Prevalence and predictors of potentially inappropriate prescribing of central nervous system and psychotropic drugs among elderly patients: A national population study in Korea

Cho, Hyunseok; Choi, Junjeong; Kim, Young Sang; Son, Sang Joon; Lee, Kang Soo; Hwang, Hee Jin; Kang, Hye Young

doi:10.1016/j.archger.2017.08.013

Cited by 16 publications

(17 citation statements)

References 46 publications

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“…It was interesting to notice the differences in prevalence of polypharmacy in geriatric patients among different studies concerning with the subject of potentially inappropriate prescribing ranging from as high as 95% in the study by (MF. Najjar et al,.2018) (13) in Saudi Arabia, 86.5% in the study by (M Gutiérrez-Valencia et al, 2017) (14) in Spain, 79% in the study by (S. Rongen et al,2016) (16) in the Netherlands to 29% In a study by (H. Cho et al,.2018) (15) in South Korea despite being defined in all these studies as patients receiving 5 or more medications, it was also found to be a significant factor for the prescribing of an inappropriate medication in all of these studies similarly to the result of this study even though we found polypharmacy only in 27% of the study participants which can be explained by the methodology of this study which included only listing the medications in the electronic medical chart which doesn't include medications used for other diseases such as hypertension or diabetes.…”

Section: Discussionmentioning

confidence: 97%

“…There are several factor that lead to the high prevalence of PIPs in 74.3% of this study patients such as: most patients admitted due to acute psychological conditions or agitation which in turn required aggressive therapeutic plans to improve patient's condition, combined with the lack of safer alternative interventions which lead to the increased use of anxiolytics, hypnotics and antipsychotic injections; other factors that may have caused a false increase in PIPs is due to a flaw in the criteria itself for not providing a rule regarding a duration of medication use to be considered inappropriate which lead to many medications used only once by the patients to be counted as potentially inappropriate (13)(14)(15)(16) . However, the result of the present study is similar to (M Gutiérrez-Valencia et al, 2017) (14) which measured a PIP prevalence of 71.5% in hospitalized geriatric patients in acute setting in Spain, and also similar to (G. Fond et al,2016) (17) which measured prevalence of PIP of psychotropic medications in hospital setting after discharge in France and found it to be 76.1%, another study measuring PIPs in psychiatric hospital in the Netherlands (S. Rongen et al,2016) (16) found a much lower prevalence of 47%.…”

Section: Discussionmentioning

confidence: 99%

“…Gender and age were considered to be a significant factor in the prescribing of PIM is some studies (G. fond et al,2016) (17) and (H. Cho et al,.2018) (15) , and considered to be insignificant in others (X. Vidal et al,2016) (18) , this can be explained by differences in study settings, prescribed medications, and discrepancies in other factors.…”

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq

Mahmood

Anwer²

2020

IJPS

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Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and polypharmacy with potentially inappropriate prescribing in elderly. This cross-sectional study was carried out using electronic medical records in Ibn Rushud psychiatry and addiction hospital in Baghdad and 369 patients were included. The mean age of the patients was (68.59 ± 3.75 years) and 177 (48%) of them had comorbidities, 100 (27.1%) of them had polypharmacy and 17 (4.6%) stayed in the hospital for more than 3 weeks, the most used drug classes were antipsychotics in (39.9%) of patients and benzodiazepines in (17.6%) of patients. The prevalence of potentially inappropriate prescribing according to Beers criteria was found to be 74.3% among study patients, the most prevalent inappropriately used drug class was benzodiazepines, and there was a significant association between the prescribing of a potentially inappropriate medication with gender (p=0.018), with comorbidities (p=0.022), and a very significant association with polypharmacy (p<0.001)

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq

Mahmood

Anwer²

2020

IJPS

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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: 89%

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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“…The use of STOPP/START to screen and address IMU in Europe, Asia, North America, South America, Africa and Australia suggests that the criteria have global relevance. 34–41 In comparison with Beers criteria, patients with STOPP-defined IMU are more likely to have an ADE, present to the emergency department and be admitted to hospital. 39…”

Section: Stopp/start Criteriamentioning

confidence: 99%

Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

Curtin

Gallagher

O’Mahony

2019

Therapeutic Advances in Drug Safety

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Polypharmacy and prescribing of potentially inappropriate medications (PIMs) are the key elements of inappropriate medication use (IMU) in older multimorbid people. IMU is associated with a range of negative healthcare consequences including adverse drug events and unplanned hospitalizations. Furthermore, prescribing guidelines are commonly derived from randomized controlled clinical trials which have specifically excluded older adults with multimorbidity. Consequently, indiscriminate application of single disease pharmacotherapy guidelines to older multimorbid patients can lead to increased risk of drug–drug interactions, drug–disease interactions and poor drug adherence. Both polypharmacy and PIMs are highly prevalent in older people and strategies to improve the quality and safety of prescribing, largely through avoidance of IMU, are needed. In the last 30 years, numerous explicit PIM criteria-based tools have been developed to assist physicians with medication management in clinically complex multimorbid older people. Very few of these PIM criteria sets have been tested as an intervention compared with standard pharmaceutical care in well-designed clinical trials. In this review, we describe the most widely used sets of explicit PIM criteria to address inappropriate polypharmacy with particular focus on STOPP/START criteria and FORTA criteria which have been associated with positive patient-related outcomes when used as interventions in recent randomized controlled trials.

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Prevalence and predictors of potentially inappropriate prescribing of central nervous system and psychotropic drugs among elderly patients: A national population study in Korea

Cited by 16 publications

References 46 publications

The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq

The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq

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

Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences

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