Potentially Inappropriate Medications Use in A Population of Iraqi Geriatric Outpatients According to Beers Criteria

Author(s):  
Ola Albaghdadi ◽  
Salam , Mohammad Hassan Morteza, Firas A Ahjel ◽  
Mohammad Hassan Morteza ◽  
Firas Aziz Rahi

Aims: Elderly in Iraq kept suffering multiple burdens, as they are a truly fragile and vulnerable segment. A major public health issue among elderly is adverse drug reactions. This study is aimed at contributing in overcoming this treatment gap by determining the prevalence of inappropriate medications used by a group of Iraqi elderly outpatients. Methods: A cross-sectional, questionnaire-based study was conducted in a sample of 85 Iraqi elderly aged ≥65 years of either gender. Participants had face-to-face interviews to answer a comprehensive questionnaire. Each drug taken by the patient was evaluated according to Beers criteria. Results: Females constituted 45.9% of the total. The average age was 69.9 years (± 4.6). Nearly 30% of the patients had 3 different diseases, and 17.8% had ≥4 different ones, with cardiovascular diseases were the most prevalent. Polypharmacy was notably identified in 47.1% of the total studied population. Twenty-eight out of 85 patients did not know the actual reason of taking at least one of their medications, and 42% were not taking their drugs as directed. Remarkably, 43.5% of patients were recognized as taking at least one medication to be avoided in elderly people according to the Beers criteria. The most common inappropriate drugs were glyburide, and proton-pump inhibitors. Conclusion: There was an obvious absence of any role of pharmacists in the health care system for our studied population. Health care professionals are encouraged to review the medications prescribed for geriatric patients using updated safety guidelines to prevent the risks associated with potentially inappropriate medications.

Author(s):  
Fangyuan Tian ◽  
Haixia Li ◽  
Zhaoyan Chen ◽  
Ting Xu

Objectives: Multimorbidity and polypharmacy in older adults always increase the prevalence of potentially inappropriate medications (PIMs) and affect the quality of life of the older adults. The purposes of this study were aimed to investigate the prevalence of PIMs prescription and the most frequent PIMs among outpatients according to Beers criteria and to explore related risk factors for PIMs prescription. Methods: The cross-sectional retrospective study was conducted among elderly outpatients in Chengdu (a city in China) from January 2018 to December 2018. The 2015 Beers criteria was used to assess PIMs in elderly outpatients. Univariate analysis and multivariate logistic regression analysis were adopted to determine the factors that may affect the prevalence of PIMs in elderly outpatients. Results: A total of 15523 patient prescriptions were enrolled, of which 4654 (29.98%) were identified with at least one PIM based on Beers criteria, and 6460 PIMs were detected. Of these PIM prescriptions, 76.32% were detected to receive 1 PIM, 16.54% were detected to receive 2 PIMs, and only 7.13% were found to have at least 3 PIMs. Benzodiazepines (2371, 50.95%), diuretics (1197, 25.72%), and selective serotonin reuptake inhibitors (439, 9.43%) were three common types of drugs that were the most frequent PIMs used. Sex, age, number of diseases, number of medications, and diseases or disease states were risk factors for PIMs in outpatients. Conclusion: The results of the study showed that the phenomenon of PIM was common among elderly outpatients in Chengdu. Risk factors for PIM in elderly outpatients include gender, age, number of diseases, number of medications, and sleep disorder.


Author(s):  
Cagla Yigitbas

Abstract Objective: The aim of this study was to determine the level of knowledge of students receiving different levels of health-care education (doctors, nurses, paramedics) on chemical, biological, radioactive, and nuclear weapons (CBRNW). Methods: This study was designed as a qualitative, descriptive, and cross-sectional research. The study reached 87.68% of the population. A survey form was created by the researcher in line with the literature. Ethical permission and verbal consents were obtained. The data were collected by face-to-face interviews. Results: It was observed that there was no difference between the enrolled departments, that the participants had very low levels of knowledge on the subject despite considering it a likely threat for Turkey, and that they thought the public and the health-care professionals in this field had insufficient knowledge. Sex, age, and field education were the variables that created a difference. Conclusion: Training regarding CBRNW should be further questioned and individuals should receive ongoing training to increase and update their knowledge and skills.


