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Alwhaibi, Monira, and Hadeel Alkofide. "Potentially Inappropriate Medications Use among Older Adults with Dyslipidaemia." Journal of Clinical Medicine 12, no. 12 (2023): 4063. http://dx.doi.org/10.3390/jcm12124063.
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Background: Since older patients with dyslipidemia frequently receive many prescriptions, medication errors are typical and expected in this population. This risk has increased by using potentially inappropriate medications. The 2019 Beers criteria were used in this study to investigate potentially inappropriate medication use among older individuals with dyslipidemia. Methods: A cross-sectional retrospective analysis used data from electronic medical records from an ambulatory-care environment. Patients with dyslipidemia who were older adults (>65 years old) were included. To describe and find potential determinants of potentially inappropriate medication usage, descriptive statistics and logistic regression were employed. Results: This study included 2209 older adults (age ≥ 65) with dyslipidemia. The mean age was 72.1 ± 6.0 years, and the majority of the study sample had hypertension (83.7%) and diabetes (61.7%), and around 80.0% were using polypharmacy. The prevalence of potentially inappropriate medications to be avoided among older adults with dyslipidemia was 48.6%. A high risk of potentially inappropriate medication usage was found in older patients with dyslipidemia who had polypharmacy and comorbid diabetes, ischemic heart disease, and anxiety. Conclusions: This study showed that the number of medications prescribed and the presence of concurrent chronic health conditions are important indicators of the risk of potentially inappropriate medications in ambulatory older patients with dyslipidemia.
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Lee, Daphne, Nataly Martini, Simon Moyes, Karen Hayman, Monica Zolezzi, and Ngaire Kerse. "Potentially inappropriate medication use: the Beers Criteria used among older adults with depressive symptoms." Journal of Primary Health Care 5, no. 3 (2013): 182. http://dx.doi.org/10.1071/hc13182.
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INTRODUCTION: The ageing population means prescribing for chronic illnesses in older people is expected to rise. Comorbidities and compromised organ function may complicate prescribing and increase medication-related risks. Comorbid depression in older people is highly prevalent and complicates medication prescribing decisions. AIM: To determine the prevalence of potentially inappropriate medication use in a community-dwelling population of older adults with depressive symptoms. METHODS: The medications of 191 community-dwelling older people selected because of depressive symptoms for a randomised trial were reviewed and assessed using the modified version of the Beers Criteria. The association between inappropriate medication use and various population characteristics was assessed using Chi-square statistics and logistic regression analyses. RESULTS: The mean age was 81 (±4.3) years and 59% were women. The median number of medications used was 6 (range 121 medications). The most commonly prescribed potentially inappropriate medications were amitriptyline, dextropropoxyphene, quinine and benzodiazepines. Almost half (49%) of the participants were prescribed at least one potentially inappropriate medication; 29% were considered to suffer significant depressive symptoms (Geriatric Depression Scale =5) and no differences were found in the number of inappropriate medications used between those with and without significant depressive symptoms (Chi-square 0.005 p=0.54). DISCUSSION: Potentially inappropriate medication use, as per the modified Beers Criteria, is very common among community-dwelling older people with depressive symptoms. However, the utility of the Beers Criteria is lessened by lack of clinical correlation. Ongoing research to examine outcomes related to apparent inappropriate medication use is needed. KEYWORDS: Depression; depressive symptoms; inappropriate prescribing; older adults
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Gray, Shelly L., Susan C. Hedrick, Ellen E. Rhinard, et al. "Potentially Inappropriate Medication Use in Community Residential Care Facilities." Annals of Pharmacotherapy 37, no. 7-8 (2003): 988–93. http://dx.doi.org/10.1345/aph.1c365.
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OBJECTIVE: To describe the prevalence of potentially inappropriate medication use in community residential care (CRC) facilities at baseline, describe exposure to potentially inappropriate drugs during the 1-year follow-up, and examine characteristics associated with potentially inappropriate use. DESIGN: A cohort study was conducted using 282 individuals aged ≥65 years entering a CRC facility in a 3-county area in the Puget Sound region of Washington State between April 1998 and December 1998 on Medicaid funding. MAIN OUTCOME MEASURE: Use of potentially inappropriate medications as defined by explicit criteria (e.g., drugs that should generally be avoided in the elderly because potential risks outweigh any potential benefits). RESULTS: Sixty-two (22%) residents took a total of 75 potentially inappropriate medications at baseline. The most common agents used at baseline were oxybutynin (3.5%) and amitriptyline (3.5%). The incidence of new use of potentially inappropriate medications was 0.1/100 person-days during the follow-up period. Potentially inappropriate use was related to self-reported fair or poor health (adjusted OR 1.42; 95% CI 1.05 to 1.92) and number of prescription drugs (adjusted OR 1.12; 95% CI 1.05 to 1.19). In the Cox proportional hazard model, no characteristics predicted new potentially inappropriate medication use during the follow-up. CONCLUSIONS: Potentially inappropriate medication use is common among residents in CRC facilities. A comprehensive periodic review may be beneficial for reducing potentially inappropriate use, especially for patients taking multiple drugs.
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Bazargan, Mohsen, James Smith, Masoud Movassaghi, et al. "Polypharmacy among Underserved Older African American Adults." Journal of Aging Research 2017 (2017): 1–8. http://dx.doi.org/10.1155/2017/6026358.
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The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants’ characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively. Thirty-eight percent of participants received prescription medications from at least three providers. Inappropriate drug use occurred among seventy percent of the participants. Multivariate analysis showed that number of providers was the strongest correlate of polypharmacy. Moreover, data show that gender, comorbidity, and potentially inappropriate medication use are other major correlates of polypharmacy. Conclusions. This study shows a high rate of polypharmacy and potentially inappropriate medication use among underserved older African American adults. We documented strong associations between polypharmacy and use of potentially inappropriate medications, comorbidities, and having multiple providers. Polypharmacy and potentially inappropriate medications may be attributed to poor coordination and management of medications among providers and pharmacists. There is an urgent need to develop innovative and effective strategies to reduce inappropriate polypharmacy and potentially inappropriate medication in underserved elderly minority populations.
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Aparasu, Rajender R., and Jane R. Mort. "Inappropriate Prescribing for the Elderly: Beers Criteria-Based Review." Annals of Pharmacotherapy 34, no. 3 (2000): 338–46. http://dx.doi.org/10.1345/aph.19006.
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OBJECTIVE: To review currently available literature applying the Beers criteria for inappropriate medication use in the elderly to prescribing practices in various settings. DATA SOURCE: Key words including inappropriate, Beers, medication, prescribing, elderly, geriatric, and criteria were used to search MEDLINE records from January 1992 to June 1999. DATA EXTRACTION: Eight relevant studies were found that applied the Beers criteria in various healthcare settings. DATA SYNTHESIS: Each study was examined for methodologic issues, criteria used, prevalence, nature and extent of inappropriate medication use, and factors associated with their use. Despite the methodologic differences, the review revealed some consistent patterns across healthcare settings. This review has shown that: (1) most of the researchers modified the Beers criteria to examine inappropriate medication use in the elderly; (2) studies using patient-based prevalence showed that between nearly one in four (23.5%) and one in seven (14.0%) elderly patients received an inappropriate medication as defined by either the Beers list of 20 inappropriate medications or the Modified Beers list; (3) the majority of these patients received one inappropriate agent; and (4) long-acting benzodiazepines, dipyridamole, propoxyphene, and amitriptyline were among the most frequently prescribed inappropriate medications. Univariate analyses indicated that women, patients >80 years old, and Medicaid patients appeared to receive more inappropriate medications than others; however, multivariate analyses found that only a higher number of medications was consistently associated with inappropriate medication use. CONCLUSIONS: Inappropriate prescribing or use trends are noteworthy because they were observed despite methodologic differences. The findings can be instrumental in developing targeted interventions to influence future prescribing practices. More research is needed to address the national trends and healthcare impact of inappropriate drug use in the elderly.
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Patel, Tejal, Karen Slonim, and Linda Lee. "Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature." Canadian Pharmacists Journal / Revue des Pharmaciens du Canada 150, no. 3 (2017): 169–83. http://dx.doi.org/10.1177/1715163517701770.
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Background: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use. Methods: MEDLINE, EMBASE, CINAHL, and International Pharmaceutical Abstracts were searched between 1946 and 2014 for articles that referenced potentially inappropriate medication use and types of dementia. One reviewer screened all titles and abstracts from the initial search and full-text articles after the initial screen for eligibility, then 2 reviewers independently abstracted data from included studies. Results: Searches yielded 81 articles, of which 7 met inclusion criteria. Prevalence of potentially inappropriate medication use varied from 15% to 46.8%. No single drug or drug class was reported consistently across all studies as the most frequent potentially inappropriate medication, but anticholinergics and benzodiazepines, drugs that affect cognition, were among the most common medications or pharmacological classes listed. Discussion: Older adults with dementia may be particularly vulnerable to potentially inappropriate medications because of cognitive impairment from their condition and the greater likelihood of experiencing adverse events from medications. Given this population’s greater susceptibility to adverse events, more intense medication and patient monitoring may be warranted, especially among those taking anticholinergics and benzodiazepines, as these drugs can contribute to cognitive impairment.
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Paksoy, Ceylan, Öznur Özkan, Bala BÖ Ustaalioğlu, et al. "Evaluation of potentially inappropriate medication utilization in elderly patients with cancer at outpatient oncology unit." Journal of Oncology Pharmacy Practice 25, no. 6 (2018): 1321–27. http://dx.doi.org/10.1177/1078155218788698.
