Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

Abstract Background: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15 361 individuals) or on the 31st December 2013 (cohort 2, 15 945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value <0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value <0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80-84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.

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Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

10.21203/rs.2.10158/v3 ◽

2019 ◽

Author(s):

Kristine Thorell ◽

Patrik Midlöv ◽

Johan Fastbom ◽

Anders Halling

Keyword(s):

Chronic Conditions ◽

Adverse Drug Events ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

P Value ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Inappropriate Medications

Abstract Background: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1) or on the 31st December 2013 (cohort 2) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value <0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value <0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80 to ≤ 85 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.

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Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

10.21203/rs.2.10158/v6 ◽

2020 ◽

Author(s):

Kristine Thorell ◽

Patrik Midlöv ◽

Johan Fastbom ◽

Anders Halling

Keyword(s):

Chronic Conditions ◽

Adverse Drug Events ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

P Value ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Inappropriate Medications

Abstract Background: With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15 361 individuals) or on the 31st December 2013 (cohort 2, 15 945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value <0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value <0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80-84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.

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Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

BMC Geriatrics ◽

10.1186/s12877-020-1476-5 ◽

2020 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Kristine Thorell ◽

Patrik Midlöv ◽

Johan Fastbom ◽

Anders Halling

Keyword(s):

Chronic Conditions ◽

Adverse Drug Events ◽

Adult Population ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Inappropriate Medications

Abstract Background With age, the number of chronic conditions increases along with the use of medications. For several years, polypharmacy has been found to be on the increase in western societies. Polypharmacy is associated with an increased risk of adverse drug events (ADE). Medications called potentially inappropriate medications (PIM) have also been found to increase the risk of ADEs in an older population. In this study, which we conducted during a national information campaign to reduce PIM, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods This is a registry-based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1, 15,361 individuals) or on the 31st December 2013 (cohort 2, 15,945 individuals) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results Use of PIM decreased from 10.60 to 7.04% (p-value < 0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55 to 23.66% (p-value < 0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80–84 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013; this shows the possibility to reduce PIM with a focused effort. Polypharmacy does not increase significantly compared to the rest of the population.

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Use of potentially inappropriate medication and polypharmacy in elderly: a repeated cross-sectional study

10.21203/rs.2.10158/v1 ◽

2019 ◽

Author(s):

Kristine Thorell ◽

Patrik Midlöv ◽

Johan Fastbom ◽

Anders Halling

Keyword(s):

Chronic Conditions ◽

Elderly Population ◽

Cross Sectional Study ◽

P Value ◽

Potentially Inappropriate Medications ◽

Primary Care Center ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Inappropriate Medications

Abstract Background Potential inappropriate medications (PIM) have an increased risk for adverse drug reactions (ADR) in an elderly population. With increasing age, multimorbidity is growing along with the use of medications. For several years, polypharmacy has been found to increase in western societies. Polypharmacy is associated with an increased risk of ADR. In this study, we analysed the prevalence of PIM in an elderly population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods This is a registry based repeated cross-sectional study including two cohorts included. Individuals aged 75 or older listed at a primary care center in Blekinge on the 31 of March 2011 (cohort 1) or on the 31 of December 2013 (cohort 2) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results Use of PIM decreased from 10.60% to 7.04% (p-value <0.001) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value <0.001). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80 to ≤ 85 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013. Polypharmacy does not increase significantly compared to the rest of the population.

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Use of potentially inappropriate medication and polypharmacy in older adults: a repeated cross-sectional study

10.21203/rs.2.10158/v2 ◽

2019 ◽

Author(s):

Kristine Thorell ◽

Patrik Midlöv ◽

Johan Fastbom ◽

Anders Halling

Keyword(s):

