scholarly journals Prescription of Potentially Inappropriate Medication in Older Inpatients of an Internal Medicine Ward: Concordance and Overlap Among the EU(7)-PIM List and Beers and STOPP Criteria

2021 ◽  
Vol 12 ◽  
Author(s):  
Carla Perpétuo ◽  
Ana I. Plácido ◽  
Daniela Rodrigues ◽  
Jorge Aperta ◽  
Maria Piñeiro-Lamas ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Circulatory System ◽  
Beers Criteria ◽  
Internal Medicine Ward ◽  
The Poor ◽  
Stopp Criteria ◽  
Older Inpatients ◽  
The Eu

Background: Age-related comorbidities prone older adults to polypharmacy and to an increased risk of potentially inappropriate medication (PIM) use. This work aims to analyze the concordance and overlap among the EU(7)-PIM list, 2019 Beers criteria, and Screening Tool of Older Person’s Prescriptions (STOPP) version 2 criteria and also to analyze the prevalence of PIM.Methods: A retrospective cohort study was conducted on older inpatients of an internal medicine ward. Demographic, clinical, and pharmacological data were collected, during March 2020. After PIM identification by the EU(7)-PIM list, Beers criteria, and STOPP v2 criteria, the concordance and overlap between criteria were analyzed. A descriptive analysis was performed, and all the results with a p-value lower than 0.05 were considered statistically significant.Results: A total of 616 older patients were included in the study whose median age was 85 (Q1–Q3) (78–89) years. Most of the older patients were male (51.6%), and the median (Q1–Q3) number of days of hospitalization was 17 (13–22) days. According to the EU(7)-PIM list, Beers criteria, and STOPP criteria, 79.7, 92.0, and 76.5% of older adults, respectively, used at least one PIM. A poor concordance (<63.4%) among criteria was observed. An association between PIM and the number of prescribed medicines was found in all applied criteria. Moreover, an association between the number of PIMs and diagnoses of endocrine, nutritional, and metabolic diseases, mental, behavioral, and neurodevelopmental disorders, and circulatory system diseases and days of hospitalization was observed according to Beers criteria, and that with diseases of the circulatory system and musculoskeletal system and connective tissue was observed according to STOPP criteria.Conclusion: Despite the poor concordance between the EU(7)-PIM list, 2019 Beers, and STOPP v2 criteria, this work highlights the need for more studies in inpatients to develop strategies to facilitate the identification of PIM to decrease the high prevalence of PIM in hospitalized patients. The poor concordance among criteria also highlights the need to develop new tools adapting the existing criteria to medical ward inpatients.

scholarly journals Comparison of adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing potentially inappropriate medication use in Hong Kong older patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huanyu ZHANG ◽  
Eliza L. Y. WONG ◽  
Samuel Y. S. WONG ◽  
Patsy Y. K. CHAU ◽  
Benjamin H. K. YIP ◽  
...  
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Female Gender ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Beers Criteria ◽  
Medical Conditions ◽  
Cross Sectional

Abstract Background The Hong Kong-specific criteria have been established in 2019 to assess potentially inappropriate medication (PIM) use in older adults and improve the local prescribing quality. The aim of this study was to compare the adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing the prevalence and correlates of PIM use in Hong Kong older patients. Methods A cross-sectional study was performed from January 1, 2014 to December 31, 2014 using the Hospital Authority (HA) database. A total of 489,301 older patients aged 65 years and older visiting general outpatient clinics (GOPCs) during the study period were included in the study. Two categories of PIM use included in the Hong Kong-specific criteria and 2015 Beers criteria, i.e. PIMs independent of diagnoses and PIMs considering specific medical conditions, were adapted to assess the prevalence of PIM use among the study sample. Characteristics of PIM users and the most frequently prescribed PIMs were investigated for each set of the criteria. Factors associated with PIM use were identified using the stepwise multivariable logistic regression analysis. Results The adaptive Hong Kong-specific criteria could detect a higher prevalence of patients exposed to at least one PIM than that assessed by the adaptive Beers criteria (49.5% vs 47.5%). Meanwhile, the adaptive Hong Kong-specific criteria could identify a higher rate of patients exposed to PIMs independent of diagnoses (48.1% vs 46.8%) and PIMs considering specific medical conditions (7.3% vs 4.9%) compared with that of the adaptive Beers criteria. The most frequently prescribed PIMs detected by the adaptive Beers criteria were all included in the adaptive Hong Kong-specific criteria. The strongest factor associated with PIM use was number of different medications prescribed. Patients with female gender, aged 65 ~ 74 years, a larger number of GOPC visits, and more than six diagnoses were associated with greater risk of PIM use, whereas advancing age was associated with lower risk of PIM use. Conclusions The adaptive Hong Kong-specific criteria could detect a higher prevalence of PIM use than the adaptive Beers criteria in older adults visiting GOPCs in Hong Kong. It is necessary to update the prevalence and correlates of PIM use regularly in older adults to monitor the burden of PIM use and identify vulnerable patients who need further interventions.