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Background The aim of the study was to evaluate potentially inappropriate medication use in elderly patients with cancer. Method This study was conducted at outpatient oncology clinic from December 2014 to March 2015 among elderly cancer patients. Screening Tool of Older Person's Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria were used to identify potentially inappropriate medication in elderly patients. Results Among 114 cancer patients 55.26% of them were male and the mean age of them was 71.78 ± 5.50 (years). The most common concurrent diseases were hypertension in 45 (39.47%) and diabetes in 26 (22.81%) patients. Polypharmacy (≥5 medications) was seen in 94.73% of them. Eighteen patients (15.79%) utilized medications inappropriately according to Screening Tool of Older Person's Prescriptions criteria. Medication omissions were identified in 112 patients (98.25%) with Screening Tool to Alert doctors to Right Treatment criteria. Conclusions Clinical pharmacists could improve the current prescribing practices in elderly patients with cancer by assessing potentially inappropriate medications.
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Laurier, Claudine, Yola Moride, and Wendy A. Kennedy. "Health Survey Data on Potentially Inappropriate Geriatric Drug Use." Annals of Pharmacotherapy 36, no. 3 (2002): 404–9. http://dx.doi.org/10.1345/aph.1z445.
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BACKGROUND: Studies have suggested that elderly patients do not always use medications appropriately. Investigations that have relied on prescription claim databases or clinical records focus on acquisition or prescription, and hypotheses must be made to assess actual consumption. Population survey data constitute an alternative way to study inappropriate use. OBJECTIVE: To estimate the prevalence of potentially inappropriate use of medications in elderly patients in Québec based on self-reported use. METHODS: Using a cross-sectional, general population, health survey in which self-reported medication use in the 2 days prior to the survey was recorded, we estimated the prevalence of inappropriate medication use in elderly patients (≥65 y old) who responded. Two sets of published criteria were used to define inappropriate use: one to assess use of inappropriate drugs, and another to assess concomitant duplications and potential interactions. RESULTS: Of the 3400 patients surveyed, 6.5% had used ≥1 inappropriate drugs, 2.5% had ≥1 occurrences of potentially inappropriate duplication of medications, and 2.7% had ≥1 potential medication interactions. Concomitant use of at least 2 benzodiazepines was reported by 8.5% of respondents using these drugs. Use of ≥1 long-acting benzodiazepines was reported by 4.2% of the sample. CONCLUSIONS: Population health surveys are a useful tool for detecting potentially inappropriate medication use in the elderly. In particular, the high prevalence of inappropriate use of benzodiazepines signals a need for improved detection and intervention in this group. TRANSFONDO: Existen estudios que demuestran que los ciudadanos viejos no siempre usan sus medicamentos adecuadamente. Estudios basados en los bancos de datos de los reclamos de prescripción o expedientes clínicos se hacen a base de la adquisición o prescripción de medicamentos. De estos se crean hipótesis para estimar el consumo real de medicamentos. Una manera alterna de realizar estudios sobre el uso inapropiado de medicamentos lo es a través de datos obtenidos de encuestas poblacionales.
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Rababa, Mohammad, and Ali Al Ghazo. "OLDER ADULTS’ PERCEPTION TOWARD DEPRESCRIBING INAPPROPRIATE MEDICATIONS." Innovation in Aging 8, Supplement_1 (2024): 879. https://doi.org/10.1093/geroni/igae098.2841.
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Abstract Introduction Inappropriate prescription of medications is a problem of growing interest in geriatrics. Initiatives have been ongoing to evaluate interventions targeting the hazards of inappropriate prescription of medications; Deprescribing is one of these initiatives. However, no current study has examined medicine-related perceptions toward deprescribing inappropriate medications among older adults. Methods A convenience sample of older adults who regularly visited the outpatient clinics during July 2023 for regular checkups were recruited. Data were collected by a graduate nursing student from one pharmacy located in a public hospital, five days per week, via in-person interviews using the Patient’s Perceptions of Deprescribing survey. Results The study found that older adults’ perceived interest in stopping medications, belief about medicine overuse, the unimportance of medicines, and medication concerns are significantly associated with a variety of sociodemographic (e.g., age), clinical (e.g., comorbidities), and PCP-related factors (e.g., knowledge of medications). Conclusion Inappropriate prescription of medication is one of the most common polypharmacy-related issues among older adults. The current study reported its findings on medicine-related perception toward deprescribing inappropriate medications among older adults. Care providers should discuss the benefits of deprescribing inappropriate medications with their patients to prevent the side effects associated with long-term unnecessary use. The long-term use of inappropriate medications by older adults should be carefully evaluated. Future studies on the effectiveness of an evidence-based deprescribing protocol on minimizing the clinical side effects associated with inappropriate prescription of medications among older adults are recommended.
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Travers, Jasmine L., Erinn M. Hade, Steven Friedman, Aasha Raval, Kimberly Hadson, and Jason R. Falvey. "Staffing and Antipsychotic Medication Use in Nursing Homes and Neighborhood Deprivation." JAMA Network Open 7, no. 4 (2024): e248322. http://dx.doi.org/10.1001/jamanetworkopen.2024.8322.
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ImportanceInappropriate use of antipsychotic medications in nursing homes is a growing public health concern. Residents exposed to higher levels of socioeconomic deprivation in the area around a nursing home may be currently exposed, or have a long history of exposure, to more noise pollution, higher crime rates, and have less opportunities to safely go outside the facility, which may contribute to psychological stress and increased risk of receiving antipsychotic medications inappropriately. However, it is unclear whether neighborhood deprivation is associated with use of inappropriate antipsychotic medications and whether this outcome is different by facility staffing levels.ObjectiveTo evaluate whether reported inappropriate antipsychotic medication use differs in severely and less severely deprived neighborhoods, and whether these differences are modified by higher levels of total nurse staffing.Design, Setting, and ParticipantsThis was a cross-sectional analysis of a national sample of nursing homes that linked across 3 national large-scale data sets for the year 2019. Analyses were conducted between April and June 2023.ExposureNeighborhood deprivation status (severe vs less severe) and total staffing hours (registered nurse, licensed practical nurse, certified nursing assistant).Main Outcome and MeasuresThis study estimated the association between neighborhood deprivation and the percentage of long-stay residents who received an antipsychotic medication inappropriately in the nursing home at least once in the past week and how this varied by nursing home staffing through generalized estimating equations. Analyses were conducted on the facility level and adjusted for state fixed effects.ResultsThis study included 10 966 nursing homes (1867 [17.0%] in severely deprived neighborhoods and 9099 [83.0%] in less deprived neighborhoods). Unadjusted inappropriate antipsychotic medication use was greater in nursing homes located in severely deprived neighborhoods (mean [SD], 15.9% [10.7%] of residents) than in those in less deprived neighborhoods (mean [SD], 14.2% [8.8%] of residents). In adjusted models, inappropriate antipsychotic medication use was higher in severely deprived neighborhoods vs less deprived neighborhoods (19.2% vs 17.1%; adjusted mean difference, 2.0 [95% CI, 0.35 to 3.71] percentage points) in nursing homes that fell below critical levels of staffing (less than 3 hours of nurse staffing per resident-day).Conclusions and RelevanceThese findings suggest that levels of staffing modify disparities seen in inappropriate antipsychotic medication use among nursing homes located in severely deprived neighborhoods compared with nursing homes in less deprived neighborhoods. These findings may have important implications for improving staffing in more severely deprived neighborhoods.
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Voukelatou, Panagiota, Ioannis Vrettos, Georgia Emmanouilidou, et al. "Predictors of Inappropriate Proton Pump Inhibitors Use in Elderly Patients." Current Gerontology and Geriatrics Research 2019 (January 1, 2019): 1–5. http://dx.doi.org/10.1155/2019/7591045.
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Introduction. Overutilization of Proton Pump Inhibitors (PPIs) both in ambulatory care and in the inpatient setting possesses economic implications and increases the risk for adverse drug reactions. This study was undertaken to identify factors associated with inappropriate PPI use among consecutively unplanned admissions of elderly patients at the time of admission. Materials and Methods. In 758 patients (54.2% women), mean age 80.3±8.0 (M±1SD), demographic characteristics, and medical and medication history were recorded. Parametric tests and multiple logistic regression analysis were applied to identify the predictors of inappropriate PPI use. Results. 232 patients (30.6%) were receiving PPIs. 37 (4.9%) were receiving PPIs appropriately and 195 (25.7%) were receiving PPIs without a proper indication. Consequently, PPIs prescribing was inappropriate in 195/232 (84%). Moreover, 512 patients (67.5%) were not receiving PPIs appropriately and 14 patients (1.8%) were not receiving PPIs but they had a proper indication. When we compared patients receiving PPIs without a proper indication with those who were not receiving PPIs, a statistical difference was found according to Charlson Comorbidity Index (p≤0.001, U=37922.00), number of diseases (p≤0.001, U=33269.00) and medications (p≤0.001, U=31218.50), Katz Index score (p=0.01, U=45328.00), and the use of blood thinners (p≤0.001, χ2=21.15). In multivariate analysis the only independent predictor of inappropriate PPI use was the number of medications (p=0.001, OR=1.16, 95%CI 1.06-1.27). Conclusions. The main predictor of inappropriate PPI use was the number of received medications. Εfforts needed to apply the predefined criteria for PPI prescription and to deprescribe PPIs received inappropriately.
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Sui, Jane Sze Yin, Ciara Marie Kelly, Patrick Barry, et al. "Inappropriate prescribing in older patients with cancer." Journal of Clinical Oncology 31, no. 15_suppl (2013): e20550-e20550. http://dx.doi.org/10.1200/jco.2013.31.15_suppl.e20550.
