scholarly journals Prevalence Of Potentially Inappropriate Medication In The Older Adult Population Within Primary Care In Portugal: A Nationwide Cross-Sectional Study

2019 ◽  
Vol Volume 13 ◽  
pp. 1569-1576 ◽  
Author(s):  
Pedro Augusto Simões ◽  
Luiz Miguel Santiago ◽  
Katia Maurício ◽  
José Augusto Simões
2019 ◽  
Author(s):  
Kristine Thorell ◽  
Patrik Midlöv ◽  
Johan Fastbom ◽  
Anders Halling

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.


BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051527
Author(s):  
Huanyu Zhang ◽  
Eliza LY Wong ◽  
Samuel YS Wong ◽  
Patsy YK Chau ◽  
Benjamin HK Yip ◽  
...  

ObjectivesTo assess the prevalence of potentially inappropriate medication (PIM) use in Hong Kong older patients visiting general outpatient clinics (GOPCs) between 2006 and 2014 and to identify factors associated with PIM use among older adults visiting GOPCs in 2014.DesignCross-sectional study.SettingGOPC.ParticipantsTwo study samples were constructed including a total of 844 910 patients aged 65 and above from 2006 to 2014 and a cohort of 489 301 older patients in 2014.MeasurementsTwo subsets of the 2015 American Geriatrics Society Beers criteria—PIMs independent of diagnosis and PIMs due to drug–disease interactions—were used to estimate the prevalence of PIM use over 12 months. PIMs that were not included in the Hospital Authority drug formulary or with any specific restriction or exception in terms of indication, dose or therapy duration were excluded. Characteristics of PIM users and non-PIM users visiting GOPCs in 2014 were compared. Independent associations between patient variables and PIM use were assessed by stepwise multivariable logistic regression analysis.ResultsThe 12-month period prevalence of PIM use decreased from 55.56% (95% CI 55.39% to 55.72%) in 2006 to 47.51% (95% CI 47.37% to 47.65%) in 2014. In the multivariable regression analysis, the strongest factor associated with PIM use was the number of different drugs prescribed (adjusted OR, AOR 23.01, 95% CI 22.36 to 23.67). Being female (AOR 0.89, 95% CI 0.85 to 0.87 for males vs females) and having a greater number of GOPC visits (AOR 1.83, 95% CI 1.78 to 1.88) as well as more than six diagnoses (AOR 1.43, 95% CI 1.36 to 1.52) were associated with PIM use.ConclusionsThe overall prevalence of PIM use in older adults visiting GOPCs decreased from 2006 to 2014 in Hong Kong although the prevalence of PIM use was still high in 2014. Patients with female gender, a larger number of medications prescribed, more frequent visits to GOPCs, and more than six diagnoses were at higher risk for PIM use.


Author(s):  
Jubina Bency Anthoorathodi ◽  
Aqueen Joju ◽  
Ann Mereena Reji ◽  
Anupama Pallivalappil Asokan ◽  
Anzeem Naseem ◽  
...  

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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