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Current Drug Safety

Editor-in-Chief

ISSN (Print): 1574-8863
ISSN (Online): 2212-3911

Research Article

Potentially Inappropriate Medication Use in Older People: A Crosssectional Study Using Beers Criteria

Author(s): Gülsüm Hatice Yüksel, Fuat Nihat Ozaydin* and Ayse Nilufer Ozaydin

Volume 17, Issue 2, 2022

Published on: 11 January, 2022

Page: [121 - 128] Pages: 8

DOI: 10.2174/1574886316666210727153124

Price: $65

Abstract

Background: The use of Potentially Inappropriate Medications (PIMs) is common and negatively affects elderly health and disease prognosis.

Objective: This study aims to analyze the frequency of PIMs in the elderly health records registered to a family health center and to identify risk factors, prescription/nonprescription distribution, distribution by healthcare institutions, number of doctors visits, and health literacy.

Methods: In this cross-sectional study, a stratified sampling method was used to select individuals aged ≥ 65 years. The health records of the participants up to the last 12 months were examined, and medicines used by participants were evaluated according to Beers 2019 criteria.

Results: Most of the participants (89.7%, n:183) had PIMs in health records. The mean number of PIMs used by the elderly was 2.9±1.9 (min:0, max:8). A positive linear relationship was observed between multimorbidity and the number of PIMs (p=0.001). There was no significant difference in terms of PIMs frequency among healthcare institutions. Prescription and non-prescription PIMs were found to belong to the same drug groups (Pain relievers and stomach medications). A linear and significant correlation was found between the number of PIMs and doctor visits (p=0.047).

Conclusion: The doctor should examine prescription and over-the-counter medications used by the elderly during the visit. It will be useful to establish a warning system stating that PIMs are available while registering the medications in the electronic system. So, it will be possible for health authorities to re-evaluate the treatment and replace PIMs with rational drug options.

Keywords: PIMs, prescription, non-prescription, pharmacy, doctor-visit, health literacy.