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e20550 Background: Inappropriate medication use is common among community dwelling and hospitalized older adults but understudied in the oncology population. We measured the incidence of inappropriate prescribing among older cancer patients attending an oncology day-ward for systemic therapy. Methods: The tools used to identify inappropriate prescribing were the Beers’ criteria (both Independent [ID] of and Considering diagnosis [CD] – 2012 version) and the STOPP tool (Screening Tool of Older People’s potentially inappropriate Prescriptions). The setting was an urban based hospital oncology day-ward. Consecutive subjects ≥ 70 years were screened and all had both tools applied to their prescription drugs, cross referenced with their current active medical diagnosis. Results: Medication lists were collected from 96 patients from November 1st 2012 to January 31st2013: 52% male, mean age 75 years (range 70-88). The most common cancers were colorectal (24%), breast (23%), lung (11%) and prostate (11%). 38 patients (40%) were on 0-4, 49 (51%) on 5-9 and 9 (9%) on >9 medications. The total number of inappropriate prescriptions (Beers ID and CD “medications to avoid”) was 34, prescribed in 29 (30%) patients. The most common drug prescribed inappropriately as per these criteria was the antiemetic, metoclopramide (n=10, 29%). An additional 70 prescriptions were dispensed for Beers “medications to use with caution” in 55 (57%) patients - predominantly vasodilators. The STOPP tool identified 13 inappropriate prescriptions in 12 patients (13%). The two most commonly prescribed inappropriate medications were long acting benzodiazepines (n=4) and long term use of sedating antihistamines (n=3). Conclusions: This study identified a high rate of inappropriate prescribing among this population using both tools, with a higher rate identified by the Beers Criteria. Routine application of a validated tool to identify inappropriate prescribing has merit in the oncology setting to minimize risk to patients. However, the development of an easy to apply tool that considers the underlying cancer diagnosis, prognosis, cancer treatment and necessary supportive therapy is warranted.
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Andrade, Amanda, Tânia Nascimento, Catarina Cabrita, Helena Leitão, and Ezequiel Pinto. "Potentially Inappropriate Medication: A Pilot Study in Institutionalized Older Adults." Healthcare 12, no. 13 (2024): 1275. http://dx.doi.org/10.3390/healthcare12131275.
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Institutionalized older adults often face complex medication regimens, increasing their risk of adverse drug events due to polypharmacy, overprescribing, medication interactions, or the use of Potentially Inappropriate Medications (PIM). However, data on medication use and associated risks in this population remain scarce. This pilot study aimed to characterize the sociodemographic, clinical and pharmacotherapeutic profiles, and the use of PIM among institutionalized elders residing in Residential Structures for Elderly People (ERPI) in the Faro municipality, located in the Portuguese region of the Algarve. We conducted a cross-sectional study in a non-randomized sample of 96 participants (mean age: 86.6 ± 7.86 years) where trained researchers reviewed medication profiles and identified potentially inappropriate medications using the EU(7)-PIM list. Over 90% of participants exhibited polypharmacy (≥5 medications), with an average of 9.1 ± 4.15 medications per person. About 92% had potential drug interactions, including major and moderate interactions. More than 86% used at least one potentially inappropriate medication, most commonly central nervous system drugs. This pilot study demonstrates that institutionalized older adults may be at high risk of potential medication-related problems. Implementing comprehensive medication review programs and promoting adapted prescribing practices are crucial to optimize medication use and improve the well-being of this vulnerable population.
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Ganassin, Amanda Rodrigues, Vanessa Terezinha Gubert de Matos, and Mônica Cristina Toffoli-Kadri. "Potentially inappropriate medication use in institutionalized older adults according to the Beers Criteria." Brazilian Journal of Pharmaceutical Sciences 50, no. 4 (2014): 827–37. http://dx.doi.org/10.1590/s1984-82502014000400018.
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The need for specific care, coupled with new family arrangements, has contributed to the increasing institutionalization of elderly members. The purpose of this study was to evaluate drug use by institutionalized older adults according to Beers Criteria. This prospective, longitudinal study was conducted in the three non-profit long-stay geriatric care institutions of Campo Grande, in the Central-West region of Brazil. All subjects aged 60 years and above on November 2011 were included and followed until November 2012. Eighteen subjects were excluded and the final sample consisted of 133 individuals aged 60 to 113 years. Overall, 212 medications were used at geriatric care institution A, 532 at B, and 1329 at C. Thirty-four drugs were inappropriately prescribed 89 times at geriatric care institution A (41.98%), 49 prescribed 177 times at B (33.27%), and 91 prescribed 461 times at C (34.68%). Statistical differences in the inappropriate drug use were found between genders (p=0.007). The most commonly used potentially inappropriate medication were first-generation antihistamines (15.34%). There was a high frequency in the use of potentially inappropriate medications which can initiate marked side effects and may compromise the fragile health of institutionalized elderly. Thus, adopting the Beers Criteria in prescribing medication contributes to minimize adverse reactions and drug interactions.
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Manias, Elizabeth, Md Zunayed Kabir, and Andrea B. Maier. "Inappropriate medications and physical function: a systematic review." Therapeutic Advances in Drug Safety 12 (January 2021): 204209862110303. http://dx.doi.org/10.1177/20420986211030371.
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Background and aims: Inappropriate medication prescription is highly prevalent in older adults and is associated with adverse health outcomes. The aim of this study was to examine the associations between potentially inappropriate medications (PIMS) and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: A systematic search was completed using the following databases: MEDLINE, CINAHL, PsycINFO, EMBASE and COCHRANE. Results were extracted from the included studies. Results: In total, 55 studies reported on 2,767,594 participants with a mean age of 77.1 years (63.5% women). Study designs comprised 26 retrospective cohort studies, 21 prospective cohort studies and 8 cross-sectional studies. Inappropriate medications in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), impaired activities of daily living (ADL; 8 out of 10 studies) and impaired instrumental ADL (IADL) score (4 out of 6 studies). Five out of seven studies also showed that PIMs were associated with poorer physical performance comprising the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many medication classes were implicated as PIMs in falls, fractures and impairment in physical performance including antipsychotic, sedative, anti-anxiety, anticholinergic, antidiabetic, opioid and antihypertensive medications. For patients not receiving musculoskeletal medications, such as calcium, vitamin D and bisphosphonates, older adults were found to be at risk of a hospital admission for a fall or fracture. Conclusion: Inappropriate medication prescriptions are associated with impaired physical function across longitudinal and cross-sectional studies in older adults situated in diverse settings. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions. Plain language summary Inappropriate medications and physical function Background and aims: The use of inappropriate medications is very common in older adults and is associated with harmful health problems. The aim was to examine associations between potentially inappropriate medications and potential prescribing omissions with physical function in older adults situated in diverse environments. Methods: Library databases were examined for possible studies to include and a systematic search was completed. Relevant information was obtained from the included studies. Results: In total, 55 studies reported on 2,767,594 participants who were an average age of 77.1 years and about 6 out of 10 were women. A variety of different study designs were used. Inappropriate medication prescriptions in community and hospital settings were significantly associated with higher risk of falls (21 out of 30 studies), higher risk of fractures (7 out of 9 studies), problems with activities of daily living (ADL), such as eating, bathing, dressing, grooming, walking and toileting (8 out of 10 studies) and problems with instrumental ADL such as managing medications, house cleaning and shopping (4 out of 6 studies). Five out of seven studies also showed that inappropriate medications were associated with poorer physical performance involving the Timed Up and Go test, walking speed, grip strength, time to functional recovery, functional independence and scale of functioning. Many types of medication classes were shown to be associated with a risk of falls, fractures and problems with physical performance. Omitted medications were also associated with falls and fractures. Conclusion: Inappropriate medication prescriptions are associated with problems relating to physical function. It is important to support older people to reduce their use of inappropriate medications and prevent prescribing omissions.
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Cox, Nicholas, Jessica Louie, and Benson Sederholm. "Inappropriate Medication Use in Hospitalized Patients Diagnosed with Parkinson’s Disease." Pharmacy 6, no. 3 (2018): 100. http://dx.doi.org/10.3390/pharmacy6030100.
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The purpose of this study was to evaluate the rate at which potentially inappropriate medications were administered for patients diagnosed with Parkinson’s disease (PD). This is a single-center, retrospective, case cohort study with data collected at an academic medical center between January 2010 and December 2013. Participants included all adult patients with admission diagnosis codes for PD. Included patients were screened for administrations of 27 potentially inappropriate medications and two potentially appropriate medications to be used for comparison. There were 1736 patients who met inclusion criteria with 175 documented administrations of potentially inappropriate medications to 77 patients. Patients who received potentially inappropriate medications had a longer mean duration of stay than the baseline population of PD patients (3.3 days vs. 1.9 days, p-value < 0.001). Despite recommendations to avoid certain medications in PD patients, a substantial number of administrations still occurred. The use of these medications can have clinical implications and our findings demonstrate increases in duration of stay. The findings from this study can assist in developing technological alerts to reduce inappropriate prescribing to PD patients. Larger prospective studies are warranted to further investigate the administration of inappropriate medications to patients diagnosed with PD.
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Kardanmoghaddam, Vida, Leila Vali, Narges Khanjani, Kourosh Rajabkhah, Moslem Taheri Soodejani, and Mohammadreza Amiresmaili. "The Relation between Using Inappropriate Medications and Quality of Life Among the Elderly Living in Kerman." Health and Development Journal 11, no. 1 (2022): 9–17. http://dx.doi.org/10.34172/jhad.2022.92062.
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Background: Disability induced by severe diseases reduces life quality among elders, and leads to increased use of medications and increase in drug misuse. This study was done to determine the relation between the number of inappropriate medications used and life quality of elderly people living in Kerman during 2014. Methods: This descriptive and analytical cross-sectional study was conducted on 150 elderly people in Kerman, Iran. The participants were selected by simple random sampling. The elderly health assessment questionnaire and Beers Criteria were used for data collection. Data were analyzed using SPSS (version 16) and running χ2 test, Fischer’s exact test, and logistic regression. The model fitness was evaluated by the Hosmer and Lemeshow test. Results: The risk of low life quality in elders using 3 to 4 inappropriate medications was 9.98 times more than elders using no unauthorized medication. The most frequent inappropriate medications were aspirin and alprazolam. A significant relation was observed between low life quality and number of inappropriate medications used by elders; that is, taking a higher number of inappropriate medications was associated with lower life quality. Conclusion: Many elderly people use inappropriate medications, which can have a serious adverse impact on their quality of life.