Older Adult ◽

Chronic Conditions ◽

Adult Population ◽

Cross Sectional Study ◽

P Value ◽

Sectional Study ◽

Cross Sectional ◽

Increased Risk ◽

Older Adult Population ◽

Inappropriate Medications

Abstract Background: Potential inappropriate medications (PIM) have an increased risk for adverse drug reactions (ADR) in an older adult population. With increasing age, multimorbidity is growing along with the use of medications. For several years, polypharmacy has been found to increase in western societies. Polypharmacy is associated with an increased risk of ADR. In this study, we analysed the prevalence of PIM in an older adult population and in different strata of the variables age, gender, number of chronic conditions and polypharmacy and how that prevalence changed over time. Methods: This is a registry based repeated cross-sectional study including two cohorts. Individuals aged 75 or older listed at a primary care centre in Blekinge on the 31st March 2011 (cohort 1) or on the 31st December 2013 (cohort 2) were included in the respective cohorts. Using a chi2 test, the two cohorts were compared on the variables age, gender, number of chronic conditions and polypharmacy. Use of five or more medications at the same time was the definition for polypharmacy. Results: Use of PIM decreased from 10.60% to 7.04% (p-value 0.000) between 2011 and 2013, while prevalence of five to seven chronic conditions increased from 20.55% to 23.66% (p-value 0.000). Use of PIM decreased in all strata of the variables age, gender number of chronic conditions and polypharmacy. Except for age 80 to ≤ 85 and males, where it increased, prevalence of polypharmacy was stable in all strata of the variables. Conclusions: Use of potentially inappropriate medications had decreased in all variables between 2011 and 2013. Polypharmacy does not increase significantly compared to the rest of the population.

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Influence of Education Level of Older Patients on Polypharmacy, Potentially Inappropriate Medications Listed in Beer’s Criteria, and Unplanned Hospitalization: A Cross-Sectional Study in Lahore, Pakistan

Medicina ◽

10.3390/medicina54040057 ◽

2018 ◽

Vol 54 (4) ◽

pp. 57 ◽

Cited By ~ 5

Author(s):

Muhammad Sarwar ◽

Sadia Iftikhar ◽

Muhammad Sarfraz

Keyword(s):

Older People ◽

Older Patients ◽

Formal Education ◽

Cross Sectional Study ◽

Education Level ◽

P Value ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Inappropriate Medications

Objective: To evaluate influence of education level of older patients on polypharmacy, potentially inappropriate medications (PIMs) listed in Beer’s Criteria, and unplanned hospitalization. Methods: A cross-sectional study was conducted among older people aged ≥65 years between 1 December 2017 and 28 February 2018. For data analysis, descriptive statistics and logistic regression analysis were employed. Results: Among 385 older patients, 88.8% were prescribed PIMs and 56.4% underwent PIMs associated unplanned hospitalization. Older people were less exposed to polypharmacy or excessive polypharmacy as their education levels increased (no formal education vs. primary vs. secondary vs. tertiary, 74% vs. 69.8% vs. 60.5% vs. 58.1%). Patients having higher education were also accompanied by significantly lower prescription of PIMs (no formal education vs. primary vs. secondary vs. tertiary, 96% vs. 87.3% vs. 84.5% vs. 79.1%) as well as unplanned hospitalization (no formal education vs. primary vs. secondary vs. tertiary, 64.7% vs. 76.2% vs. 40.3% vs. 46.5%). Results of regression analysis revealed that no formal education (OR = 1.202, 95% CI = 1.032–2.146, p-value = 0.003) and primary education level (OR = 1.175, 95% CI = 1.014–1.538, p-value = 0.039) were significantly associated with the use of polypharmacy among older people. On the other hand, no formal education was significantly associated with the prescription of PIMs (OR = 1.898, 95% CI = 1.151–2.786, p-value = 0.007). Furthermore, older people with no formal education (OR = 1.402, 95% CI = 1.123–1.994, p-value = 0.010) and primary education level (OR = 1.775, 95% CI = 1.281–3.018, p-value = <0.001) were significantly more likely to undergo unplanned hospitalization. Conclusions: Patients having low literacy level are more likely to receive PIMs, polypharmacy, and undergo unplanned hospitalization in comparison to highly educated patients. Hence, promotion of health literacy for patients is crucial to overcome these problems.

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Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria

Pharmacia ◽

10.3897/pharmacia.68.e73597 ◽

2021 ◽

Vol 68 (4) ◽

pp. 789-795

Author(s):

Heba Khader ◽

Luai Z. Hasoun ◽

Ahmad Alsayed ◽

Mahmoud Abu-Samak

Keyword(s):

Geriatric Patients ◽

Adverse Drug Events ◽

Cross Sectional Study ◽

Community Dwelling ◽

Sample Population ◽

Beers Criteria ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional ◽

Inappropriate Medications

The aims of this study were to estimate the prevalence of potentially inappropriate medications (PIMs) in a community-dwelling Jordanian population of geriatrics according to the 2019 American Geriatrics Society Beers Criteria, to identify the most used PIMs and factors independently associated with PIMs use. This was an observational, descriptive, cross-sectional study. The sample population included 386 participants. Data were collected by face-to-face interviews. A total of 2894 medications were evaluated. The prevalence of patients using at least one PIM was 49.2%. The most used PIMs were proton pump inhibitors (24.6%) and long-acting sulfonylurea (20.5%). Participants who had diabetes mellitus, peptic ulcer, or irritable bowel syndrome had significantly higher numbers of PIMs. The use of PIMs was high in Jordanian geriatric patients. The results of this study might help healthcare providers to detect high-risk patients and reconsider the necessity of using PIMs to decrease the risk of adverse drug events.