scholarly journals Assessment of Inappropriate Prescribing to Elderly Patients in an Internal Medicine Ward According to the 2019 Beers Criteria

2020 ◽  
Vol 03 (02) ◽  
Author(s):  
Cátia Pereira ◽  
Ana Guiomar ◽  
Alexandra Cunha ◽  
Catarina Alves Cunha ◽  
José Pedro Barbosa ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Prescribing ◽  
Beers Criteria ◽  
Internal Medicine Ward

Potentially Inappropriate Medications in Nursing Home Residents: A Comparison of Two Approaches

2020 ◽  
pp. 016327871990065 ◽  
Author(s):  
Marko Stojanović ◽  
Milica Vuković ◽  
Milan Jovanović ◽  
Srđan Dimitrijević ◽  
Miroslav Radenković
Keyword(s):  
Nursing Home ◽  
Inappropriate Medication ◽  
Nursing Home Residents ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Limited Information ◽  
The European Union ◽  
Geriatric Population ◽  
Inappropriate Medications ◽  
The Eu

There is currently limited information on the comparative effectiveness of the European Union(7)-potentially inappropriate medication (EU(7)-PIM) list and the Beers criteria for screening PIMs, of which PIMs are a significant concern, in the geriatric population of nursing home residents. This study aims to determine and compare the rates of PIMs detected with the Beers criteria (five sections of which the first is a list of inappropriate medications in older adults) and the EU(7)-PIM list (based on the first section of the Beers criteria). The study, conducted in Gerontology Center Belgrade ( n = 427), is retrospective and observational. The EU(7)-PIM list detected 876 PIMs, while the first section of the Beers criteria detected 782 PIMs (1,803 with all five sections). The majority of PIMs belong to psychotropic drugs (benzodiazepines being the most common). The EU(7)-PIM list detected significantly more PIMs than the first section of the Beers criteria (2.03 ± 1.63 vs. 1.83 ± 1.27; p = .0005). The number of detected PIMs with both criteria correlates with age, the number of chronic illnesses, the number of medication prescribed, and the comorbidity status. Ultimately, the EU(7)-PIM list detected more PIMs compared to the first section of the Beers criterion.

scholarly journals Comparison of Beers criteria and EU(7) potentially inappropriate medications list for the potentially inappropriate medications in Indian elderly inpatients

2019 ◽  
Vol 8 (5) ◽  
pp. 1106
Author(s):  
Manoj H. Thummar ◽  
Tejas K. Patel ◽  
Varsha Y. Godbole ◽  
Manoj Kumar Saurabh
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Elderly Inpatients ◽  
Internal Medicine Wards ◽  
Inappropriate Medications

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.

scholarly journals Antidepressant use in older inpatients: current situation and application of the revised STOPP criteria

2018 ◽  
Vol 9 (8) ◽  
pp. 373-384 ◽  
Author(s):  
Lynn Gers ◽  
Mirko Petrovic ◽  
Stany Perkisas ◽  
Maurits Vandewoude
Keyword(s):  
Older Patients ◽  
Screening Tool ◽  
University Hospital ◽  
Evidence Based ◽  
Stopp Criteria ◽  
Patients With Diabetes ◽  
Older Inpatients ◽  
Antidepressant Use ◽  
Study Participants ◽  
Important Indication

Objectives: Antidepressant use increases as age rises. Moreover, older patients are more sensitive to side effects and drug interactions. This descriptive study aims to map antidepressant use among patients at the geriatrics department of a university hospital and to evaluate whether prescribing happens in an evidence-based manner. Methods: Patients aged 75 years and over, admitted to the geriatrics department of the Middelheim Hospital in Antwerp between February and July 2017 were included. We checked whether they took antidepressants, which types and doses were prescribed, who prescribed the antidepressants, and whether prescribing was in concordance with the revised STOPP (Screening Tool of Older People’s Prescriptions) criteria. Results: Out of the 239 included patients, 61 were found to use antidepressants, with depression being the most important indication. General practitioners appeared to be the most frequent prescribers. Trazodone was the most prescribed antidepressant and was often used for sleeping disorders. Antidepressants were taken longer than recommended in almost one out of five cases. Patients with diabetes and renal insufficiency were prescribed antidepressants less frequently. Only 2.8% of the study participants were prescribed antidepressants for anxiety disorders. Conclusion: We can conclude that prescription of antidepressants in older patients at the geriatrics department is often not evidence based. Clear guidelines may offer a solution; therefore more studies are needed on antidepressant use in older patients.