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Lynas, Kathie. "Seniors' use of inappropriate medications declining: CIHI." Canadian Pharmacists Journal 140, no. 6 (2007): 353. http://dx.doi.org/10.3821/1913-701x(2007)140[353a:suoimd]2.0.co;2.
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King, Ebony, Mohsen Bazargan, Nana Entsuah, Sayaka W. Tokumitsu, Cheryl Wisseh, and Edward K. Adinkrah. "Potentially Inappropriate Medication Use among Underserved Older Latino Adults." Journal of Clinical Medicine 12, no. 9 (2023): 3067. http://dx.doi.org/10.3390/jcm12093067.
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Background: Previous studies identified alarming increases in medication use, polypharmacy, and the use of potentially inappropriate medications (PIMs) among minority older adults with multimorbidity. However, PIM use among underserved older Latino adults is still largely unknown. The main objective of this study is to examine the prevalence of PIM use among underserved, community-dwelling older Latino adults. This study examines both the complexity of polypharmacy in this community and identifies associations between PIM and multimorbidity, polypharmacy, and access to medical care among this segment of our population. Methods: This community-based, cross-sectional study included 126 community-dwelling Latinos aged 65 years and older. The updated 2019 AGS Beers Criteria was used to identify participants using PIMs. We used multinomial logistic regression to examine the independent association of PIM with several independent variables including demographic characteristics, the number of chronic conditions, the number of prescription medications used, level of pain, and sleep difficulty. In addition, we present five cases in order to offer greater insight into PIM use among our sample. Results: One-third of participants had at least one use of PIM. Polypharmacy (≥5 medications) was observed in 55% of our sample. In addition, 46% took drugs to be used with caution (UWC). In total, 16% were taking between 9 and 24 medications, whereas 39% and 46% were taking 5 to 8 and 1 to 4 prescription medications, respectively. The multinomial logit regression analysis showed that (controlling for demographic variables) increased PIM use was associated with an increased number of prescription medications, number of chronic conditions, sleep difficulty, lack of access to primary care, financial strains, and poor self-rated health. Discussion: Both qualitative and quantitative analysis revealed recurrent themes in the missed identification of potential drug-related harm among underserved Latino older adults. Our data suggest that financial strain, lack of access to primary care, as well as an increased number of medications and co-morbidity are inter-connected. Lack of continuity of care often leads to fragmented care, putting vulnerable patients at risk of polypharmacy and drug–drug interactions as clinicians lack access to a current and complete list of medications patients are using at any given time. Therefore, improving access to health care and thereby continuity of care among older Latino adults with multimorbidity has the potential to reduce both polypharmacy and PIM use. Programs that increase access to regular care and continuity of care should be prioritized among multimorbid, undeserved, Latino older adults in an effort toward improved health equity.
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Sgnaolin, Vanessa, Paula Engroff, Natascha Melo Linkievicz, Irenio Gomes, and Alfredo Cataldo Neto. "Potentially inappropriate medication and associated factors such as depression and dementia: An analysis of middle-aged and elderly people." Scientia Medica 30, no. 1 (2020): e34478. http://dx.doi.org/10.15448/1980-6108.2020.1.34478.
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AIMS: To establish the frequency potentially inappropriate medications use and the associated factors, such as signs and symptoms of depression and cognitive deficit among middle-aged and elderly people.METHODS: A cross-sectional population study was performed with 2,350 people, aged between 55-103 years, registered in the primary health care. Potentially inappropriate medications were defined by updated 2019 Beers criteria. Studied variables were sociodemographic, lifestyle and health, and signs and symptoms of depression and cognitive deficit. Multinomial regression analysis was executed.RESULTS: The frequency of potentially inappropriate medications use was 65.4%. Former and current smokers, regular self-perception of health, polypharmacy, and individuals with signs and symptoms of depression and cognitive deficit were significantly associated with potentially inappropriate medications use. Antiarrhythmics, antihistamines and antiadrenergic agents were the highest potentially inappropriate medications classes used for individuals with signs and symptoms of depression and cognitive deficit.CONCLUSIONS: The frequency of use of potentially inappropriate medications is high among middle-aged people, a population that was previously under-researched, as well as among elderly people. Cognitive impairment alone or together with depression symptoms were associated factor for a potentially inappropriate medications use. Knowledge of the pharmacoepidemiology of potentially inappropriate medications is an important for the promotion of the rational use of drugs in public health.
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Enayat, Kamal Aziz, Mariwan Abdulla Hama Salih, and Muhammed Babakir-Mina. "Assessment of Medication Use by Publics in Sulaimani Province." Kurdistan Journal of Applied Research 5, no. 1 (2020): 66–76. http://dx.doi.org/10.24017/science.2020.1.5.
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Drug uses is a multi-step process starting from consulting doctor, prescribing, ordering and using via individual either public or healthcare staff for therapeutic reasons. This process can be problematic for several reasons, especially in developing countries due to easily access to medications, self-diagnosis and people recommendation for certain cases. The aims of the present study were to assess the practice and attitude of medication uses and the knowledge about medication advantage and their risks by publics in Sulaymaniyah province. Then to build correlations between demographic characteristics and medication uses, in order to show the main impact of widely used medication on public health status. Finally, to provide community with statistical data about the level of knowledge, attitude and practice KAP in this region. The overall six hundred participant from the average of ten locations between governmental and privates hospitals and pharmacies as well as clinics were selected from central city and towns for data collection. The majority of participants were public from different background. The present study concluded that the 60 percentage of the participant were lack of adequate knowledge about the ability for differentiation between analgesic and antibiotic medications. The results of the current study showed inappropriate practices and attitudes that contribute to increasing health risks. It is also found that 72 percentage of participant who use prescription only drugs such as antibiotics can be possibly stopped after situation disappeared. This study also investigated several reasons for inappropriate practice, such as wrong believes with irregular consumption of medications, illiteracy, poor health services in terms of pharmacies and healthcare staff as well as easy access to most of the types of medications. Therefore, effort by governmental authorities is urgent toward reducing the risk of the situation, and negative consequences regarding inappropriate practice toward patient care in the region.
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Enayat, Kamal Aziz, Mariwan Abdulla Hama Salih, and Mohammed Babakir Mina. "Assessment of Medication Use by Publics in Sulaimani Province." Kurdistan Journal of Applied Research 5, no. 1 (2020): 66–76. http://dx.doi.org/10.24017/science.2020.5.
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Drug uses is a multi-step process starting from consulting doctor, prescribing, ordering and using via individual either public or healthcare staff for therapeutic reasons. This process can be problematic for several reasons, especially in developing countries due to easily access to medications, self-diagnosis and people recommendation for certain cases. The aims of the present study were to assess the practice and attitude of medication uses and the knowledge about medication advantage and their risks by publics in Sulaymaniyah province. Then to build correlations between demographic characteristics and medication uses, in order to show the main impact of widely used medication on public health status. Finally, to provide community with statistical data about the level of knowledge, attitude and practice KAP in this region. The overall six hundred participant from the average of ten locations between governmental and privates hospitals and pharmacies as well as clinics were selected from central city and towns for data collection. The majority of participants were public from different background. The present study concluded that the 60 percentage of the participant were lack of adequate knowledge about the ability for differentiation between analgesic and antibiotic medications. The results of the current study showed inappropriate practices and attitudes that contribute to increasing health risks. It is also found that 72 percentage of participant who use prescription only drugs such as antibiotics can be possibly stopped after situation disappeared. This study also investigated several reasons for inappropriate practice, such as wrong believes with irregular consumption of medications, illiteracy, poor health services in terms of pharmacies and healthcare staff as well as easy access to most of the types of medications. Therefore, effort by governmental authorities is urgent toward reducing the risk of the situation, and negative consequences regarding inappropriate practice toward patient care in the region.
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Steele, Abigail J., Josef D. Berletic, and Michael R. Gionfriddo. "Pharmacist-Driven Geriatric Medication Assessment at an Acute Care Teaching Hospital." Senior Care Pharmacist 38, no. 5 (2023): 179–84. http://dx.doi.org/10.4140/tcp.n.2023.179.
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Older patients are often prescribed many medications and are at higher risk for medication-related problems. Pharmacists can help to identify potentially inappropriate medication use that may precipitate adverse drug events resulting in mental status changes, falls, and hospitalization. A Pharmacist-Driven Geriatric Medication Assessment program was established by clinical pharmacists to evaluate medication use in older patients admitted to a pilot unit of an acute care hospital as part of an Age-Friendly Care initiative. This article describes the implementation of this program and the types of medication interventions pursued by the pharmacists. Pharmacist recommendation acceptance rate by the health care team was greater than 90% overall for medication reconciliation, potentially inappropriate medications, and other medication interventions.
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Rajeev, Dr Aswin, Dr George Paul, Dr Sobha George, and Dr Priya Vijayakumar. "The study on prevalence of polypharmacy in elderly patients presenting for first time to the geriatric clinic of a tertiary care hospital in Kerala." International Journal Of Medical Science And Clinical Invention 5, no. 2 (2018): 3542–44. http://dx.doi.org/10.18535/ijmsci/v5i2.10.
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Introduction : Elderly patients are the most common group who use heath care facilities. This study assesses the prevalence of polypharmacy and use of potentially inappropriate medications in elderly patients presenting to the geriatric clinic of a tertiary care hospital in Kerala for first time.
 Materials and methods : The study was a hospital based retrospective study. The data from patients presenting to Geriatrics clinic from period of 1 st January 2016 to 31 st December 2016 were retrieved from the medical records and assessed for polypharmacy (taking >5 medications at a time) and potentially inappropriate drugs in accord with modified 2012 Beer’s criteria.