Graphical Abstract

[1]
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.
[http://dx.doi.org/10.18549/PharmPract.2019.2.1439]
[2]
Fialová D, Brkić J, Laffon B, et al. Applicability of EU(7)-PIM criteria in cross-national studies in European countries. TherAdv Drug Saf 2019; 10: 2042098619854014.
[3]
Brahma DK, Wahlang JB, Marak MD. Adverse drug reactions in the elderly. J Pharmacol Pharmacother 2013; 4(2): 91-4.
[5]
Vrdoljak D, Borovac JA. Medication in the elderly - considerations and therapy prescription guidelines. Acta Med Acad 2015; 44(2): 159-68.
[PMID: 26702910]
[6]
Motter FR, Fritzen JS, Hilmer SN, Paniz ÉV, Paniz VMV. Potentially inappropriate medication in the elderly: A systematic review of validated explicit criteria. Eur J Clin Pharmacol 2018; 74(6): 679-700.
[http://dx.doi.org/10.1007/s00228-018-2446-0] [PMID: 29589066]
[7]
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 MedicineArch Intern Med 1991; 151(9): 1825-32.
[http://dx.doi.org/10.1001/archinte.1991.00400090107019]
[8]
By the 2019 american geriatrics society beers criteria® update expert panel. American geriatrics society 2019 updated AGS beers criteria® for potentially inappropriate medication use in older patients. J Am Geriatr Soc 2019; 67(4): 674-94.
[9]
Bozkurt H, Demirci H. Health literacy among older persons in Turkey. Aging Male 2019; 22(4): 272-7.
[http://dx.doi.org/10.1080/13685538.2018.1437901]
[10]
Park NH, Song MS, Shin SY, Jeong JH, Lee HY. The effects of medication adherence and health literacy on health-related quality of life in older people with hypertension. Int J Older People Nurs 2018; 13(3): e12196.
[http://dx.doi.org/10.1111/opn.12196]
[11]
Open Source Epidemiologic Statistics for Public Health.. Available from: https://www.openepi.com/SampleSize/SSPropor.htm.
[12]
Masnoon N, Shakib S, Kalisch-Ellett L. What is polypharmacy? A systematic review of definitions. BMC Geriatr 2017; 17(1): 230.
[13]
Ay P, Akici A, Harmancı H. Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, Turkey. Int J Clin Pharmacol Ther 2005; 43(4): 195-202.
[14]
Bahat G, Bay I, Tufan A, Tufan F, Kilic C, Karan MA. Prevalence of potentially inappropriate prescribing among older adults: A comparison of the Beers 2012 and Screening Tool of Older Person's Prescriptions criteria version 2. Geriatr Gerontol Int 2012; 17(9): 1245-51.
[15]
Cıbık B, Sahin EM, Kılıncaslan MG. A population-based study:The appropriateness of drug use in the elderly according to BEERs criteria. Turk Geriatri Derg 2018; 21(1): 1-5.
[http://dx.doi.org/10.31086/tjgeri.2018137962]
[16]
Storms H, Marquet K, Aertgeerts B, Claes N. Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review. Eur J Gen Pract 2017; 23(1): 69-77.
[http://dx.doi.org/10.1080/13814788.2017.1288211] [PMID: 28271916]
[17]
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): 154.
[http://dx.doi.org/10.1186/s12877-019-1168-1] [PMID: 31142286]
[18]
Mielke N, Huscher D, Douros A, et al. Self-reported medication in community-dwelling older adults in Germany: Results form the Berlin Initiative Study. BMC Geriatr 2020; 20(1): 22.
[http://dx.doi.org/10.1186/s12877-020-1430-6]
[19]
Moore N, Scheiman JM. Gastrointestinal safety and tolerability of oral non-aspirin over-the-counter analgesics. Postgrad Med 2018; 130(2): 188-99.
[20]
Johnson DA, Katz PO, Armstrong D, et al. The safety of appropriate use of over-the-counter proton pump inhibitors: An evidence-based review and delphi consensus. Drugs 2017; 77(5): 547-61.
[21]
Kargar M, Atrianfar F, Rashidian A, et al. Prescribing for geriatrics in Tehran; is it appropriate and rational? Med J Islam Repub Iran 2019; 33: 143.
[http://dx.doi.org/10.47176/mjiri.33.143] [PMID: 32280649]
[22]
Monroe T, Carter M, Parish A. A case study using the Beers list criteria to compare prescribing by family practitioners and geriatric specialists in a rural nursing home. Geriatr Nurs 2011; 32(5): 350-6.
[http://dx.doi.org/10.1016/j.gerinurse.2011.07.003]
[23]
Chang CB, Lai HY, Yang SY, et al. Patient and clinic visit-related factors associated with potentially inappropriate medication use among older home healthcare service recipients. PLoS One 2014; 9(4): e94350.
[24]
Al Aqqad SM, Chen LL, Shafie AA, Hassali MA, Tangiisuran B. The use of potentially inappropriate medications and changes in quality of life among older nursing home residents. Clin Interv Aging 2014; 9: 201-7.
[PMID: 24489461]
[25]
Akkawi ME, Nik Mohamed MH. Does inappropriate prescribing affect elderly patients’ quality of life? A study from a Malaysian tertiary hospital. Qual Life Res 2019; 28(7): 1913-20.
[26]
Varga S, Alcusky M, Keith SW, et al. Hospitalization rates during potentially inappropriate medication use in a large population-based cohort of older adults. Br J Clin Pharmacol 2017; 83(11): 2572-80.
[http://dx.doi.org/10.1111/bcp.13365]
[27]
Alayed N, Alkhalifah B, Alharbi M, Alwohaibi N, Farooqui M. Adverse Drug Reaction (ADR) as a cause of hospitalization at a government hospital in Saudi Arabia: a prospective study. Curr Drug Saf 2019; 14(3): 192-8.
[http://dx.doi.org/10.2174/1574886314666190520105330] [PMID: 31109277]
[28]
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): 408-23.
[http://dx.doi.org/10.1111/ijpp.12541] [PMID: 30964225]
[29]
Hamano J, Ozone S, Tokuda Y. A comparison of estimated drug costs of potentially inappropriate medications between older patients receiving nurse home visit services and patients receiving pharmacist home visit services: a cross-sectional and propensity score analysis. BMC Health Serv Res 2015; 15: 73.
[http://dx.doi.org/10.1186/s12913-015-0732-4] [PMID: 25889514]
[30]
Rankin A, Cadogan CA, Patterson SM, et al. Interventions to improve the appropriate use of polypharmacy for older people. Cochrane Database Syst Rev 2018; 9(9): CD008165.
[http://dx.doi.org/10.1002/14651858.CD008165.pub4] [PMID: 30175841]
[31]
Gulcin DU, Pınar S, Busra T. A TI. Cost of medication in older patients: before and after comprehensive geriatric assessment. Clin In-terv Aging. 2018;13:603-613. J Med Internet Res 2019; 21(11): e15385.
[PMID: 31724956]
[32]
Monteiro L, Maricoto T, Solha I, Ribeiro-Vaz I, Martins C, Monteiro-Soares M. Reducing potentially inappropriate prescriptions for older patients using computerized decision support tools: systematic review. J Med Internet Res 2019; 21(11): e15385.
[http://dx.doi.org/10.2196/15385] [PMID: 31724956]
[33]
Turkey Pharmaceuticals and Medical Devices Agency of the Ministry of Health. Workshop on current problems and solution suggestions in drug use in the elderly. 26-27 may 2015, Ankara. Workshop Report. 2015. Available at: http://www.akilciilac.gov.tr/wp-content/uploads/2015/12/Geriatri-Rapor-Son.pdf

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