2021 ◽  
Vol 1 (1) ◽  
pp. 27-33
Author(s):  
Wei Chern Ang ◽  
Nur Syafiqah Zulkepli ◽  
Nur Safinaz Mukhtar ◽  
Nur Atikah Zulkefli

Introduction: Malaysia will be a full aging nation by 2030. The elderly (aged >65 years old) population often has multiple comorbidities, which increases the risk of polypharmacy and potentially inappropriate medications (PIMs). This study aims to investigate the prevalence, factors associated with PIMs among elderly outpatients, and its burden of direct pharmacotherapy cost to the Ministry of Health Malaysia. Materials and method:  A cross-sectional study involving clinic prescriptions among the elderly with more than one-month prescribing duration received from a tertiary hospital specialist clinic pharmacy from March to April 2017. Patient identifiers were screened using the Pharmacy Information System (PhIS) by including prescriptions from other clinics while excluding multiple visits and duplicate prescriptions. Patients were categorised as PIM group and non-PIM groups using Beers Criteria 2015. Logistic regression analysis was conducted to examine the factors associated with PIMs. The median monthly prescription cost was compared between PIM and non-PIM groups by Mann-Whitney test. Results: Among 472 patients, 39.4% of patients had at least one PIM while 60.6% of patients did not receive any PIM. The number of medications prescribed was an independent risk factor contributing to PIMs (OR:2.04; 95% CI:1.40, 2.97). The median monthly prescription cost for the PIM group was MYR 29.50 (?USD 7.53) which was not statistically significant (p=0.735) compared with the non-PIM group which was MYR 28.50 (USD 7.28).  Conclusion: PIM was frequently prescribed in our setting with the number of medications as the only factor. However, the prescribing of PIM did not add nor reduce the direct cost of pharmacotherapy.


2020 ◽  
Author(s):  
Monira Alwhaibi

Abstract Background Potentially inappropriate medications (PIMs) are medications that should be avoided among older adults due to their risk which offsets their benefit. The objective of this study is to estimate the prevalence of PIMs use and to evaluate its associated factors among older adults with comorbid diabetes and hypertension using the 2019 Beers criteria.Methods A cross-sectional retrospective study design was used. This study included 1,853 older adults (age ≥ 65 years) with comorbid diabetes and hypertension visited an ambulatory care setting in a large hospital in the central region of Saudi Arabia. The primary outcome was the prevalence of PIMs use based on the updated 2019 American Geriatric Society (AGS) Beers Criteria. The secondary outcome was the factors associated with the presence of PIMs use (use of one or more PIMs) by referencing the Beers Criteria list.Results Almost one out of two individuals had PIMs use with the average number of medication taken was seven; where 40.3% of the older adults taken one PIMs, and about 16% were using two or more PIMs. The most commonly prescribed PIMs were the use of gastrointestinal and endocrine medications. High risk of PIMs use was among those with ischemic heart disease and anxiety comorbidities and those using multiple medications (i.e., polypharmacy).Conclusions Given higher PIMs use among older adults with diabetes and hypertension comorbidities, tailored strategies and interventions to minimize the PIMs use in this population are warranted. There is a need for greater vigilance when managing patients with comorbid conditions to avoid the use of inappropriate medications.


Pharmacia ◽  
2021 ◽  
Vol 68 (4) ◽  
pp. 789-795
Author(s):  
Heba Khader ◽  
Luai Z. Hasoun ◽  
Ahmad Alsayed ◽  
Mahmoud Abu-Samak

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.


Author(s):  
Manoj H. Thummar ◽  
Tejas K. Patel ◽  
Varsha Y. Godbole ◽  
Manoj Kumar Saurabh

Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.Methods: This cross-sectional study was carried out on medical records of elderly patients (≥65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria.


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