An open-label, single-center pilot study to test the effects of an amino acid mixture in older patients admitted to internal medicine wards

Nutrition ◽  
2020 ◽  
Vol 69 ◽  
pp. 110588 ◽  
Author(s):  
Francesco Bellanti ◽  
Aurelio Lo Buglio ◽  
Elena Di Stasio ◽  
Giorgia di Bello ◽  
Rosanna Tamborra ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Amino Acid ◽  
Pilot Study ◽  
Older Patients ◽  
Amino Acid Mixture ◽  
Acid Mixture ◽  
Single Center ◽  
Open Label ◽  
Internal Medicine Wards

scholarly journals Screening for atrial fibrillation during automated blood pressure measurement among patients admitted to internal medicine ward

2021 ◽  
Author(s):  
Giacomo Pucci ◽  
Edoardo Santoni ◽  
Valeria Bisogni ◽  
Camilla Calandri ◽  
Alberto Cerasari ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Atrial Fibrillation ◽  
Blood Pressure ◽  
Adult Population ◽  
Blood Pressure Measurement ◽  
University Hospital ◽  
Daily Routine ◽  
Internal Medicine Ward ◽  
Clinical Conditions ◽  
Electrocardiogram Ecg

AbstractAtrial fibrillation (AF), the commonest sustained cardiac arrhythmia affecting the adult population, is often casually discovered among hospitalized people. AF onset is indeed triggered by several clinical conditions such as acute inflammatory states, infections, and electrolyte disturbance, frequently occurring during the hospitalization. We aimed to evaluate whether systematic AF screening, performed through an automated oscillometric blood pressure (BP) device (Microlife WatchBP Office AFIB, Microlife AG, Switzerland), is effective for detecting AF episodes in subjects admitted to an Internal Medicine ward. 163 patients consecutively hospitalized at the Unit of Internal Medicine of the “Santa Maria” Terni University Hospital between November 2019 and January 2020 (mean age ± standard deviation: 77 ± 14 years, men proportion: 40%) were examined. Simultaneously with BP measurement and AF screening, a standard 12-lead electrocardiogram (ECG) was performed in all subjects. AF was diagnosed by ECG in 29 patients (18%). AF screening showed overall 86% sensitivity and 96% specificity. False negatives (n = 4) had RR-interval coefficient of variation lower than true positives (n = 25, p < 0.01), suggesting a regular ventricular rhythm during AF. The repeated evaluation substantially confirmed the same level of agreement. AF screening was positive in all patients with new-onset AF (n = 6, 100%). Systematic AF screening in patients admitted to Internal Medicine wards, performed using the Microlife WatchBP Office AFIB, is feasible and effective. The opportunity to implement such technology in daily routine clinical practice to prevent undiagnosed AF episodes in hospitalized patients should be the subject of further research.

scholarly journals Prevalence and determinants of potentially inappropriate medication use in Hong Kong older patients: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051527
Author(s):  
Huanyu Zhang ◽  
Eliza LY Wong ◽  
Samuel YS Wong ◽  
Patsy YK Chau ◽  
Benjamin HK Yip ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Analysis ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Sectional Study ◽  
Cross Sectional

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.

scholarly journals Comparative study of the prevalence of sepsis in patients admitted to dermatology and internal medicine wards

2013 ◽  
Vol 88 (5) ◽  
pp. 739-747
Author(s):  
Luiz Mauricio Costa Almeida ◽  
Michelle dos Santos Diniz ◽  
Lorena dos Santos Diniz ◽  
Jackson Machado-Pinto ◽  
Francisco Chagas Lima Silva
Keyword(s):  
Internal Medicine ◽  
Comparative Study ◽  
Medical Records ◽  
Skin Barrier ◽  
Epidemiological Studies ◽  
Internal Medicine Ward ◽  
Cross Sectional ◽  
Systemic Corticosteroids ◽  
Internal Medicine Wards ◽  
Belo Horizonte

BACKGROUND: Sepsis is a common cause of morbidity and mortality among hospitalized patients. The prevalence of this condition has increased significantly in different parts of the world. Patients admitted to dermatology wards often have severe loss of skin barrier and use systemic corticosteroids, which favor the development of sepsis. OBJECTIVES: To evaluate the prevalence of sepsis among patients admitted to a dermatology ward compared to that among patients admitted to an internal medicine ward. METHODS: It is a cross-sectional, observational, comparative study that was conducted at Hospital Santa Casa de Belo Horizonte. Data were collected from all patients admitted to four hospital beds at the dermatology and internal medicine wards between July 2008 and July 2009. Medical records were analyzed for the occurrence of sepsis, dermatologic diagnoses, comorbidities, types of pathogens and most commonly used antibiotics. RESULTS: We analyzed 185 medical records. The prevalence of sepsis was 7.6% among patients admitted to the dermatology ward and 2.2% (p = 0.10) among those admitted to the internal medicine ward. Patients with comorbidities, diabetes mellitus and cancer did not show a higher incidence of sepsis. The main agent found was Staphylococcus aureus, and the most commonly used antibiotics were ciprofloxacin and oxacillin. There was a significant association between sepsis and the use of systemic corticosteroids (p <0.001). CONCLUSION: It becomes clear that epidemiological studies on sepsis should be performed more extensively and accurately in Brazil so that efforts to prevent and treat this serious disease can be made more effectively.

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