A study of prescribing pattern, comorbidities, and cost analysis in elderly hospitalized patients in Pune

Raut, Asawari; Vohra, Faizal; Surve, Rahul; Pawar, Atmaram

doi:10.4103/2348-3334.183739

Cited by 4 publications

(5 citation statements)

References 3 publications

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“…However, another study conducted at Pune found more male patients (51.66%) than females (48.33%). [ 12 ] These differences could be incidental or due to different population characteristics. As can be seen in our study, more subjects were in the 60–69-year age group as compared to two successively higher age groups with 10 years of class intervals viz.…”

Section: Discussionmentioning

confidence: 99%

Cost analyses of hospital admissions among the elderly seeking care at a rural tertiary care hospital, South India

Tripathi

Reddy

Bhattacharyya

2021

Journal of Family Medicine and Primary Care

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Introduction: In a developing country like India, a proportionately higher number of elderly people live in the rural areas and many of them are financially challenged. Hospitalization and consequent cost thereto pose a heavy burden especially for the elderly. Objective: Among elderly in.patients at a tertiary care rural hospital to estimate the average number of episodes of hospitalizations, duration of stay in the hospital, and the direct and indirect costs associated with hospitalizations with 1 year as a reference period. Materials and Methods: A structured pre.tested questionnaire was used to capture the details regarding hospitalizations and the costs involved and also the hospital records were verified for the current hospital admission to finally arrive at the direct and indirect costs calculations. Quantitative details like age, episodes of hospitalization in the last 1 year, duration of hospitalization, hospitalization costs, etc., were summarized as median (inter.quartile range [IQR]). Costing analyses were noted separately as direct, indirect, and total costs and expressed in Indian National Rupees (INR). Results: The total number of episodes of hospitalization among the 150 study participants was 204 with a mean of 1.36 episodes per person in 1-year duration. The average total cost per episode of hospitalization was found to be INR 11,249 while the average total cost per person per day was INR 1,670.30. The median (IQR) direct and indirect costs were INR 6,222 (3,060-12,670) and INR 690 (200-700), respectively. Conclusion: Duration, as well as cost of hospitalization, has been found to be more among females in most age groups among elderly in.patients.

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Section: Discussionmentioning

confidence: 99%

Cost analyses of hospital admissions among the elderly seeking care at a rural tertiary care hospital, South India

Tripathi

Reddy

Bhattacharyya

2021

Journal of Family Medicine and Primary Care

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“…67,68 The higher prevalence of specific diseases in older patients with cognitive impairment could guide physicians to predict associated DRPs with those diseases. 69 For example, with a greater prevalence of cardiovascular and neurological diseases such as hypertension, ischemic heart disease and ischemic stroke, there are greater potential DDIs related to cardiovascular and neurological system medications including the combination of heparin with aspirin. In terms of DDI, most identified drug-paired interactions have been potentially severe.…”

Section: Discussionmentioning

confidence: 99%

<p>The Changes in Medication Prescribing Among the Older People with Cognitive Impairment in the Acute Care Setting</p>

Ruangritchankul

Peel

Hanjani

et al. 2020

CIA

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Purpose: Most older people with cognitive impairment usually have multiple comorbidities. In the last decade, the guidelines for the management of chronic diseases have been changed, leading to changes in the patterns of medication prescribing and in the prevalence of drugrelated problems (DRPs). The main objectives were to explore the changes in medication use and in the prevalence of polypharmacy (PP), the use of potentially inappropriate medications (PIMs) and drug-drug interactions (DDIs) among older hospitalized adults with cognitive impairment in a 5-year period. Patients and Methods: Older hospitalized patients with cognitive impairment diagnosed by cognitive performance scale (CPS) score of 2 or more at tertiary hospital in Brisbane, Australia in 2009 and 2015 to 2016 were enrolled. Prescribed medication use, and exposures to PP, PIM and/ or DDI were evaluated at two time points. The associated factors with patients exposed to >1 criteria of PP, PIM or DDI were analyzed by using logistic regression analyses. Results: The median number of prescribed medications was not significantly different between the two periods. The number of medications use as dermatological agents and analgesics substantially increased over 5 years. In contrast, there was a decrease in prescription of drugs for acid-related disorders, drugs used in diabetes, and mineral supplements. Most of the participants were exposed to at least one of PP, PIM or DDI. In multivariate regression analysis, the presence of diabetes diagnosis was a risk factor associated with increased exposure to >1 criteria of PP, PIM or DDI. Conclusion: The patterns of many prescribed medications use have altered in a 5-year period. The present study confirms that the majority of older adults with cognitive impairment admitted in an acute care setting are prone to PP, PIM and DDI. Comprehensive medication reviews should be undertaken in clinical care of older patients with cognitive impairment.

