scholarly journals Prevalence, Factors and Cost Comparison due to Potentially Inappropriate Medications (PIMs) of Elderly Outpatients in a State Hospital in Malaysia.

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 ◽  
Vol 73 (suppl 3) ◽  
Author(s):  
Anderson da Silva Rêgo ◽  
Cremilde Aparecida Trindade Radovanovic ◽  
Maria Aparecida Salci ◽  
Aline Zulin ◽  
Elaine Trevezanuto Correia ◽  
...  

ABSTRACT Objective: to analyze factors associated with the use of potentially inappropriate medications by elderly people with hypertension. Method: a cross-sectional study, conducted in the first semester of 2016, with elderly people undergoing treatment for hypertension, living in the city of Maringá. Interviews, medical records analysis, and measurement of clinical and anthropometric parameters of the participants were carried out. Inferential analysis was used. Results: a total of 260 elderly people who used potentially inappropriate medications participated in the study. The high use of these medications was associated with clinical and anthropometric conditions, such as obesity (p=0.022), smoking (p=0.004), polypharmacy (p=0.034) and the health services provided, such as organizationally accessible treatment (p=0.027) and consultation time (p=0.007), predisposing to low adherence to routine consultations (p=0.003). Conclusion: it was shown that the factors associated with the use of potentially inappropriate medications were associated with anthropometric, clinical, and organizational variables, intrinsic to the family health strategy.


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.


1970 ◽  
Vol 4 ◽  
pp. 129-142 ◽  
Author(s):  
Raj Kumar Subedi

Insomnia is one of the major and unsolved problems in older people. Most of the sleep studies report that the different forms of insomnia like Difficulty Initiating Sleep (DIS), Difficulty Maintaining Sleep (DMS) and Non-Restorative Sleep (NRS) are common among the elderly that are associated to many factors. The objective of the study was to measure the prevalence of insomnia and the factors associated to it among the elderly people. A cross-sectional study was conducted among 142 elderly people of and above 60 years of age in Sarangdanda VDC of Panchthar District of Eastern Nepal. The presence or absence of insomnia and the associated factors were assessed on them by the help of interview schedule. The results were analyzed using chi-square test in SPSS (version 11.5). DMS was the most common reported form of insomnia among the elderly followed by DIS and NRS. Association between insomnia and each of factors like use of tobacco before sleeping hours, eating too close to bedtime, use of tea/coffee before sleeping hours and use of alcohol before sleeping hours were statistically significant at 95% level of confidence. Insomnia affects a large proportion of elderly and is triggered by many factors like use of tobacco before sleeping hours, use of tea/coffee before sleeping hours, eating too close to bedtime and use of alcohol before sleeping hours. Keywords: Alcohol; tea/coffee; difficulty initiating sleep (DIS); difficulty maintaining sleep (DMS); non-restorative sleep (NRS); tobacco DOI: 10.3126/dsaj.v4i0.4517 Dhaulagiri Journal of Sociology and Anthropology Vol.4 2010 pp.129-142


2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai

Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.


Author(s):  
Yuya Uragami ◽  
Kazuhiro Takikawa ◽  
Hajime Kareki ◽  
Koji Kimura ◽  
Kazuyuki Yamamoto ◽  
...  

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.


2014 ◽  
Vol 17 (3) ◽  
pp. 705-718 ◽  
Author(s):  
Iara Guimarães Rodrigues ◽  
Gustavo Pereira Fraga ◽  
Marilisa Berti de Azevedo Barros

Purpose: The aim of the present study was to identify factors associated with the occurrence of falls among elderly adults in a population-based study (ISACamp 2008). Methods: A population-based cross-sectional study was carried out with two-stage cluster sampling. The sample was composed of 1,520 elderly adults living in the urban area of the city of Campinas, São Paulo, Brazil. The occurrence of falls was analyzed based on reports of the main accident occurred in the previous 12 months. Data on socioeconomic/demographic factors and adverse health conditions were tested for possible associations with the outcome. Prevalence ratios (PR) were estimated and adjusted for gender and age using the Poisson multiple regression analysis. Results: Falls were more frequent, after adjustment for gender and age, among female elderly participants (PR = 2.39; 95% confidence interval (95%CI) 1.47 - 3.87), elderly adults (80 years old and older) (PR = 2.50; 95%CI 1.61 - 3.88), widowed (PR = 1.74; 95%CI 1.04 - 2.89) and among elderly adults who had rheumatism/arthritis/arthrosis (PR = 1.58; 95%CI 1.00 - 2.48), osteoporosis (PR = 1.71; 95%CI 1.18 - 2.49), asthma/bronchitis/emphysema (PR = 1,73; 95%CI 1.09 - 2.74), headache (PR = 1.59; 95%CI 1.07 - 2.38), mental common disorder (PR = 1.72; 95%CI 1.12 - 2.64), dizziness (PR = 2.82; 95%CI 1.98 - 4.02), insomnia (PR = 1.75; 95%CI 1.16 - 2.65), use of multiple medications (five or more) (PR = 2.50; 95%CI 1.12 - 5.56) and use of cane/walker (PR = 2.16; 95%CI 1.19 - 3,93). Conclusion: The present study shows segments of the elderly population who are more prone to falls through the identification of factors associated with this outcome. The findings can contribute to the planning of public health policies and programs addressed to the prevention of falls.