 Results : A total of 275 patients were included in the study of which 110 (40%) were males and 165 (60%) were females. The prevalence of polypharmacy found to be 22.9%. 63 out of total 275 patients took more than 5 medications at a time. 81 (29.5%) out of 275 patients had at least one potentially inappropriate medication.
 Conclusion : The prescription of potentially inappropriate medications is a serious problem which can affect overall quality of health care. Hence regular medication review and reconciliation practices should be implemented to prevent this to an extent.
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Thummar, Manoj H., Tejas K. Patel, Varsha Y. Godbole, and Manoj Kumar Saurabh. "Comparison of Beers criteria and EU(7) potentially inappropriate medications list for the potentially inappropriate medications in Indian elderly inpatients." International Journal of Basic & Clinical Pharmacology 8, no. 5 (2019): 1106. http://dx.doi.org/10.18203/2319-2003.ijbcp20191609.
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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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Deardorff, W. James, Bocheng Jing, Matthew Growdon, Kristine Yaffe, Kenneth Boockvar, and Michael Steinman. "UNNECESSARY AND HARMFUL MEDICATION USE IN COMMUNITY DWELLING PERSONS WITH DEMENTIA." Innovation in Aging 6, Supplement_1 (2022): 414. http://dx.doi.org/10.1093/geroni/igac059.1626.
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Abstract Persons with dementia (PWD) often have multiple comorbidities which results in extensive medication use despite potentially limited benefit and increased risk of adverse events. Compared to the nursing home, little is known about medication overuse and misuse among the ~70% of PWD in the community. Therefore, we examined medication use from Medicare Part D prescriptions among 1,289 community-dwelling PWD aged ≥66 from the Health and Retirement Study. We classified medication overuse as over-aggressive treatment of chronic conditions (e.g., insulin/sulfonylurea use with hemoglobin A1c&lt;7.5%) and medications inappropriate near the end of life. We classified medication misuse as medications that negatively affect cognition (strongly anticholinergics/sedative-hypnotics) and problematic medications (using Beers and STOPP criteria). We describe the prevalence and patterns of different types of medication overuse/misuse. Frequently problematic medications included antipsychotics (9%), benzodiazepines (12%), and gabapentinoids (13%). Our findings highlight the burden of unnecessary/harmful medications among PWD and inform future deprescribing interventions.
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Pratama, Gumilar, Sri Wahyuningsih, and Faizal Hermanto. "REVIEW: POTENSI KETIDAKTEPATAN PENGGUNAAN OBAT PADA PASIEN GERIATRI DI BEBERAPA RUMAH SAKIT DI INDONESIA." Jurnal Buana Farma 4, no. 4 (2024): 403–12. https://doi.org/10.36805/jbf.v4i4.1144.
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Inappropriate medication use in geriatric patients, particularly related to Potentially Inappropriate Medications (PIMs), is a major concern in elderly healthcare management. This study aims to explore the prevalence and types of PIMs found in several hospitals in Indonesia. A narrative review method was employed, with journal data searched using the query: “Potentially Inappropriate Medications” OR “Potentially Inappropriate Prescribing”, “identification of PIMs”, “evaluation of PIMs”, “Beers Criteria” OR “Beers Criteria”, “STOPP Criteria”, “PRISCUS PIMs” in Google Scholar, Garuda, and PubMed databases. Articles selected met the inclusion criteria, including national and international journals published within the last 10 years and available in full text. The results showed that the prevalence of PIMs in a hospital in Semarang was 487 medication items, with sodium diclofenac being the most frequently found medication (12.96%). At RSUD Arjawinangun, the occurrence of PIMs reached 56.82%, with furosemide being the most dominant medication (22.73%). A study in Jakarta showed that prescription review by pharmacists successfully reduced the occurrence of PIMs to 18.89%. Inappropriate medication use in geriatric patients remains high, and it is essential to improve patient education and enhance collaboration between pharmacists and doctors to reduce PIMs risks. The use of Beers, STOPP, and PRISCUS criteria can help assess and prevent PIMs in geriatric patients.
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Yang, Bo Ram, Hye-Yeon Um, Min Taek Lee, Myo Song Kim, and Sun-Young Jung. "Characterizing tramadol users with potentially inappropriate co-medications: A latent class analysis among older adults." PLOS ONE 16, no. 2 (2021): e0246426. http://dx.doi.org/10.1371/journal.pone.0246426.
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Background Although tramadol is an effective weak opioid analgesic, careful monitoring of potential central nervous system adverse reactions in older adults is needed, especially when used with concomitant medications which may trigger the adverse effects. We aimed to characterize tramadol users with potentially inappropriate co-medications in older adults using a latent class analysis (LCA). Method Patients aged 65 years or older using tramadol and receiving potentially inappropriate co-medications were included from a nationwide healthcare claims database. We defined antidepressants, first-generation antihistamines, and anxiolytics as potentially inappropriate co-medications. We applied an LCA for grouping tramadol users based on the common characteristics of medication use and healthcare utilization, and each patient was probabilistically assigned to a class. Patients’ characteristics in different latent classes were compared. Potential adverse drug reactions (ADRs) was defined as the any visits for emergency department after the occurrence of potentially inappropriate co-medications. Logistic regression analysis was used to examine the association between latent classes and potential ADRs. Results We identified four distinct latent classes of tramadol users representing different patterns of co-medications: multiple potential drug-drug interaction (pDDI) combination users, antihistamines-tramadol users, antidepressants-tramadol users, and anxiolytics-tramadol users. Multiple pDDI combination users showed high proportion of regular tramadol use, tended to visit more medical institutions, and had a high Charlson comorbidity score. The duration of use of potentially inappropriate co-medications with tramadol was the longest in multiple pDDI combination users and the shortest in antihistamines-tramadol users. When compared with antihistamines-tramadol users, increased potential ADR risk was observed in multiple pDDI combination users (adjusted odds ratio (OR), 1.81; 95% confidence interval (CI), 1.75–1.88), antidepressants-tramadol users (1.24; 1.19–1.29), and anxiolytics-tramadol users (1.04; 1.00–1.08). Conclusions Four distinct classes were identified among older adults using tramadol and potentially inappropriate co-medications. Differences in potential ADR risk were observed between these classes. These findings may help to identify patients at a high risk for ADRs owing to potentially inappropriate co-medications with tramadol.
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Perri, Matthew, Ajit M. Menon, Aparna D. Deshpande, et al. "Adverse Outcomes Associated with Inappropriate Drug Use in Nursing Homes." Annals of Pharmacotherapy 39, no. 3 (2005): 405–11. http://dx.doi.org/10.1345/aph.1e230.
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BACKGROUND: Little empirical evidence exists regarding the influence and outcomes of inappropriate medication use among elderly nursing home residents. OBJECTIVE: To identify the prevalence of inappropriate medication use among elderly patients in Georgia nursing homes using the Beers criteria and identify the relationship between inappropriate drug use and the likelihood of an adverse health outcome. METHODS: A cohort design was used to review 1117 patient medical records in 15 Georgia nursing homes with a high risk of polypharmacy. Prevalence of inappropriate medication use among elderly patients, as defined by the Beers criteria, was estimated. The adverse health outcomes of hospitalizations, emergency department visits, or deaths were identified from Medicaid claims data. RESULTS: A total of 519 (46.5%) patients received at least one inappropriate medication and 143 (12.8%) patients experienced at least one adverse health outcome. Logistic regression revealed that the total number of medications taken (OR 1.139, 95% CI 1.105 to 1.173) significantly increased the likelihood of receiving an inappropriate drug, while having a diagnosis of “dementia” (OR 0.748, 95% CI 0.565 to 0.991) decreased the likelihood. Inappropriate medication use increased the likelihood of experiencing at least one adverse health outcome more than twofold (OR 2.34, 95% CI 1.61 to 3.40). Propoxyphene use alone was significantly associated with the occurrence of an adverse health outcome (OR 2.39, 95% CI 1.54 to 3.71). CONCLUSIONS: Inappropriate drug use was common in our study cohort. Inappropriate use of medication in the elderly, particularly propoxyphene, is associated with a higher risk of adverse health outcomes.
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Ortega López, Irma L., Ivette Reyes Hernández, Niurka M. Dupotey Varela, et al. "Potentially inappropriate medication in elderly patients in Santiago de Cuba." Journal of Pharmacy & Pharmacognosy Research 7, no. 1 (2019): 288–96. http://dx.doi.org/10.56499/jppres19.559_7.4.288.
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Context: Several studies have reported the high use of inappropriate medication in the elderly, as well as the associated risks; for this reason, it has become a major health problem. Aim: To characterize the use of potentially inappropriate medication in the elderly based on the reality observed in Santiago de Cuba. Methods: A descriptive cross-sectional study was carried out, with a random selection that included elderly patients from the community and institutional care in Santiago de Cuba. The data were obtained by reviewing medical records and interviews with patients/caregivers. The potentially inappropriate medication was identified through the Beer's Criteria and the Screening Tool of Older Person’s Prescriptions/ Screening Tool to Alert doctors to Right; i.e., appropriate indicated treatment. Results: There were detected 895 potentially inappropriate medications in 632 patients, which affected 81.01% of them, for an average of 1.41 problems per patient. The predominantly inappropriate medication was independent of the diagnosis, which represented 61.7% of the total detected. The most commonly used drugs or groups of drugs were oral hypoglycemic agents, β-blockers, platelet antiaggregants, psychotropic drugs, inhibitors of angiotensin converting enzyme, nifedipine, digoxin, and non-steroidal anti-inflammatory. Conclusions: There is a high use of potentially inappropriate medication in the elderly, in the health context of Santiago de Cuba, which may be an expression of the limited attention to health needs related to the use of medications in these patients.
