Prevalence of Potentially Inappropriate Medication Use in Elderly Patients

Abstract

Inappropriate drug use as defined by the Beers criteria was common in both medical and geriatric inpatients. Compared with internists, geriatricians appear to be more aware of PIMs that should generally be avoided, but less aware of PIMs related to a specific diagnosis, and of the need to avoid anticholinergic drug use. However, the results of this study should be interpreted with caution because some of the drugs identified as potentially inappropriate may in fact be beneficial when the patient's clinical condition is taken into consideration.

Potentially Inappropriate Medication Use Among Older Hospitalized Patients in a Brazilian General Hospital

“…The most frequently prescribed PIMs in this study, namely, the long-acting benzodiazepine diazepam, digoxin, scopolamine and short-acting nifedipine, also featured among the five most prescribed PIMs of other similar studies (16,17,26,28). These results demonstrate that hospitalized elderly may be at greater risk of ADRs such as constipation, orthostatic hypotension, sedation, walking difficulties, falls and fractures (18,19).…”

“…The prevalence of prescription of PIMs independent of diagnoses or condition (59.3%) was higher than that reported in other studies employing similar methods (14,16,17,26,28) The high frequency of prescription of PIMs may reflect the lack of knowledge regarding the Beers Criteria among prescribers. This reinforces the importance of the dissemination of the Beers Criteria among physicians, and the implementation of prescription review.…”

“…This shows that, although patients hospitalized for longer periods are believed to be more fragile, no additional efforts were made to safeguard them from the potential harm of polypharmacy and PIM use. Likewise, several other studies also found an association between longer lengths of stay and PIM use (17,26,28).…”

“…Also, in geriatric prescribing, combinations of medicines which cause drug interactions, fixed combinations, dual therapy, and drugs with questionable therapeutic value should all be avoided (9)(10)(11).The quality of drugs prescription for the elderly may, therefore, be assessed by different indicators. In pharmacoepidemiological studies targeting hospitalized elderly, evaluation of parameters such as the use of potentially inappropriate medication (PIM) and polypharmacy is common (8,(12)(13)(14)(15)(16)(17).…”

Influence of Admission to a Tertiary Care Hospital after a Fall on Use of Potentially Inappropriate Medications among Older Patients

“…5 A PIM is defined as a medication for which the potential risk for ADEs outweighs the possible clinical benefit for the patient. 11,12 The well-known Beers criteria define PIMs with the potential to increase fall risk in elderly individuals, and it is recommended that certain medication classes be avoided for elderly patients with a history of falls (unless safer alternatives are not available). 12 We believe that admission to hospital provides an opportunity to make changes in the type of drugs and the total number of PIMs prescribed.…”