Potentially Inappropriate Medication Use and the Hospitalization Rate among Thai Elderly Patients: a Retrospective Cohort Study

AbstractPurposeTo examine the association between potentially inappropriate medications (PIMs) use and the hospitalization rate in elderly Thai patients.MethodsIn this retrospective cohort study, we collected the electronic medical data of elderly patients aged 60 years and older who visited the outpatient department (OPD) at Thammasat University Hospital in Thailand in 2015. The patients were categorized into PIM and non-PIM users according to the Beers 2019 criteria. We calculated descriptive statistics for demographic variables. We also examined the association between PIM use and various different factors with hospitalization rate during follow-up using log-binomial regression. We calculated the relative risk for association between PIM use and other factors with the hospitalization rate.ResultsWe collected data for a total of 32,261 patients. The majority of participants were female (59.65%) and had a mean age of 70.21 years (SD=7.88). Overall, 63.98% of the patients (n=20,641) were PIM users and 49.45% (n=15,952) received polypharmacy (≥5 medications). The most common PIM prescription was proton-pump inhibitors, which were 27.51% of all medications prescribed. We found that PIM use increased the risk of hospitalization by 1.31 times (adjusted RR=1.31, 95% CI: 1.21 – 1.41, p-value < 0.001). Other factors associated with a higher rate of hospitalizations included older age, male gender, polypharmacy, and a higher number of OPD visits.ConclusionPIMs were commonly prescribed to the elderly in the OPD, and were significantly associated with subsequent hospitalization. The provision of an alternative drug list can help physicians avoid prescribing PIMs to the elderly. If PIMs prescription is unavoidable, physicians should closely monitor patients for drug-related problems and deprescribe PIMs when they are no longer indicated.

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Diabetes Mellitus as a Risk Factor for Drug Resistance Tuberculosis: A Retrospective Cohort Study at King Abdul Aziz University, Jeddah

Journal of Advances in Medicine and Medical Research ◽

10.9734/jammr/2021/v33i2031115 ◽

2021 ◽

pp. 136-145

Author(s):

Sumyia Mehrin M. D. Abulkalam ◽

Mai Kadi ◽

Mahmoud A. Gaddoury ◽

Wallaa Khalid Albishi

Keyword(s):

Diabetes Mellitus ◽

Drug Resistance ◽

Risk Factor ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

University Hospital ◽

P Value ◽

Baseline Characteristic ◽

Drug Resistant

Background: The association between tuberculosis (TB) and diabetes mellitus (DM) is re-emerging with the epidemic of type II diabetes. Both TB and DM were of the top 10 causes of death.[1] This study explores diabetes mellitus as a risk factor for developing the different antitubercular drug-resistant (DR) patterns among TB patients. Methods: A retrospective cohort study has been conducted on all TB cases reported to the King Abdul Aziz University Hospital, Jeddah, between January 2012 to January 2021. All culture-confirmed and PCR-positive TB cases were included in this study. Categorical baseline characteristic of TB patient has been compared with DM status by using Fisher's exact and Pearson chi-square test. The univariable and multivariable logistic regression model was used to estimate the association between DM and different drug resistance patterns. Results: Of the total 695 diagnosed TB patients, 92 (13.24%) are resistant to 1st line anti TB drugs. Among 92 DR-TB patients, 36 (39.13%) are diabetic. The percentage of different patterns of DR-TB with DM, in the case of mono DR (12.09%), poly DR (4.19%) MDR (0.547%). As a risk factor, DM has a significant association with DR-TB, mono drug-resistant, and pyrazinamide-resistant TB (P-value <0.05). The MDR and PDR separately do not show any significant association with DM, but for further analysis, it shows a significant association with DM when we combined. Conclusion: Our study identified diabetes mellitus as a risk factor for developing DR-TB. Better management of DM and TB infection caring programs among DM patients might improve TB control and prevent DR-TB development in KSA.

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Management of concomitant hyperparathyroidism and thyroid diseases in the elderly patients: a retrospective cohort study

Aging Clinical and Experimental Research ◽

10.1007/s40520-016-0665-8 ◽

2016 ◽

Vol 29 (S1) ◽

pp. 29-33 ◽

Cited By ~ 5

Author(s):

Alessandra Panarese ◽

Vito D’Andrea ◽

Stefano Pontone ◽

Pasqualino Favoriti ◽

Daniele Pironi ◽

...

Keyword(s):

Cohort Study ◽

Elderly Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

The Elderly ◽

Thyroid Diseases

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Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: a retrospective cohort study

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-01861-w ◽

2020 ◽

Vol 15 (1) ◽

Author(s):

Takako Nagai ◽

Masahiro Nagaoka ◽

Koji Tanimoto ◽

Yoshiaki Tomizuka ◽

Hiroshi Uei ◽

...