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Mamun, K., CTC Lien, CYE Goh-Tan, and WST Ang. "Polypharmacy and Inappropriate Medication Use in Singapore Nursing Homes." Annals of the Academy of Medicine, Singapore 33, no. 1 (2004): 49–52. http://dx.doi.org/10.47102/annals-acadmedsg.v33n1p49.
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Introduction: At present, 7.2% of the population in Singapore is in the geriatric age group, which will increase to 18.4% in the year 2030. The frailest segment of the geriatric population live in nursing homes. They suffer from multiple co-morbidities requiring multiple medication use. Polypharmacy and inappropriate medication use have been considered as quality indicators for nursing home care. As no data of these indicators are available in Singapore, this study was planned to assess the prevalence of polypharmacy and inappropriate medication use in Singapore nursing homes. Materials and Methods: A total of 454 residents in the geriatric age group residing in 3 randomly selected nursing homes were involved in the study. Case notes were reviewed for demographic information, clinical history and medication use. The data were analysed for polypharmacy (5 or more medication orders) and inappropriate medication use (based on established criteria). Results: Residents were on an average of 5.32 medications. Polypharmacy and inappropriate medication use were seen in 266 (58.6%) and 318 (70.0%) residents, respectively. There was significant association between polypharmacy and inappropriate medication use [P <0.001, χ2 = 82.56 at 95% confidence interval (CI)]. The most common medication-related problems were the use of medication without proper indication (n = 302), significant potential for adverse drug reactions (n = 281) and drug interactions (n = 141). Conclusion: The prevalence of polypharmacy and inappropriate medication use is high in Singapore nursing homes. Current practice of medication use in the nursing homes may lead to significant adverse drug reactions and drug interactions. A multidisciplinary approach involving geriatricians, nursing home physicians, nurses and pharmacists may potentially reduce polypharmacy and inappropriate medication use in Singapore nursing homes.
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Poudel, A., NM Peel, C. Mitchell, LM Nissen, and RE Hubbard. "A systematic review of prescribing criteria to evaluate appropriateness of medications in frail older people." Reviews in Clinical Gerontology 24, no. 4 (2014): 304–18. http://dx.doi.org/10.1017/s0959259814000161.
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SummaryThis study systematically reviews the published literature regarding inappropriate prescribing in frail individuals aged at least 65 years. Twenty-five of 466 identified studies met the inclusion criteria. All papers measured some surrogate indicators of frailty, such as performance-based tests, cognitive function and functional dependency. Beers criteria were used in 20 studies (74%) to evaluate inappropriate medication use and 36% (9/25) studies used more than one criterion. The prevalence of inappropriate medications ranged widely from 11 to 92%. Only a few studies reported the relationship between potentially inappropriate medication use and surrogate measures of frailty. These diverse findings indicate the need for a standardized measure for assessing appropriateness of medication in frail older individuals. Prescribing tools should address both medication and patient-related factors such as life expectancy and functional status to minimize inappropriate prescribing in frail individuals.
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GÜVEL, Muhammed Cihan, Funda YILDIRIM BORAZAN, Hacer DOĞAN VARAN, Berna GÖKER, and Canan ULUOĞLU. "Detection of potentially inappropriate prescriptions using TIME and STOPP/START lists in Turkish geriatric patients: A single center experience." Turkish journal of Geriatrics 27, no. 4 (2024): 339–48. https://doi.org/10.29400/tjgeri.2024.407.
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Introduction: Screening Tool of Older Person’s Prescriptions (STOPP) / Screening Tool to Alert Doctors to the Right Treatment (START) is among the most forthcoming lists developed to detect potentially inappropriate prescribing, which consists of potentially inappropriate medications and potential prescription omissions. Turkish Inappropriate Medication Use in the Elderly (TIME) was developed based on STOPP/START version 2 for the eastern European population. We aimed to compare the effectiveness of STOPP/START and TIME in detecting potentially inappropriate prescribing, potentially inappropriate medications, and potential prescribing omissions. Materials and methods: Eighty-five patients who presented to Gazi University Hospital’s Geriatrics Outpatient Clinic between November 2020 and March 2022 were included in this study. The patients’ detailed clinical records were evaluated according to TIME and STOPP/START. The numbers of potentially inappropriate prescribing, potentially inappropriate medications, and potential prescribing omissions were determined. Results: Median number of potentially inappropriate prescribing detected according to TIME was significantly higher than according to STOPP/START (6 [IQR 4-7] vs. 3 [IQR 2-5], p<0.001). However, no significant difference was observed in the number of potentially inappropriate medications detected. The number of patients meeting potentially inappropriate prescribing criteria according to the TIME was significantly higher than START, which was attributable primarily to the disparity in the vaccination category. Conclusion: Our results suggest that TIME is more successful in detecting potentially inappropriate prescribing than STOPP/START in Turkish geriatric patients. This success was probably due to the better performance of TIME in detecting potential prescribing omissions. Further studies are needed to confirm these findings. Keywords: Potentially Inappropriate Medication List; Polypharmacy; Drug Therapy; Geriatric Assessment; Drug Interactions.
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DEMİRCAN, Celaleddin, Ulviyya HASANZADE, Mustafa TATAR, and Mustafa Çağatay BÜYÜKUYSAL. "Evaluating Potentially Inappropriate Medications in the Elderly with Seven Different Screening Tools." Turkish journal of Geriatrics 26, no. 4 (2023): 413–23. http://dx.doi.org/10.29400/tjgeri.2023.369.
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Introduction: We aimed to determine the rates of potentially inappropriate medications using various screening tools and also the affecting factors in elderly patients. Materials and Method: In this prospective cross-sectional study, we recorded in detail the concomitant chronic diseases, geriatric syndromes, and drugs used in elderly patients admitted to a university hospital and then assessed potentially inappropriate medications using seven different screening tools. Results: The study included 315 patients (190 female; 125 male). We evaluated potentially inappropriate medication use with the PRISCUS, EU(7), Beers 2019, STOPP v2, and TIME-to-STOP criteria and evaluated potential prescription omissions with the START v2 and TIME-to-START criteria; the resulting identified rates of PIMs were 15.9%, 45.1%, 48.9%, 44.8%, 48.3%, 73.9%, and 97.5%, respectively. The lowest value was found with PRISCUS, as it uses fewer criteria than the others. The EU(7), Beers 2019, STOPP v2, and TIME-to-STOP results were similar to one another. START v2 and TIME-to-START yielded higher outcomes than the others due to the omission of vaccines in patients. The highest outcome was found with TIME-to-START due to the omission of the herpes zoster vaccine (97.5%), which appears only in that screening tool. Potentially inappropriate medication rates increased with the number of drugs used and with the number of concomitant chronic diseases. Conclusion: This study detected potentially inappropriate medication use in approximately half of the patients with the EU(7), Beers 2019, STOPP v2, and TIME-to-STOP screening tools. There was a positive correlation between potentially inappropriate medications and polypharmacy and increased disease burden. Keywords: Potentially Inappropriate Medication List; Polypharmacy; Aged.
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Brooke, J., R. Darnell, M. Boltova, and N. Hashemi. "14 Rational Prescribing in the Frail Elderly Population: A Quality Improvement Project to Reduce Inappropriate Prescribing Using STOPP-Frail Criteria." Age and Ageing 49, Supplement_1 (2020): i1—i8. http://dx.doi.org/10.1093/ageing/afz183.14.
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Abstract Introduction 2.5 million people in the UK are aged over 80 and up to 50% can be considered frail. Complex co-morbidities and polypharmacy are linked with adverse drug effects and negative outcomes. NICE recommends a medication review yearly, and a hospital admission provides an opportunity for this. STOPP-Frail is a screening tool designed to highlight medications that could be reduced/stopped with a view to improving quality of life. We conducted a quality improvement project to quantify levels of inappropriate prescribing at Croydon University Hospital (CUH), with a view to de-prescribing and reducing adverse drug effects. Methods A retrospective analysis was carried out on the Elderly Care wards at CUH. Data was collected from 60 consecutive patients discharged from 1st November 2018, utilising electronic Cerner records. Recorded medication on admission and discharge, noting any amendments in accordance with the STOPP-Frail criteria. Results Data collected from 60 patients; one exclusion for not meeting STOPP-Frail criteria (n=59). Median age 86 years (69 to 103 years). Mean number of medications on admission 7.42 (1 to 15). 93.2% patients had polypharmacy (defined as ≥ 4 medications). Mean number of medications on discharge 8.22; an increase of 0.8/patient. 19.4% admission medications met STOPP-Frail criteria for inappropriate prescriptions. Only 18.8% of these were reduced or stopped during admission. Gastrointestinal and cardiovascular medications were most commonly inappropriately prescribed (n=27 and 24 respectively). Most common medications not amended were lipid-lowering therapies (n=21) and proton-pump inhibitors (n= 20). Conclusions The opportunity to rationalise medication in the frailest patients admitted to CUH is missed in over 80% of cases. STOPP-Frail provides clear guidance to aid clinicians in reducing inappropriate prescribing. An educational programme is in place to highlight medication rationalisation and guide clinicians in the use of the STOPP-Frail tool. This includes doctors’ induction, departmental teaching, posters and computer flash cards.
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Yılmaz, Tuğba, Şükran Ceyhan, Şeyma Handan Akyön, and Tarık Eren Yılmaz. "Enhancing Primary Care for Nursing Home Patients with an Artificial Intelligence-Aided Rational Drug Use Web Assistant." Journal of Clinical Medicine 12, no. 20 (2023): 6549. http://dx.doi.org/10.3390/jcm12206549.
