scholarly journals The Burden of Potentially Inappropriate Medications in Chronic Polypharmacy

2020 ◽  
Vol 9 (11) ◽  
pp. 3728
Author(s):  
Jordan Guillot ◽  
Sandy Maumus-Robert ◽  
Alexandre Marceron ◽  
Pernelle Noize ◽  
Antoine Pariente ◽  
...  
Keyword(s):  
Older Adults ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medications ◽  
Middle Aged ◽  
Cross Sectional ◽  
Long Acting ◽  
Chronic Use ◽  
Inappropriate Medications

We aimed to describe the burden represented by potentially inappropriate medications (PIMs) in chronic polypharmacy in France. We conducted a nationwide cross-sectional study using data from the French National Insurance databases. The study period was from 1 January 2016 to 31 December 2016. Chronic drug use was defined as uninterrupted daily use lasting ≥6 months. Chronic polypharmacy was defined as the chronic use of ≥5 medications, and chronic hyperpolypharmacy as the chronic use of ≥10 medications. For individuals aged ≥65 (older adults), PIMs were defined according to the Beers and Laroche lists, and for individuals aged 45–64 years (middle-aged) PIMs were defined according to the PROMPT (Prescribing Optimally in Middle-aged People’s Treatments) list. Among individuals with chronic polypharmacy, 4009 (46.2%) middle-aged and 18,036 (64.8%) older adults had at least one chronic PIM. Among individuals with chronic hyperpolypharmacy, these figures were, respectively, 570 (75.0%) and 2544 (88.7%). The most frequent chronic PIM were proton pump inhibitors (43.4% of older adults with chronic polypharmacy), short-acting benzodiazepines (older adults: 13.7%; middle-aged: 16.1%), hypnotics (6.1%; 7.4%), and long-acting sulfonylureas (3.9%; 12.3%). The burden of chronic PIM appeared to be very high in our study, concerning almost half of middle-aged adults and two-thirds of older adults with chronic polypharmacy. Deprescribing interventions in polypharmacy should primarily target proton pump inhibitors and hypnotics.

scholarly journals Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

2021 ◽  
Vol 12 ◽  
pp. 215013272110350
Author(s):  
Pasitpon Vatcharavongvan ◽  
Viwat Puttawanchai
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Clinical Decision ◽  
Cross Sectional Study ◽  
Study Data ◽  
Patient Specific ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medications

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.

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

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.

scholarly journals The use of proton pump inhibitors among older adults with intellectual disability: A cross sectional observational study

2018 ◽  
Vol 26 (7) ◽  
pp. 1012-1021
Author(s):  
Hadiah AlMutairi ◽  
Máire O'Dwyer ◽  
Mary McCarron ◽  
Philip McCallion ◽  
Martin C. Henman
Keyword(s):  
Older Adults ◽  
Intellectual Disability ◽  
Observational Study ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cross Sectional

scholarly journals Effects of Attitude, Motivation, and Eagerness for Physical Activity among Middle-Aged and Older Adults

2020 ◽  
Vol 2020 ◽  
pp. 1-9
Author(s):  
Md Mizanur Rahman ◽  
Dongxiao Gu ◽  
Changyong Liang ◽  
Rao Muhammad Rashid ◽  
Monira Akter
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Positive Attitude ◽  
Sports Participation ◽  
Cost Effective ◽  
Cross Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Cost Effective Method ◽  
Global Statistics

Background. Although physical activity (PA) is a noninvasive and cost-effective method of improving the quality of health, global statistics show that only a few middle-aged and older adults engage in the recommended PAs. This is due to a lack of motivation and companionship. Objective. This study analyses the attitudes and self-determined motivation of Chinese middle-aged and older adults for PAs and their eagerness to participate in PAs such as sports, exercise, and recreational and cultural activities (RCAs), from attitudinal, eagerness, and motivational objectives of PAs perspective. Methods. A cross-sectional study was carried out on 840 middle-aged (35–54 years) and older adults (55+ years). To determine their attitude, eagerness, and self-determined motivation for PA, we used attitudinal, Eagerness for Physical Activity Scale (EPAS), and Situational Motivational Scale (SIMS). The data were analyzed with SPSS 23.0. Results. The results show that 39.1% of the participants were not satisfied with PAs. Compared with females, males reported a less positive attitude towards PAs. Moreover, a positive attitude decreases with age. Participants’ motivation and eagerness in activities such as RCAs, exercise, and sports are decreasing. Regarding self-determined motivation, there are gender differences in RCAs, but there is none for exercise and sports participation. Conclusion. The findings show the importance of RCAs and the support of family and friends enhancing the eagerness, attitude, and motivation to participate in PAs. Furthermore, the findings can help to create more effective PA programs for middle-aged and older adults. By engaging in RCAs, participants can reap the benefits of PAs. Participating in RCAs can lead to social equity in health.