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Effect of number of medications and use of potentially inappropriate medications on frailty among early-stage older outpatients

Journal of Pharmaceutical Health Care and Sciences ◽

10.1186/s40780-021-00195-x ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Yuya Uragami ◽

Kazuhiro Takikawa ◽

Hajime Kareki ◽

Koji Kimura ◽

Kazuyuki Yamamoto ◽

...

Keyword(s):

Early Stage ◽

Linear Trend ◽

Cross Sectional Study ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Antithrombotic Drugs ◽

Cross Sectional ◽

The Relationship ◽

Inappropriate Medications ◽

Frailty Score

Abstract Background Frailty is an urgent concern among an aging population worldwide. However, the relationship between frailty and number and types of medications has not been studied in detail among early-stage older patients, and it is unclear what prescriptions may have a role in preventing frailty. This study aimed to clarify the effects of number of medications and use of potentially inappropriate medications (PIMs) on frailty among early-stage older outpatients in Japan. Methods A cross-sectional study was undertaken. Frailty scores and medications of outpatients aged 65–74 years who regularly visited community pharmacies were investigated. Frailty scores were classified as 0 (non-frailty), 1–2 (pre-frailty), and ≥ 3 (frailty). The association between frailty and number of medications was analyzed by age and compared between PIM use and non-use groups. The proportion of patients who used PIMs was also analyzed by frailty score. Results Of 923 older outpatients, 49 (5.3%) and 318 (34.5%) patients had frailty and pre-frailty scores, respectively. The numbers of medications among patients with pre-frailty and frailty were significantly higher than among those with non-frailty (p < 0.001 for both). A similar increase was shown for PIM use groups aged 69–71 and 72–74 years, but not for the PIM use group aged 65–68 years and all groups without PIM use. An increasing linear trend was observed for the relationship between the proportion of patients who used any PIM, as well as some subcategories of PIMs (such as NSAIDs, benzodiazepines, loop diuretics and antithrombotic drugs) and frailty score. Conclusions Unnecessary medication use among early-stage older outpatients, especially patients aged ≥69 years who use PIMs and many medications, seems to be associated with frailty, but further research is needed to confirm these findings.

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Cross sectional study on the prevalence of polypharmacy and potentially inappropriate medications among elderly patients in a tertiary care centre in central Kerala

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20210836 ◽

2021 ◽

Vol 8 (3) ◽

pp. 1415

Author(s):

Jubina Bency Anthoorathodi ◽

Aqueen Joju ◽

Ann Mereena Reji ◽

Anupama Pallivalappil Asokan ◽

Anzeem Naseem ◽

...

Keyword(s):

Diabetes Mellitus ◽

Risk Factors ◽

Clinical Care ◽

Inappropriate Medication ◽

Cross Sectional Study ◽

Health Concern ◽

Potentially Inappropriate Medication ◽

Potentially Inappropriate Medications ◽

Sectional Study ◽

Cross Sectional

Background: Polypharmacy or the concurrent use of multiple medications, is on the rise, especially in the elderly population as they suffer from multiple co-morbidities. Polypharmacy has been reported to increase the risks for inappropriate medication intake. Objectives: The aim was to investigate the prevalence of polypharmacy and usage of potentially inappropriate medication using Beer’s criteria and to find out the various risk factors of polypharmacy in hospitalised elderly.Methods: A cross sectional study was done in patients aged 60 years and above using a pre designed semi structured questionnaire and from their case records to assess the pattern of polypharmacy by different socio-demographic characteristics and also to found out the risk factors of polypharmacy.Results: 50 patients aged 60 and above were involved in our study out of which, 46% were females and 54% were males. Mean age of our study population was 71.5±8.3. Among them, 30 were hypertensive, 27 were diabetic, 9 of them had dyslipidaemia and 8 of them had coronary artery disease Mean number of medication use was 5.1±4.1. Polypharmacy was observed in 42% of the patients. 20% patients received potentially inappropriate drugs from Beer’s list. We also found significant association of polypharmacy with diabetes mellitus and hypertension.Conclusions: The present study has shown polypharmacy and usage of potentially inappropriate medication as an emerging public health concern. Diabetes mellitus and hypertension were found to be risk factors of polypharmacy. Deprescription should be integrated into clinical care and prescribers need to be educated about Beers criteria and encouraged for rational prescription.

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