OpenLB
Open Library of Bioscience
Advanced Search
International journal of clinical practice
Nov, 2021;75 (11): e14715.

Potentially inappropriate medications in older adults according to Beers criteria 2019: Prevalence and risk factors.

Asma Ahmed Abdelwahed, Faris El-Dahiyat, Dina Aljawamis, Jumana Al Ajimi, Khuloud Jamal Bin Rafeea
Author Information
  1. Asma Ahmed Abdelwahed: Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, UAE.
  2. Faris El-Dahiyat: Clinical Pharmacy Program, College of Pharmacy, Al Ain University, Al Ain, UAE. ORCID
  3. Dina Aljawamis: Pharmacy Department, Tawam Hospital, Abu Dhabi, UAE.
  4. Jumana Al Ajimi: Pharmacy Department, Tawam Hospital, Abu Dhabi, UAE.
  5. Khuloud Jamal Bin Rafeea: Pharmacy Department, Tawam Hospital, Abu Dhabi, UAE.
PMID: 34378294 DOI: 10.1111/ijcp.14715

Abstract

AIM: Older patients are more prone to receive potentially inappropriate medications (PIMs) that are better to be avoided or dose adjusted to protect them from their unnecessary or harmful use. This study aims to detect the prevalence of PIMs among older patients discharged from Tawam hospital according to Beers criteria 2019. Moreover, the common risk factors of the older patients may subject them to PIMs use.
METHODS: A retrospective charts review study of older patients ≥65 years who were prescribed 5 or more medications and were discharged from Tawam hospital from 1 October 2018 to 31 December 2018. Each patient's medical record was scanned to detect PIMs. (PIMs) were classified according to Beers criteria 2019, and the predictors of PIMs were also assessed.
RESULTS: A total of 502 older patients (51.6% females and 48.4% males) medical charts were reviewed. The prevalence of PIMs among the study population was 34.7%. Antipsychotics (27.5%) and sulphonylurea's (16.8%) were among the most common avoided PIMs. Anticoagulants (40%) and ranitidine (35%) were the most PIMs based on the kidney function of the patient. Female gender [OR 1.8; 95% CI (1.22-2.66), P < .05] and increasing number of medications [OR 1.08; 95% CI (1.03-1.14), P < .05] were the independent predictors of PIMs.
CONCLUSION: Based on the prevalence of PIMs among older patients, it is recommended to revise each patient's medications prescription to avoid inappropriate prescribing and hence decrease the prevalence of PIMs.