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Polypharmacy can result in drug–drug interactions, severe side-effects, drug–disease interactions, inappropriate medication use in the elderly, and escalating costs. This study aims to evaluate nursing home residents’ medication regimens using a rational drug use web assistant developed by researchers to mitigate unnecessary medication usage. This analytical, cross-sectional study included data from nursing home residents recently recorded in a training family health center. Sociodemographic information, medical conditions, and prescribed medications of all patients in the nursing home (n = 99) were documented. Medications were assessed using an artificial intelligence-aided rational drug use web assistant. Instances of inappropriate drug use and calculations of contraindicated drug costs were also recorded. The study revealed that 88.9% (n = 88) of patients experienced polypharmacy, with a mean value of 6.96 ± 2.94 drugs per patient. Potential risky drug–drug interactions were present in 89.9% (n = 89) of patients, contraindicated drug–drug interactions in 20.2% (n = 20), and potentially inappropriate drug use in 86.9% (n = 86). Plans to discontinue 83 medications were estimated to reduce total direct medication costs by 9.1% per month. After the assessment with the rational drug use web assistant, the number of drugs that patients needed to use and polypharmacy decreased significantly. This study concludes that the rational drug use web assistant application, which is more cost-effective than the traditional manual method, assisted by artificial intelligence, and integrated into healthcare services, may offer substantial benefits to family physicians and their geriatric patients.
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Williams, Brent, and Charles Betley. "Inappropriate Use of Nonpsychotropic Medications in Nursing Homes." Journal of the American Geriatrics Society 43, no. 5 (1995): 513–19. http://dx.doi.org/10.1111/j.1532-5415.1995.tb06098.x.
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Garfield, Sheila. "Inappropriate Medication Use." AJN, American Journal of Nursing 111, no. 6 (2011): 12. http://dx.doi.org/10.1097/01.naj.0000398516.51390.5e.
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Campeau Calfat, Alexandre, Marc Simard, Amina Ouali, Claudia Blais, and Caroline Sirois. "Polypharmacy among older individuals with heart failure: trends between 2000 and 2017 in the province of Quebec, Canada." Therapeutic Advances in Cardiovascular Disease 16 (January 2022): 175394472211139. http://dx.doi.org/10.1177/17539447221113946.
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Objective: Pharmacological management of heart failure and comorbidities may result in polypharmacy, but there are few population-based studies that portray the use of medications over time. We aimed to describe the trends in polypharmacy and medication use in older adults with heart failure. Methods: We performed a study including all adults >65 years with heart failure between 2000 and 2017 using health administrative databases in Quebec, Canada. Medication use was ascertained by the presence of at least one claim in each year. We defined three levels of polypharmacy: ⩾10, ⩾15 and ⩾20 different medications/year, and evaluated the use of guideline-recommended and potentially inappropriate medications. We calculated age- and sex-standardized proportions of users each year. Results: The use of ⩾10, ⩾15 and ⩾20 medications increased from 62.2%, 30.6% and 12.2% in 2000 to 71.9%, 43.9% and 22.7%, respectively, in 2017. The combination of β-blocker and angiotensin-converting enzyme inhibitor (ACEI)/angiotensin II receptor blocker (ARB) was used by 30.4% of individuals in 2000 and 45.5% in 2017. ACEI/ARB users decreased from 65.8% in 2000 to 62.1% in 2017. Potentially inappropriate medication use decreased over time. Conclusion: Polypharmacy is significant among older adults with heart failure. Implications of such medication burden should be investigated.
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Chang, Chee-Tao, Ju-Ying Ang, Md Asiful Islam, Huan-Keat Chan, Wee-Kooi Cheah, and Siew Hua Gan. "Prevalence of Drug-Related Problems and Complementary and Alternative Medicine Use in Malaysia: A Systematic Review and Meta-Analysis of 37,249 Older Adults." Pharmaceuticals 14, no. 3 (2021): 187. http://dx.doi.org/10.3390/ph14030187.
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Drug-related problems (DRPs) in the elderly include polypharmacy, potentially inappropriate medications, nonadherence, and drug-related falls. In this systematic review and meta-analysis, the prevalence of DRPs and complementary and alternative medicine (CAM) use among the Malaysian elderly was estimated. PubMed, Scopus, Web of Science, and Google Scholar databases were searched to identify studies published since their inception up to 24 August 2020. A random-effects model was used to generate the pooled prevalence of DRPs along with its corresponding 95% confidence interval (CI). The heterogeneity of the results was estimated using the I2 statistics, and Cochran’s Q test and sensitivity analyses were performed to confirm the robustness of the results. We identified 526 studies, 23 of which were included in the meta-analysis. (n = 29,342). The pooled prevalence of DRPs among Malaysian elderly was as follows: (1) polypharmacy: 49.5% [95% CI: 20.5–78.6], (2) potentially inappropriate medications: 28.9% [95% CI: 25.4–32.3], (3) nonadherence to medications: 60.6% [95% CI: 50.2–70.9], and (4) medication-related falls 39.3% [95% CI: 0.0–80.8]. Approximately one in two Malaysian elderly used CAM. The prevalence of polypharmacy and potentially inappropriate medications among the Malaysian elderly population was high, calling for measures and evidence-based guidelines to ensure the safe medication use.
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Díez, Raquel, Raquel Cadenas, Julen Susperregui, et al. "Potentially Inappropriate Medication and Polypharmacy in Nursing Home Residents: A Cross-Sectional Study." Journal of Clinical Medicine 11, no. 13 (2022): 3808. http://dx.doi.org/10.3390/jcm11133808.
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Inappropriate prescribing in the elderly is a risk factor for higher adverse drugs reactions, hospitalisation, and mortality rates. Therefore, it is necessary to identify irrational prescriptions and implement interventions to improve geriatric clinical practices in nursing homes. This study aimed to examine and compare the prevalence of potentially inappropriate medications in nursing home residents using three different updated criteria: 2019 Beers criteria, PRISCUS list, and v2 STOPP criteria, and to determine the prevalence of potential prescribing omissions according to v2 START criteria. A descriptive, observational, and cross-sectional study design was used. A total of 218 residents were involved in this study. Data on drug use were collected from medical charts. Information was screened with the software CheckTheMeds. Potentially inappropriate medications were present in 96.3%, 90.8%, and 35.3% of residents, according to the STOPP, Beers, and PRISCUS criteria or list, respectively. Inappropriate medication was found to be significantly associated with polypharmacy and severe or moderate drug–drug interactions with the three tools and with pathologies and unnecessary drugs only for STOPP criteria. The most frequent inappropriate medications were benzodiazepines and proton pump inhibitors. A regular use of software to review medications in nursing home residents would help to reduce the risk of these drug-related problems.
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Wardman, Dennis, Nadia Khan, and Nady el-Guebaly. "Prescription Medication Use among an Aboriginal Population Accessing Addiction Treatment." Canadian Journal of Psychiatry 47, no. 4 (2002): 355–60. http://dx.doi.org/10.1177/070674370204700406.
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Objectives: Inappropriate prescription medication use can have significant consequences. Although it is suspected that Aboriginal populations within Canada have high rates of inappropriate use, published information is lacking. To better understand this issue, we studied an Aboriginal population seeking addiction treatment. Methods: We surveyed Aboriginal clients who accessed addiction treatment in Calgary, Alberta, for prescription medication use in the previous year, frequency of medication use, and medication source(s), if inappropriately used. Results: Sixty-nine percent of the clients completed the survey ( n = 144). Most respondents were aged 31 to 50 years (56%), and 52% were male. Of the respondents, 48% reported that they used prescription medication inappropriately, 8% indicated appropriate use, and the rest indicated no medication use. Sedatives or relaxants were most frequently used inappropriately. Among those who inappropriately used medication, 47% used medication more than 10 times in the previous year. Common sources for those who used medication inappropriately included medication given by a friend or a stranger (52%), medication bought on the street (45%), and medication prescribed by a physician (41%). Age greater than or equal to 30 years was associated with inappropriate use. Sex, residence, and Aboriginal status were not found to be associated with inappropriate use. Conclusion: Inappropriate prescription medication use was a significant problem among an Aboriginal population that sought addiction treatment, and many of these individuals accessed medication from a prescribing physician.
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Cobb, Sharon, Mohsen Bazargan, and Shervin Assari. "Correlates of Pain, Opioid Use, and Psychotropic Medications Among Older African Americans." Innovation in Aging 4, Supplement_1 (2020): 785–86. http://dx.doi.org/10.1093/geroni/igaa057.2844.
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Abstract Unrecognized and undertreated pain among older African Americans (AAs) is well-documented. This study explored the link between social, behavioral, and health correlates of pain and psychotropic as well as opioid-based medications in a sample of underserved 740 AA older adults. Almost 16% and 17% of participants used at least one psychotropic and opioid-based medications, respectively. Of those who use opioid-based medications, 73% used opioids only, 28% used opioids and at least one psychotropic medication. Use of opioid or psychotropic medications were associated with increased polypharmacy. Multivariate analysis showed different types of pain are predictors of opioid use, however, depressive symptoms and level of pain were associated with use of psychotropic medication. Moreover, the relationship of pain and psychotropic medications warrants more study due to emerging mental health crisis. These findings underscore the need for optimal concurrent management of pain and mental health for older AAs with potential inappropriate medication use.
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Rijal, Saibijaya, Kajiram Adhikari, Deepak Sigdel, and Shyam Kumar Mallik. "Prescribing Pattern of Drugs in Geriatrics Patients Using Beers Criteria." Journal of Nepal Health Research Council 17, no. 2 (2019): 153–57. http://dx.doi.org/10.33314/jnhrc.v0i0.1774.
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Background: Geriatric people particularly those with multiple co-morbid condition may result in polypharmacy which can be associated with use of potentially inappropriate medication. This study aims to understand about prescription pattern and to find out inappropriate medication used in geriatric patients using Beer’s criteria 2012.Methods: A cross sectional study was conducted from May 2018 to Aug 2018 in Koshi Zonal Hospital in Biratnagar. Data of all elderly patients greater above or equal to 60 years those were admitted to General Medical Ward during this period was analyzed.Results: Eighty-six percent of the prescriptions were appropriate and 14% were inappropriate. Seventy-seven percent of drugs belong to Group I of Beer’s criteria (Potentially inappropriate medication use in older adults), 23% of drugs belong to Group III (Potentially inappropriate medication to be used with caution in older adults) and no drugs fall under Group II (Potentially inappropriate medication use in older adults due to Drug-Disease or Drug-Syndrome interactions that may exacerbate the disease or syndrome) of Beer’s criteria.Conclusions: Potentially inappropriate medication was found out to be 14%. The use of inappropriate medications can be avoided using Beer’s criteria 2012 which is important clinical tool that can be used by physicians, pharmacist and other health care professionals. Keywords: Beer’s criteria; geriatric; potentially inappropriate medication; prescribing pattern.