2017 ◽  
Vol 20 (1) ◽  
pp. 138-148 ◽  
Author(s):  
Natália Araujo de Almeida ◽  
Annelita Almeida Oliveira Reiners ◽  
Rosemeiry Capriata de Souza Azevedo ◽  
Ageo Mário Cândido da Silva ◽  
Joana Darc Chaves Cardoso ◽  
...  

Abstract Objective: to verify the prevalence of and factors associated with polypharmacy among elderly residents of the city of Cuiabá, in the state of Mato Grosso. Method: a cross-sectional study of 573 people aged 60 and over was performed. Polypharmacy was defined as the use of five or more medications. To investigate the association between polypharmacy and sociodemographic variables, health and access to medication, the Mantel Haenszel chi square test was used in bivariate analysis and Poisson regression was used in multivariate analysis. The significance level adopted was 5%. Result: the prevalence of polypharmacy was 10.30%. Statistically significant associations were found between polypharmacy and living with others, describing suffering from circulatory, endocrine, nutritional and digestive tract diseases, and referring to financial difficulties for the purchase of medicines. Conclusion: some social and health condition factors play an important role in the use of multiple medications among the elderly.


2018 ◽  
Vol 46 (5-6) ◽  
pp. 298-309 ◽  
Author(s):  
Sophie Vandepitte ◽  
Koen Putman ◽  
Nele Van Den Noortgate ◽  
Sofie Verhaeghe ◽  
Eric Mormont ◽  
...  

Background/Aims: Dementia is one of the main reasons for institutionalization among the elderly. Few studies have explored factors associated with the caregivers’ (CG) desire to institutionalize (DTI) a person with dementia (PWD). The objective of this study is to identify modifiable and non-modifiable psychosocial and sociodemographic factors associated with a caregiver’s DTI. Methods: Cross-sectional data of 355 informal CG of community-dwelling PWD were analyzed. Several characteristics were identified in CG and PWD to be included in a multivariable regression model based on the purposeful selection method. Results: Positively modifiable associated factors were: higher CG burden, being affected by behavioral problems, and respite care use. Positively associated non-modifiable factors were: CG older age, being professionally active, and CG higher educational level. Cohabitation and change of professional situation were negatively associated. Conclusion: Although no causality can be assumed, several practical recommendations can be suggested. First of all, these results reconfirm the importance of multicomponent strategies, especially support aimed at decreasing burden and in learning coping strategies. Also, CG might benefit from information about support options, such as respite care services. Finally, special attention should be given to older and working CG. In the latter, flexible and adaptive working conditions might alleviate burden and therefore reduce the DTI of the PWD.


2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Tasya Virrisya Tania ◽  
Fajar Susanti ◽  
Erlin Ifadah ◽  
Apri Sunadi

Dementia is an acquired intellectual and memory dysfunction caused by brain disease, and is not associated with impaired levels of consciousness. The purpose of this study was to determine the factors associated with dementia in the elderly at the Cakung District Health Center in 2020. This study is a quantitative study with a correlative descriptive research design with a cross sectional study approach. The population consisted of elderly patients who participated in prolanis activities at the Cakung District Health Center. Sampling using total sampling. The sample consisted of 60 respondents. Data analysis using chi square test. The results showed a relationship between age (p = 0.000), physical activity (p = 0.000) and dementia. Physical activity needs to be done by the elderly to inhibit the factors that accelerate the onset of dementia. Counseling and learning about physical activity in the elderly should be a program in providing health services to the elderly, especially to prevent dementia. Keywords : Dementia, Physical Activity 


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