References

  1. Corsonello A, Pranno L, Garasto S, Fabietti P, Bustacchini S, Lattanzio F. Potentially inappropriate medication in elderly hospitalized patients. Drugs Aging. 2009;26(Suppl 1):31-39.
  2. O’Connor MN, Gallagher P, Omahony D. Inappropriate prescribing: Criteria, detection and prevention. Drugs Aging. 2012;29(6):437-452.
  3. Nash DB, Koenig JB, Chatterton ML. Why the elderly need individualized pharmaceutical care. Thomas Jefferson University; 2000.
  4. Baruth JM, Gentry MT, Rummans TA, Miller DM, Burton MC. Polypharmacy in older adults: the role of the multidisciplinary team. Hospital Practice. 2020;48(sup1):56-62. https://doi.org/10.1080/21548331.2019.1706995
  5. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine. Arch Intern Med. 1991;151(9):1825-1832.
  6. Steinman MA, Beizer JL, Dubeau CE, Laird RD, Lundebjerg NE, Mulhausen P. How to use the American Geriatrics Society 2015 beers criteria - a guide for patients, clinicians, health systems, and payors. J Am Geriatr Soc. 2015;63(12):e1-e7. https://doi.org/10.1111/jgs.13701
  7. American Geriatrics Society Beers Criteria Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2019;67(4):674-694.
  8. Cannon KT, Choi MM, Zuniga MA. Potentially inappropriate medication use in elderly patients receiving home health care: A retrospective data analysis. Am J Geriatr Pharmacother. 2006;4(2):134-143. https://doi.org/10.1016/j.amjopharm.2006.06.010
  9. Vieira De Lima TJ, Garbin CAS, Garbin AJÍ, Sumida DH, Saliba O. Potentially inappropriate medications used by the elderly: prevalence and risk factors in Brazilian care homes. BMC Geriatr. 2013;13(1):1-7.
  10. Domínguez-Almendros S, Benítez-Parejo N, Gonzalez-Ramirez AR. Logistic regression models. Allergol Immunopathol (Madr). 2011;39(5):295-305.
  11. Thomas RE, Thomas BC. A systematic review of studies of the stopp/start 2015 and American Geriatric Society beers 2015 criteria in patients ≥ 65 years. Curr Aging Sci. 2019;12(2):121-154.
  12. Al-Busaidi S, Al-Kharusi A, Al-Hinai M, et al. Potentially inappropriate prescribing among elderly patients at a primary care clinic in Oman. J Cross Cult Gerontol. 2020;35(2):209-216. https://doi.org/10.1007/s10823-019-09393-5
  13. Alhmoud E, Khalifa S, Bahi AA. Prevalence and predictors of potentially inappropriate medications among home care elderly patients in Qatar. Int J Clin Pharm. 2015;37(5):815-821.
  14. Alyazeedi A, Algendy AF, Sharabash M, Karawia A. Prevalence, determinants and associated risk of potentially inappropriate prescribing for older adults in qatar: a national retrospective study. Clin Interv Aging. 2019;14:1889-1899.
  15. Al-Azayzih A, AlAmoori R, Altawalbeh SM. Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study. Pharm Pract. 2019;17(2):1439. https://doi.org/10.18549/PharmPract.2019.2.1439
  16. Alhawassi TM, Alatawi W, Alwhaibi M. Prevalence of potentially inappropriate medications use among older adults and risk factors using the 2015 American Geriatrics Society Beers criteria. BMC Geriatr. 2019;19(1):1-8.
  17. Alturki A, Alaama T, Alomran Y, Al-Jedai A, Almudaiheem H, Watfa G. Potentially inappropriate medications in older patients based on Beers criteria: a cross-sectional study of a family medicine practice in Saudi Arabia. BJGP Open. 2020;4(1):bjgpopen20X101009.
  18. Najjar MF, Sulaiman SAS, Al Jeraisy M, Balubaid H. The impact of a combined intervention program: An educational and clinical pharmacist’s intervention to improve prescribing pattern in hospitalized geriatric patients at King Abdulaziz Medical City in Riyadh, Saudi Arabia. Ther Clin Risk Manag. 2018;14:557-564.
  19. Fulone I, Lopes LC. Potentially inappropriate prescriptions for elderly people taking antidepressant: comparative tools. BMC Geriatr. 2017;17(1):1-8.
  20. Reis CM, dos Santos AG, de Jesus SP, Reis AMM. Factors associated with the use of potentially inappropriate medications by older adults with cancer. J Geriatr Oncol. 2017;8(4):303-307. https://doi.org/10.1016/j.jgo.2017.05.003
  21. Skaar DD, O’Connor HL. Use of the Beers criteria to identify potentially inappropriate drug use by community-dwelling older dental patients. Oral Surg Oral Med Oral Pathol Oral Radiol. 2012;113(6):714-721.
  22. Suehs BT, Davis C, Ng DB, Gooch K. Impact of 2015 update to the beers criteria on estimates of prevalence and costs associated with potentially inappropriate use of antimuscarinics for overactive bladder. Drugs Aging. 2017;34(7):535-543.
  23. Komagamine J. Prevalence of potentially inappropriate medications at admission and discharge among hospitalised elderly patients with acute medical illness at a single centre in Japan: a retrospective cross-sectional study. BMJ Open. 2018;8(7):1-8.
  24. Kose E, Hirai T, Seki T, Hayashi H. Role of potentially inappropriate medication use in rehabilitation outcomes for geriatric patients after strokes. Geriatr Gerontol Int. 2018;18(2):321-328.
  25. Page RL, Linnebur SA, Ruscin Bryant LL, JM. Inappropriate prescribing in the hospitalized elderly patient: defining the problem, evaluation tools, and possible solutions. Clin Interv Aging. 2010;7(5):75-87. https://doi.org/10.2147/cia.s9564
  26. Nothelle SK, Sharma R, Oakes A, Jackson M, Segal JB. Factors associated with potentially inappropriate medication use in community-dwelling older adults in the United States: a systematic review. Int J Pharm Pract. 2019;27(5):408-423.
  27. Roux B, Sirois C, Simard M, Gagnon M-E, Laroche M-L. Potentially inappropriate medications in older adults: a population-based cohort study. Fam Pract. 2020;37:173-179.
  28. Simões PA, Santiago LM, Maurício K, Simões JA. Prevalence of potentially inappropriate medication in the older adult population within primary care in Portugal: a nationwide cross-sectional study. Patient Prefer Adherence. 2019;13:1569-1576.
  29. Morgan SG, Weymann D, Pratt B, et al. Sex differences in the risk of receiving potentially inappropriate prescriptions among older adults. Age Ageing. 2016;45(4):535-542.
  30. World Health Organization. Global Health and Aging (NIH publication no. 11-7737) [Internet]. National Institutes of Health, US Department of Health and Human Services; 2011. Available from: https://www.who.int/ageing/publications/global_health.pdf. Accessed January 9, 2021.
  31. Goulding MR. Inappropriate medication prescribing for elderly ambulatory care patients. Arch Intern Med. 2004;164(3):305-312.
  32. Corsonello A, Pedone C, Lattanzio F, et al. Potentially inappropriate medications and functional decline in elderly hospitalized patients. J Am Geriatr Soc. 2009;57(6):1007-1014.
  33. Raji MA, Ostir GV, Markides KS, Espino DV, Goodwin JS. Potentially inappropriate medication use by elderly Mexican Americans. Ann Pharmacother. 2003;37(9):1197-1202.
  34. Blackwell DL, Lucas JW, Clarke TC. Summary health statistics for U.S. adults: national health interview survey, 2012. Vital Health Stat 10. 2014;260:1-161.
  35. Schuler J, Dückelmann C, Beindl W, Prinz E, Michalski T, Pichler M. Polypharmacy and inappropriate prescribing in elderly internal-medicine patients in Austria. Wien Klin Wochenschr. 2008;120(23-24):733-741.
  36. Liew NY, Chong YY, Yeow SH, Kua KP, Saw PS, Lee SWH. Prevalence of potentially inappropriate medications among geriatric residents in nursing care homes in Malaysia: a cross-sectional study. International Journal of Clinical Pharmacy. 2019;41(4):895-902. https://doi.org/10.1007/s11096-019-00843-1
  37. Vatcharavongvan P, Puttawanchai V. Potentially inappropriate medications among the elderly in primary care in Thailand from three different sets of criteria. Pharm Pract. 2019;17(3):1-8.
  38. Saboor M, Kamrani AAA, Momtaz YA, Sahaf R. Prevalence and associated factors of potentially inappropriate medications among Iranian older adults. Med Glas. 2019;16(1):121-127.
  39. Bao Y, Shao H, Bishop TF, Schackman BR, Bruce ML. Inappropriate medication in a national sample of US elderly patients receiving home health care. J Gen Intern Med. 2012;27(3):304-310.
  40. Uhlig K, Leff B, Kent D, et al. A framework for crafting clinical practice guidelines that are relevant to the care and management of people with multimorbidity. J Gen Intern Med. 2014;29(4):670-679.
  41. Miller GE, Sarpong EM, Davidoff AJ, Yang EY, Brandt NJ, Fick DM. Determinants of potentially inappropriate medication use among community-dwelling older adults. Health Serv Res. 2017;52(4):1534-1549.

