional study of patients aged ≥65 years was conducted from June 2017 to June 2018 at the Family and Community Medicine (FCM) clinics of King Saud Medical City (KSMC) in Riyadh, Saudi Arabia.MethodThis cross-sectional study included patients aged ≥65 years who were seen at new appointments or followed-up at the FCM clinics of KSMC in Riyadh, Saudi Arabia. Data were collected by extensive face-to-face interviews and from the patients’ medical records.ResultsA total of 270 older patients aged 72.41 ±6.23 years (mean ±standard deviation [SD]) were included in the present study. The prevalence of PIMs was 60.7% (n = 164). Multivariate analyses identified three independent variables associated with PIMs: incremental age per 5 years (odds ratio [OR] 1.47, 95% confidence intervals [CI] = 1.15 to 1.88; P = 0.002), female sex (OR 1.95, 95% CI = 1.10 to 3.42; P = 0.021), and polypharmacy (OR 8.21, 95% CI = 4.58 to 14.7; P<0.001). The most common PIMs used were 39.4% related to proton pump inhibitors (PPI), 25.2% to diuretics (other than spironolactone), 10.6% to non-steroidal anti-inflammatory drugs (NSAIDs), and 8.7% to aspirin use.ConclusionThis study showed high prevalence of PIMs. Increasing age, female sex, and polypharmacy were found to be significant risk factors for PIM use. The frequency of morbidities was not significantly different among patients with PIMs compared to those without PIMs, except for hypertension and osteoarthritis, which were more common in the PIMs group. The present study reinforces the importance of comprehensive medication management and reviews.

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“…Several studies have shown that PIMs among older patients are correlated with increased adverse drug reactions (ADRs) [ 3 - 6 ], health care utilization [ 7 - 9 ], death [ 10 , 11 ], poor adherence [ 12 , 13 ] and greater economic burden [ 7 , 14 , 15 ]. The cost of potentially inappropriate medications is estimated to be high [ 16 - 18 ], and this has become an important public health issue worldwide [ 2 ]. PIMs among older home care patients are common [ 19 ], and an important issue in developed countries with an aging population, such as Japan, where the number of older home care patients is predicted to increase rapidly in the future.…”

Section: Introductionmentioning

confidence: 99%

A comparison of estimated drug costs of potentially inappropriate medications between older patients receiving nurse home visit services and patients receiving pharmacist home visit services: a cross-sectional and propensity score analysis

Hamano

Ozone

Tokuda

2015

BMC Health Serv Res

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BackgroundThere have been no multicenter studies that estimated the relations of either nurse or pharmacist home visit program to drug costs of potentially inappropriate medications (PIMs). This study aimed to establish whether patients who used nurse or pharmacist home visit programs (nurse or pharmacist program) had lower drug costs of PIMs than those who did not use nurse or pharmacist programs for older patients living at home.MethodsThis cross-sectional study was conducted in home care settings in Japan, involving 430 patients aged 65 or older, of whom 276 were female. All received regular home visits from five clinics between May and December 2013. After the PIMs were identified with the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) criteria, we estimated the drug costs based on actual pharmaceutical prices and measured against who using nurse or pharmacist programs after a propensity score weighted adjustment.ResultsPatients who used nurse programs had lower drug cost of PIMs than those who did not use, but it was not significantly different (5.9 ± 13.1 vs 7.1 ± 13.9 USD per month, P = 0.199). The cost of PIMs for patients who used pharmacist programs also had no difference. (7.2 ± 14.5 vs 5.5 ± 11.5 USD per month, P = 0.06). In the patient groups who used nurse programs, patients who also used pharmacist programs had significantly higher costs of PIMs than those who used only nurse programs (5.5 ± 13.9 vs 2.5 ± 6.0 USD per month, P = 0.006). In patients group who did not use pharmacist programs, patients who only used nurse programs had significantly lower costs of PIMs than those who did not use nurse programs (3.6 ± 7.7 vs 5.8 ± 12.7 USD per month, P = 0.022).ConclusionsPatients who used nurse program have a trend towards lower drug costs of PIMs than those who used nurse and pharmacist program or pharmacist program alone. Although this study tried to adjust the potential confounders as possible as we could by using propensity score analysis, further studies are needed to confirm our results.

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Prescribing of potentially inappropriate medications among the elderly population in an ambulatory care setting in a Saudi military hospital: Trend and cost

Cited by 30 publications

References 25 publications

Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: A comparison between Beers 2003 and 2012 criteria

Use of potentially inappropriate medications in hospitalized elderly at a teaching hospital: A comparison between Beers 2003 and 2012 criteria

Potentially inappropriate medications in older patients based on Beers criteria: a cross-sectional study of a family medicine practice in Saudi Arabia

A comparison of estimated drug costs of potentially inappropriate medications between older patients receiving nurse home visit services and patients receiving pharmacist home visit services: a cross-sectional and propensity score analysis

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