scholarly journals Prevalence of potentially inappropriate medications at admission and discharge among hospitalised elderly patients with acute medical illness at a single centre in Japan: a retrospective cross-sectional study

BMJ Open ◽  
2018 ◽  
Vol 8 (7) ◽  
pp. e021152 ◽  
Author(s):  
Junpei Komagamine
Keyword(s):  
Elderly Patients ◽  
Cross Sectional Study ◽  
Medical Illness ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Single Centre ◽  
Cross Sectional ◽  
Coronary Syndrome ◽  
Hospitalised Patients ◽  
Inappropriate Medications

ObjectiveTo determine the prevalence of potentially inappropriate medications (PIMs) at admission and discharge among hospitalised elderly patients with acute medical illness in Japan.DesignA retrospective single-centre cross-sectional study.ParticipantsHospitalised patients aged 65 years or older admitted for pneumonia, heart failure, ischaemic stroke, acute coronary syndrome, chronic obstructive pulmonary disease or asthma, gastrointestinal bleeding, urinary tract infection or epilepsy from September 2014 to June 2016 who were still alive at discharge.Main outcome measuresThe primary outcome was the proportion of patients taking at least one PIM at admission and discharge. PIMs were defined based on the 2015 American Geriatric Society Beers Criteria. Temporal changes in the proportion of patients taking at least one PIM from admission to discharge were also evaluated.ResultsDuring the study period, 689 eligible patients were identified. The median patient age was 82.0 years (IQR 76.0–88.0), 348 (50.5%) were men and the median number of medications at admission was 5.0 (IQR 3.0–8.0). The proportions of patients taking any PIMs at admission and discharge were 47.9% (95% CI 44.2% to 51.6%) and 25.1% (95% CI 21.9% to 28.4%), respectively. The proportion of patients taking any PIMs was significantly lower at discharge than at admission (reduction rate 0.48, 95%, CI 0.41 to 0.53).ConclusionsA substantial proportion of hospitalised elderly patients with acute medical illness took PIMs at admission and discharge. These findings should be confirmed at other hospitals in Japan.

Benefits of volunteerism for middle-aged and older adults: comparisons between types of volunteering activities

2021 ◽  
pp. 1-20
Author(s):  
Alfred H. K. Lam ◽  
Dannii Y. Yeung ◽  
Edwin K. H. Chung
Keyword(s):  
Older Adults ◽  
Life Satisfaction ◽  
Depressive Symptoms ◽  
Cross Sectional Study ◽  
Middle Aged ◽  
Cross Sectional ◽  
Health And Wellbeing ◽  
Hand Grip ◽  
Middle Aged Adults ◽  
Main Effects

Abstract Volunteering is a popular activity among middle-aged and older adults as means to contribute to the society and to maintain personal health and wellbeing. While the benefits of volunteering have been well-documented in the current literature, it does not tend to distinguish between various types of volunteering activities. This cross-sectional study aims to compare the effects of instrumental (e.g. food preparation, fundraising) and cognitively demanding volunteering activities (e.g. befriending, mentoring) in a sample of 487 middle-aged and older Hong Kong Chinese adults. Participation in instrumental and cognitively demanding volunteering, life satisfaction, depressive symptoms, cognitive functioning and hand-grip strength were measured. The results of two-way between-subject robust analyses of variance demonstrated significant main effects of volunteering type and their interaction effect with age on life satisfaction and depressive symptoms. Comparisons among four volunteering groups (no volunteering, instrumental volunteering, cognitively demanding volunteering and both types) revealed that individuals engaging in instrumental volunteering exhibited lower life satisfaction and more depressive symptoms compared to those who engaged in cognitively demanding volunteering and those who did not volunteer at all. This detrimental pattern of instrumental volunteering was only seen in middle-aged adults, but not in older adults. Findings of this study revealed distinctive effects of two volunteering types, and provide valuable directions for designing future volunteering programmes.

Prevalence and Associations of the Use of Proton-Pump Inhibitors in Nursing Homes: A Cross-Sectional Study

2013 ◽  
Vol 14 (4) ◽  
pp. 265-269 ◽  
Author(s):  
Philipe de Souto Barreto ◽  
Maryse Lapeyre-Mestre ◽  
Céline Mathieu ◽  
Christine Piau ◽  
Catherine Bouget ◽  
...  
Keyword(s):  
Nursing Homes ◽  
Proton Pump Inhibitors ◽  
Proton Pump ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional

scholarly journals 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 ◽  
2018 ◽  
Vol 54 (4) ◽  
pp. 57 ◽  
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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