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“…20 Another study showed the average cost of treating an ADR among hospitalized inpatients in India was Rs.1,328.71 (US$21.90). 21…”

Section: Extent Of Adr In Elderlymentioning

confidence: 99%

“…16 On the contrary, in studies by Harugeri et al (OR = 1.52; CI: 1.04–2.22; p = 0.03), Raut et al (55.48%), and Prathyusha et al, female sex was shown to be an important ADR risk factor. 20 21 22 In a study by Sharma et al on chemotherapy-induced ADRs, females predominated ( n = 88, 54%), with only 16% of ADRs occurring in those older than 65 years. 23 It could be attributed to a higher body fat percentage and a lower body water content in females than in men, which can affect the distribution and elimination of drugs in the body.…”

Section: Vulnerability To Adverse Drug Reactionsmentioning

confidence: 99%

“…In general, ADR-related hospital admissions accounted for 5.9 to 10% of all admissions. 20 21 26 An ADR-related hospitalization accounted for 0.7% of all hospitalizations in one South Indian study in the general population, and ADR-related mortality accounted for 1.8% of all hospitalizations. 27 In a study of older patients admitted to the medical emergency department, 14.4% were drug related, 6.7% were due to ADRs, and 7.6% were due to prescription noncompliance.…”

Section: Extent Of Adr In Elderlymentioning

confidence: 99%

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Adverse Drug Reaction Reporting in Geriatric Oncology in India: An Understudied Topic that Needs Attention

Kuriachan

Palatty

George

et al. 2023

Indian J Med Paediatr Oncol

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In the elderly, polypharmacy is a common problem, and drug interactions and adverse drug reactions (ADR) have been linked to considerable harm in several population-based studies. However, when compared with other medical disciplines, studies with elderly cancer patients are lacking in oncology and India in particular. Additionally, intake of multiple drugs and, at times, potentially inappropriate medications (PIMs) are also common in older cancer patients. Physiologically, the body's metabolic functions are reduced in the elderly, resulting in altered medication pharmacokinetics and pharmacodynamic characteristics. There is also a high risk of aging-related disorders, and an increase in pharmaceutical use. Because cancer can affect the physiological milieu, patients are more likely to experience negative drug responses, drug–disease interactions, and drug–drug interactions, thereby making the elderly more vulnerable to the ill effects. Considering this, there is a need for greater knowledge and measures that try to lessen exposure to and the risks connected to drug combinations that might be detrimental. As the geriatric population grows, the need to address medical issues among aging cancer patients becomes more pressing, particularly in India. As far as the authors are aware, there is no review that addresses the drug–drug interactions and adverse drug responses brought on by polypharmacy in older cancer patients. It is expected that this endeavor will help the fraternity and the patients, and will serve as a valuable academic material for the health care students.

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A study of prescribing pattern, comorbidities, and cost analysis in elderly hospitalized patients in Pune

Cited by 4 publications

References 3 publications

Cost analyses of hospital admissions among the elderly seeking care at a rural tertiary care hospital, South India

Cost analyses of hospital admissions among the elderly seeking care at a rural tertiary care hospital, South India

<p>The Changes in Medication Prescribing Among the Older People with Cognitive Impairment in the Acute Care Setting</p>

Adverse Drug Reaction Reporting in Geriatric Oncology in India: An Understudied Topic that Needs Attention

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