Relationship between potentially inappropriate medications and functional prognosis in elderly patients with distal radius fracture: 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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1 Risk of Emergency Department Revisit or Hospitalization in Older Adults Discharged With Potentially Inappropriate Medications: A Retrospective Cohort Study

Annals of Emergency Medicine ◽

10.1016/j.annemergmed.2019.08.004 ◽

2019 ◽

Vol 74 (4) ◽

pp. S1

Author(s):

N. Hammouda ◽

U. Hwang

Keyword(s):

Older Adults ◽

Emergency Department ◽

Cohort Study ◽

Retrospective Cohort Study ◽

Retrospective Cohort ◽

Potentially Inappropriate Medications ◽

Inappropriate Medications

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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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