Keyword(s):

Cohort Study ◽

Elderly Patients ◽

Distal Radius Fracture ◽

Distal Radius ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Radius Fracture ◽

Potentially Inappropriate Medications ◽

Inappropriate Medications

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Outcome of Elderly Patients with Venous Thromboembolism Treated with Direct Oral Anticoagulants—A Retrospective Cohort Study

Journal of Clinical Medicine ◽

10.3390/jcm10235673 ◽

2021 ◽

Vol 10 (23) ◽

pp. 5673

Author(s):

Irit Ayalon-Dangur ◽

Yakov Vega ◽

Miriam Rozi Israel ◽

Alon Grossman ◽

Galia Spectre ◽

...

Keyword(s):

Cohort Study ◽

Venous Thromboembolism ◽

Elderly Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Oral Anticoagulants ◽

Direct Oral Anticoagulants ◽

Cohort Analysis ◽

The Elderly ◽

Composite Outcome

Introduction: Randomized controlled trials that compared direct oral anticoagulants (DOACs) to vitamin K antagonists (VKA) for the treatment of venous thromboembolism (VTE), demonstrated both efficacy and safety of DOACs. The aim of the current study was to compare DOACs to VKA for the treatment of VTE in the elderly, in a real-life setting. Methods: A retrospective cohort study was performed in Rabin Medical Center encompassing a 7-year period. Hospitalized patients >65 years, with a diagnosis of VTE discharged with DOACs or VKA were included. The primary outcome was a composite of all-cause mortality, major bleeding, recurrent VTEs and hospitalizations throughout the follow-up period of one year. Results: A total of 603 patients were included in the final analysis. The mean age was 79.6 ± 8.5 years. The primary composite outcome occurred in 74.6% and 56.7% of the patients in the VKA group and DOACs group, respectively, hazard ratio 0.59, 95% confidence interval 0.46 to 0.76, in favor of the DOACs group. In a matched cohort analysis, the results were the same as the original analysis. Conclusion: In the elderly population, treatment of VTE with DOACs was associated with a lower rate of the composite outcome. DOACs are safe and effective for elderly patients with VTE.

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Bacterial infection secondary to Trimeresurus species bites: A retrospective cohort study in a university hospital in Bangkok

Emergency Medicine Australasia ◽

10.1111/1742-6723.13788 ◽

2021 ◽

Author(s):

Suppanut Kriengkrairut ◽

Rittirak Othong

Keyword(s):

Cohort Study ◽

Bacterial Infection ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

University Hospital

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Clinical characteristics and factors related to antibiotic-associated diarrhea in elderly patients with pneumonia: a retrospective cohort study

BMC Geriatrics ◽

10.1186/s12877-021-02267-x ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Yoko Takedani ◽

Tsukasa Nakamura ◽

Noriko Fukiwake ◽

Toshihiro Imada ◽

Junji Mashino ◽

...

Keyword(s):

Risk Factors ◽

Cohort Study ◽

Elderly Patients ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Tertiary Care ◽

Multivariate Logistic Regression Model ◽

Care Hospital ◽

Antibiotic Associated Diarrhea ◽

Elderly Inpatients

Abstract Background Antibiotic-associated diarrhea (AAD) is a common problem among elderly inpatients because many elderly patients are admitted for pneumonia or other conditions that necessitate antibiotic treatment. In the super aging population, more patients are suffering from pneumonia than before, but the incidence or risk factors for AAD among many elderly patients have not been well scrutinized. Methods We conducted a retrospective cohort study of elderly patients diagnosed with pneumonia from April 2014 to March 2019 who were admitted to the Department of General Medicine of a Tertiary Care Hospital in Japan. Patients (≥ 65 years of age) who were diagnosed with bacterial pneumonia or aspiration pneumonia and treated with antibiotics were included. We defined AAD by diarrhea with more than three loose or watery stools per day and included patients who had these symptoms for either one day or two or more consecutive days. We also assessed the length of hospital stay and in-hospital mortality. The potential risk factors for AAD included age, sex, body weight, body mass index, smoking, alcohol, activities of daily living (ADL),　comorbidities, vital signs, laboratories, the severity of pneumonia, antibiotic and other medication use. Results There were 1,067 patients, the mean age was 83 years, and men accounted for 59 %. β-Lactamase inhibitors were frequently prescribed antibiotics in 703 patients (66 %), and proton pump inhibitors (PPIs) were also commonly administered (48 %). AAD developed in 322 patients (30 %). The multivariate logistic regression model showed that β-lactamase inhibitors (OR 1.43, 95 % CI 1.05–1.95) and PPIs (OR 1.37, 95 % CI 1.03–1.83) were associated with AAD as well as age (OR 1.03 per year, 95 % CI 1.01–1.05). Conclusions AAD was common among elderly inpatients with pneumonia, and β-lactamase inhibitors and PPIs were associated with AAD. Strict use of such medication should be considered to decrease the risk of AAD.

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