Potentially Inappropriate Medication Use in Older Hospitalized Patients with Type 2 Diabetes: A Cross-Sectional Study.
Rishabh Sharma, Manik Chhabra, Kota Vidyasagar, Muhammed Rashid, Daniela Fialova, Akshaya S Bhagavathula
Author Information
Rishabh Sharma: Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga 142001, Punjab, India.
Manik Chhabra: Department of Pharmacy Practice, Indo-Soviet Friendship College of Pharmacy, Moga 142001, Punjab, India. ORCID
Kota Vidyasagar: Department of Pharmaceutical Sciences, University College of Pharmaceutical Sciences, Hanamkonda 506009, Telangana, India. ORCID
Muhammed Rashid: Department of Pharmacy Practice, Sri Adichunchanagiri College of Pharmacy, Adichunchanagiri University, B G Nagara 571448, Karnataka, India. ORCID
Daniela Fialova: Department of Social and Clinical Pharmacy, Faculty of Phamacy, 50005 Hradec Králové, Czech Republic. ORCID
Akshaya S Bhagavathula: Department of Social and Clinical Pharmacy, Faculty of Phamacy, 50005 Hradec Králové, Czech Republic.
Older patients with type 2 diabetes mellitus (T2DM) are at greater risk of receiving potentially inappropriate medications (PIM) during hospitalization which may result in adverse outcomes. To evaluate the extent of PIM use in the older population with T2DM during hospitalization in a tertiary care hospital in India. A cross-sectional study was carried out from August 2019 to January 2020 in a tertiary care teaching hospital among the older population (aged ≥ 65 years) hospitalized with T2DM. Medications prescribed during hospitalization were reviewed following Beers Criteria 2019 to identify the extent of polypharmacy and PIM use. Binary logistic regression was applied to determine the factors associated with PIM use. The mean age of the 150 patients hospitalized with T2DM was 68.85 ± 5.51 years, most of whom were men (54.7%). The participants had at least four comorbidities and were receiving an average of nine medications per day; the median length of hospital stay was 8 days (interquartile range (IQR): 4-19 days). Overall, three quarters (74%) of the participants had at least one PIM prescribed during their hospitalization as per Beers Criteria. Significant factors associated with the use of PIM during hospitalization are patients taking a higher number of medications (odds ratio (OR): 7.85, 95% CI 1.49-41.10), lower creatinine clearance values (OR: 12.90, 95% CI 2.81-59.28) and female patients (OR: 2.29; 95% CI: 1.05-4.97). PIM use is frequently observed in older T2DM patients during hospitalization. Polypharmacy, reduced renal function and female gender are associated with higher PIM use. Engaging clinical pharmacists in evaluating medication appropriateness can improve the outcomes of older patients.