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Murphy, Claire, Adam H. Dyer, Brian Lawlor, and Sean P. Kennelly. "97 Potentially Inappropriate Medications in Patients with Alzheimer’s Disease: Data from NILVAD." Age and Ageing 48, Supplement_3 (2019): iii1—iii16. http://dx.doi.org/10.1093/ageing/afz102.21.
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Abstract Background Prescription of Potentially Inappropriate Medications (PIMs) is common in older adults and is associated with adverse drug events, hospitalisation and mortality. Less well described are the patterns and predictors of PIM usage in patients with Alzheimer’s Disease (AD), a patient group who may be particularly vulnerable to polypharmacy and medication associated adverse events. Methods Secondary analysis of the NILVAD trial, an international phase three trial of Nilvadipine in mild/moderate AD. The v2 STOPP/START criteria were individually applied by a physician to each participant’s medication list and cross-reference with their medical history to identify PIM usage. Predictors of PIM usage were modelled using binary logistic regression. Results Five-hundred and ten patients with AD were included (mean age 72.8 +/-8.3 years; 62% female). The median number of prescribed medications was 5 (IQR 3-7). Over half (55.5%) were prescribed at least one PIM, whilst a minority of patients (14.8%) were prescribed three or more PIMs. The most frequent PIMs were benzodiazepines >4 weeks without indication (n = 55), long-term Proton-Pump Inhibitor (PPI) use without appropriate indication (n = 49), use of non-steroidal analgesics without use of PPI (n=19) and antimuscarinic use in dementia (n= 18). On multivariate analysis, significant predictors of PIM use were higher total number of medications (p=0.001; OR 1.52; 1.36-1.59) in addition to greater AD severity, as rated using the Clinical Dementia Rating Scale Sum-of-Boxes (CDR-sb) (p=0.024; OR 1.18; 1.02-1.35). Conclusion The majority of older patients with AD were prescribed at least one PIM. Usage of PIMs was associated with greater number of medications and increased dementia severity. Particularly concerning is the potentially inappropriate use of benzodiazepines and anti-muscarinic agents in this population, given recent evidence for the adverse cognitive profile associated with these medications. De-prescribing and medication review interventions aimed particularly at patients with AD are warranted.
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Alwhaibi, Monira. "Inappropriate Medications Use and Polypharmacy among Older Adults with Anxiety Disorder." Journal of Clinical Medicine 12, no. 13 (2023): 4195. http://dx.doi.org/10.3390/jcm12134195.
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Background: Elderly with mental health conditions usually use multiple medications, which predisposes them to inappropriate use of medications, which is defined as medications that should be avoided due to their risk; this outweighs their benefit given that safer alternatives are available. This study aimed to examine potentially inappropriate medication use among older patients with anxiety disorder. Methods: This study used a cross-sectional retrospective study design using twelve months of data extracted from the Electronic Health Record (EHR) database for older adults diagnosed with anxiety disorder and treated in the ambulatory care setting. Potentially inappropriate medications (PIMs) use was evaluated using the 2019 Beers criteria. Descriptive statistics were used to describe the sample. Pearson’s chi-square tests (for categorical variables) and t-tests (for continuous variables) were utilized to measure the differences in independent variables between patients with and without PIMs. Binary logistic regression was used to examine the associations between PIMs use and identify potential factors for PIMs use among older adults with anxiety disorder. Analyses were performed using the Statistical Analysis Software version 9.4 (SAS® 9.4). Results: The study sample includes 371 older adults (age ≥ 65 years) with anxiety disorder; their average age was (72.1 ± 5.8) years. PIMs use was highly prevalent among older adults with anxiety (66.6%). About 35.6% of the study sample used one PIM, 22.6% used two PIMs, and 8.4% used three PIMs. The most frequently prescribed PIMs were NSAIDs and gastrointestinal agents. The adjusted regression analysis found that PIMs use was less likely among men than women. In addition, PIMs use was more likely among women with diabetes, cancer, and polypharmacy. Conclusions: Future studies on strategies and interventions rationing PIMs use in older adults with anxiety disorder are necessary given the high prevalence of PIMs and polypharmacy within this population.
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Pagno, Andressa Rodrigues, Carolina Baldissera Gross, Daiana Meggiolaro Gewehr, Christiane de Fátima Colet, and Evelise Moraes Berlezi. "Drug therapy, potential interactions and iatrogenesis as factors related to frailty in the elderly." Revista Brasileira de Geriatria e Gerontologia 21, no. 5 (2018): 588–96. http://dx.doi.org/10.1590/1981-22562018021.180085.
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Abstract Objective: to investigate the use of drugs, potential drug interactions and iatrogenesis, as factors associated with frailty. Method: an observational, cross-sectional, population-based study of elderly persons registered with the Family Health Strategies of the urban area of a municipal region in the south of Brazil was carried out. The sample was probabilistic and involved 554 elderly persons; and the proportional stratified sampling technique by FHS and gender was used. Data collection was performed in the home, with the gathering of information regarding sociodemographic characteristics and pharmacotherapeutic profile and the evaluation of frailty based on Fried et al. (2001). Results: medications were taken by 86.3% of the elderly and there was a prevalence of frailty of 63.0%. A total of 39.4% of the elderly were exposed to polypharmacy, 49.1% used potentially inappropriate medications and 52.2% were exposed to potential drug interactions, the most frequent being enalapril and metformin. An association between increased risk of frailty and the variables: polypharmacy; use of potentially inappropriate medications; potential drug interactions; more than two potential drug interactions with the presence or absence of potentially inappropriate medication was identified. Conclusion: an association was found between frailty and polypharmacy, the use of potentially inappropriate medication and the presence of drug interactions. The findings underscore the importance of the monitoring of drug therapy in this population group with a view to the early detection, prevention and resolution of iatrogenesis arising from the use of medicines.
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Pinto, Mauro Cunha Xavier, Felipe Ferré, and Marcos Luciano Pimenta Pinheiro. "Potentially inappropriate medication use in a city of Southeast Brazil." Brazilian Journal of Pharmaceutical Sciences 48, no. 1 (2012): 79–86. http://dx.doi.org/10.1590/s1984-82502012000100009.
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Potentially inappropriate medication use by the Diamantina (Minas Gerais State) population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179) and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82) of prescriptions and 92.68% (n=76) of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268) while 21.99% (n=91) of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society, representing an issue requiring effective actions to promote rational use of medicines.
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Nuguru, Meenakshi. "Abuse Of Over The Counter Medications And Tradition Medicines -Strategies & Barriers." International Journal of Pharmaceutical Sciences 2, no. 7 (2024): 1729–33. https://doi.org/10.5281/zenodo.12801611.
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Tone drug and tone care Pratices are essential for any health care systems. The medications attained by cases for treatment of common affections, without a tradition from a physician, are known as Over The Counter (OTC) Medications . OTC drug abuse do due to the incorrect lozenge forms , lack of interaction knowledge , inappropriate medication use and incorrect duration of use. Physicians need to watch for tradition medications and OTC drug abuse. Treatment strategies include Inquiring about tradition, OTC medicines. Inquiring about medication use Furnishing disposal holders that patients can use to dispose of their OTC medications Treating pain aggressively and appropriately. Rehearsing careful record keeping of tradition renewals. Pertaining patients who are addicted to medications to 12 steps program similar as Alcoholic Anonymous, Narcotics Anonymous considering Detoxification.
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Monzón-Kenneke, Michele, Paul Chiang, Nengliang (Aaron) Yao, and Mark Greg. "Pharmacist medication review: An integrated team approach to serve home-based primary care patients." PLOS ONE 16, no. 5 (2021): e0252151. http://dx.doi.org/10.1371/journal.pone.0252151.
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Background Comprehensive medication review is a patient-centered approach to optimize medication use and improve patient outcomes. This study outlines a pilot model of care in which a remote corporate-based clinical pharmacist implemented comprehensive medication reviews for a cohort of medically complex home-based primary care (HBPC) patients. Method Ninety-six medically complex patients were assessed for medication-related problems. Data collected on these patients were: number of chronic conditions, number of medications, appropriate indication for each medication, dose appropriateness, drug interactions, recommendations for medication optimization and deprescribing. The number of accepted recommendations by the HBPC practice was analyzed. Results On average, the patients were 82 years old and had 13 chronic conditions. They were taking a median of 17 medications. Over a four-month pilot period, 175 medication recommendations were made, and 53 (30.3%) of them were accepted, with most common being medication discontinuation, deprescribing, and dose adjustments. Sixty-four (66.7%) patients were on a medication listed as potentially inappropriate for use in older adults. The most common potentially inappropriate medication was a proton-pump inhibitor (38.5%), followed by aspirin (24%), tramadol (15.6%), a benzodiazepine (13.5%) or an opioid (8.3%). Eighty-one medications were recommended for deprescribing and 27 medications were discontinued (33.3%). There were 24 recommended dose adjustments and 11 medications were dose adjusted (45.8%). Thirty-four medications were suggested as an addition to the current patient regimen, 2 medications were added (5.9%). Conclusion Pharmacist comprehensive medication review is a necessary component of the HBPC healthcare continuum. Additional research is needed to examine whether aligning pharmacists to deliver support to HBPC improves clinical outcomes, reduces healthcare expenditures and improves the patient’s experience.