Prescription of Potentially Inappropriate Medication Use in Older Cancer Outpatients With Multimorbidity: Concordance Among the Chinese, AGS/Beers, and STOPP Criteria

Tian, Fang; Zhao, Mengnan; Chen, Zhaoyan; Yang, Ruike

doi:10.3389/fphar.2022.857811

Cited by 12 publications

(22 citation statements)

References 43 publications

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“…The prevalence of PIM use in older lung cancer patients was higher than that in patients with the other two cancers according to the 2012 Beers criteria. The prevalence of PIM use, according to the 2019 Beers criteria, in our study was 37.28% over 3 years, which was higher than that reported in another study on the prevalence of PIM use among older Chinese cancer outpatients which were outside of palliative care and hospice service (32.65%; Tian et al, 2022a). Our previous study found that lung cancer was positively associated with PIM use in older cancer outpatients, which explains the higher prevalence of PIM use in this study.…”

Section: Discussioncontrasting

confidence: 85%

Increasing Trends of Polypharmacy and Potentially Inappropriate Medication Use in Older Lung Cancer Patients in China: A Repeated Cross-Sectional Study

Tian

Chen

et al. 2022

Front. Pharmacol.

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Objectives: Polypharmacy and potentially inappropriate medication (PIM) use are frequent in older lung cancer patients. This study aimed to examine the trends of polypharmacy and PIM use and explore risk factors for PIM use based on the 2019 Beers criteria in older Chinese lung cancer outpatients with multimorbidity.Methods: A repeated cross-sectional study was conducted using electronic medical data consisting of the prescriptions of older lung cancer outpatients in China from January 2016 to December 2018. Polypharmacy was defined as the use of five or more medications. The 2019 Beers criteria were used to evaluate the PIM use of older cancer outpatients (age ≥65 years), and multivariate logistic regression was used to identify the risk factors for PIM use.Results: A total of 3,286 older lung cancer outpatients and their prescriptions were included in the study. The prevalence of polypharmacy was 14.27% in 2016, 16.55% in 2017, and 18.04% in 2018. The prevalence of PIM use, according to the 2019 Beers criteria, was 31.94% in 2016, 35.78% in 2017, and 42.67% in 2018. The two most frequently used PIMs in older lung cancer outpatients were estazolam and tramadol. The logistic regression demonstrated that age 75 to 79, polypharmacy, irrational use of drugs, and lung cancer accompanied by sleep disorders, anxiety or depression, or pain were positively associated with PIM use in older lung cancer outpatients.Conclusion: The prevalence of polypharmacy and PIM use in older lung cancer outpatients with multimorbidity was high in China, and polypharmacy and PIM use increased over time. Further research on interventions rationing PIM use in the older lung cancer patient population is needed.

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Section: Discussioncontrasting

confidence: 85%

Increasing Trends of Polypharmacy and Potentially Inappropriate Medication Use in Older Lung Cancer Patients in China: A Repeated Cross-Sectional Study

Tian

Chen

et al. 2022

Front. Pharmacol.

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“…Between 1999 and 2021, a total of 51 studies 11,[37][38][39][40][41][42][79][80][81][82][83][84][85][86][87][88][89][90][91][92]108,109 were performed in high-income countries, 23 studies [17][18][19][20][21][22][23][24][25][26][27][28][29]77,78,[93][94][95][96][97][98][99][100] in upper-to middle-income countries, 17 studies [30][31][32][33][34][35]…”

