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

Abstract

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.

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

“…Our study found that, with the increase in multimorbidity in Chinese older cancer patients, the risk of PIM use gradually increased. This phenomenon is similar to older Chinese patients with other chronic diseases in some studies ( Li et al, 2021 ; Zhao et al, 2021 ). The growth was more obvious with the 2014 STOPP criteria, as the PIM use of these criteria was more affected by the disease.…”

Potentially inappropriate medications in Chinese older outpatients in tertiary hospitals according to Beers criteria: A cross‐sectional study

“…The study reported that the prevalence of PIMs amongst inpatients in China based on the Beers criteria 2019 was 64.80% by He et al, which was higher than the results of outpatients in our study 16 . Whereas a study of 8235 geriatric patients in the Chinese communities found that 32.16% used at least one PIM, which was similar to our results 24 …”

“…16 Whereas a study of 8235 geriatric patients in the Chinese communities found that 32.16% used at least one PIM, which was similar to our results. 24 From the results obtained in the study, it is found that benzodiazepines were the drugs with a higher incidence of PIMs, and the finding was similar to most previous studies. [25][26][27] The high prescription rate of benzodiazepines could be attributed to the high prevalence of insomnia in the geriatric.…”

Prevalence of Polypharmacy and Potentially Inappropriate Medications Use in Elderly Chinese Patients: A Systematic Review and Meta-Analysis

“…24 articles were excluded as they did not report the PIMs or polypharmacy, meeting abstracts, and the population was not elderly. Finally, 8 studies ( Fu et al, 2020 ; Huang et al, 2020 ; Ma et al, 2020 ; Zheng et al, 2020 ; Tian et al, 2021a ; He et al, 2021 ; Li et al, 2021 ; Zhao et al, 2021 ) were included in the study ( Figure 1 ).…”

“…Eight studies ( Fu et al, 2020 ; Huang et al, 2020 ; Ma et al, 2020 ; Zheng et al, 2020 ; Tian et al, 2021b ; He et al, 2021 ; Li et al, 2021 ; Zhao et al, 2021 ) showed the prevalence of polypharmacy in the elderly Chinese population. Four studies were on outpatients ( Fu et al, 2020 ; Huang et al, 2020 ; Tian et al, 2021b ; Li et al, 2021 ); and four studies were on inpatients ( Ma et al, 2020 ; Zheng et al, 2020 ; He et al, 2021 ; Zhao et al, 2021 ). The pooled prevalence of polypharmacy in China was found to be 48% (95% CI: 0.17, 0.79, p = 0.003).…”