MeSH Term

Aged
Cross-Sectional Studies
Female
Humans
Inappropriate Prescribing
Male
Potentially Inappropriate Medication List
Prevalence
Retrospective Studies
Risk Factors
Journal Article
Article has an altmetric score of 7

Word Cloud

Created with Highcharts 10.0.0PIMspatientsoldermedications1prevalenceamonginappropriatestudyaccordingBeerscriteriaavoidedusedetectdischargedTawamhospital2019commonriskfactorscharts2018patient'smedicalpredictors[OR95%CIP <05]AIM:OlderpronereceivepotentiallybetterdoseadjustedprotectunnecessaryharmfulaimsMoreovermaysubjectMETHODS:retrospectivereview≥65 yearsprescribed5October31DecemberrecordscannedclassifiedalsoassessedRESULTS:total502516%females484%malesreviewedpopulation347%Antipsychotics275%sulphonylurea's168%Anticoagulants40%ranitidine35%basedkidneyfunctionpatientFemalegender822-266increasingnumber0803-114independentCONCLUSION:BasedrecommendedreviseprescriptionavoidprescribinghencedecreasePotentiallyadults2019:Prevalence

Similar Articles

Cited By (13)

Potentially inappropriate medications in geriatric blood or marrow transplantation (BMT) survivors: A BMT Survivor Study report.Prevalence and Predictors of Potentially Inappropriate Prescribing in Older People Receiving Home Health Care in Saudi Arabia According to the American Geriatrics Society Beers Criteria 2019.Prevalence of key potentially inappropriate drugs use in pediatrics: a cross-sectional study.Assessing Medication Use Quality in Older Outpatients Using the Beers Criteria: Findings from a Single-Center Retrospective Study.Prevalence and factors associated with potentially inappropriate medication and medication complexity for older adults in the emergency department of a secondary teaching hospital in Indonesia.Potentially inappropriate medicine use and predicting risk factors in hospitalized older adult patients: findings of a prospective observational study from Ethiopia.Potentially inappropriate medications in older Chinese outpatients based on the Beers criteria and Chinese criteria.Potentially Inappropriate Medications in Hospitalized Older Patients in Tabuk, Saudi Arabia Using 2023 Beers Criteria: A Retrospective Multi-Centric Study.Potentially inappropriate medications use among the older patients diagnosed with psychiatric diseases in Saudi Arabia: a cross-sectional study.Association Between Inappropriate Prescribing According to the 2023 Beers Criteria and Different Health Outcomes: A 1-Year Longitudinal Study in Community-Dwelling Older Adults.
See all "Cited by" articles