Section: Study Characteristicsmentioning

confidence: 99%

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

Tian,

Chen,

Zeng

et al. 2023

JAMA Netw Open

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ImportanceThe use of potentially inappropriate medications (PIMs) is widespread yet continues to receive little attention in outpatient services.ObjectiveTo estimate the overall prevalence of PIM use in outpatient services.Data SourcesPubMed, Embase, and Web of Science were searched to identify relevant studies published from January 1, 1990, to November 21, 2022.Study SelectionObservational studies that reported the prevalence of PIM use among older patients in outpatient services were screened.Data Extraction and SynthesisTwo reviewers independently selected eligible articles, extracted data, and assessed the risk of bias. A random-effects meta-analysis was conducted to pool the prevalence estimates.Main Outcomes and MeasuresThe global patterns in the prevalence of PIM use among older patients in outpatient services were estimated, and the temporal trends and regional differences in PIM use were investigated.ResultsA total of 94 articles with 132 prevalence estimates were analyzed, including nearly 371.2 million older participants from 17 countries. Overall, the pooled prevalence of PIM use was 36.7% (95% CI, 33.4%-40.0%). Africa had the highest prevalence of PIM use (47.0%; 95% CI, 34.7%-59.4%), followed by South America (46.9%; 95% CI, 35.1%-58.9%), Asia (37.2%; 95% CI, 32.4%-42.2%), Europe (35.0%; 95% CI, 28.5%-41.8%), North America (29.0%; 95% CI, 22.1%-36.3%), and Oceania (23.6%; 95% CI, 18.8%-28.8%). In addition, the prevalence of PIM use is highest in low-income areas. Use of PIMs among older patients has become increasingly prevalent in the past 2 decades.Conclusions and RelevanceThis study of patterns of PIM use by different groups, such as geographic regions and World Bank countries, suggests noticeable geographic environment and economic income differences in the burden of PIMs in outpatient services. Furthermore, the high prevalence trend in the past 2 decades indicates that the global burden of PIM use continues to be worthy of attention.

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“…The study has proved that there was little difference between the 2017 Chinese and 2019 AGS/Beers criteria ( Tian et al, 2022 ), so the Beers criteria was also capable for Chinese. Our results are comparable to the PIM rate of ( Beezer et al, 2022 ), who reported that the incidence of PIM was 61.1% during hospitalization in older patients with heart failure.…”

Section: Discussionmentioning

confidence: 91%

Potentially inappropriate medication among older patients with diabetic kidney disease

Wang

Zhu²,

Shan³

et al. 2023

Front. Pharmacol.

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Objective: Potentially inappropriate medications (PIM) contribute to poor outcomes in older patients, making it a widespread health problem. The study explored the occurrence and risk factors of PIM in older diabetic kidney disease (DKD) patients during hospitalization and investigated whether polypharmacy was associated with it.Methods: Retrospective analysis of the patients ≥ 65 years old diagnosed with DKD from July to December 2020; the PIM was evaluated according to the American Beers Criteria (2019). Factors with statistical significance in univariate analysis were included in Logistic multivariate analysis to explore the potential risk factors related to PIM.Results: Included 186 patients, 65.6% of patients had PIM, and 300 items were confirmed. The highest incidence of PIM was 41.7% for drugs that should be carefully used by the older, followed by 35.3% that should be avoided during hospitalization. The incidence of PIM related to diseases or symptoms, drug interactions to avoid, and drugs to avoid or reduce dose for renal insufficiency patients were 6.3%, 4.0% and 12.7%, respectively. The medications with a high incidence of PIM were diuretics (35.0%), benzodiazepines (10.7%) and peripheral ɑ1 blockers (8.7%). Compared with hospitalization, there were 26% of patients had increased PIM at discharge. Multivariate Logistic regression analysis showed that polypharmacy during hospitalization was an independent risk factor for PIM, OR = 4.471 (95% CI: 2.378, 8.406).Conclusion: The incidence of PIM in hospitalized older DKD patients is high; we should pay more attention to the problem of polypharmacy in these patients. Pharmacists identifying the subtypes and risk factors for PIM may facilitate risk reduction for older DKD patients.

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Prescription of Potentially Inappropriate Medication Use in Older Cancer Outpatients With Multimorbidity: Concordance Among the Chinese, AGS/Beers, and STOPP Criteria

Cited by 12 publications

References 43 publications

Increasing Trends of Polypharmacy and Potentially Inappropriate Medication Use in Older Lung Cancer Patients in China: A Repeated Cross-Sectional Study

Increasing Trends of Polypharmacy and Potentially Inappropriate Medication Use in Older Lung Cancer Patients in China: A Repeated Cross-Sectional Study

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

Potentially inappropriate medication among older patients with diabetic kidney disease

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