Impact of potentially inappropriate medication and continuity of care in a sample of <scp>T</scp>aiwan elderly patients with diabetes mellitus who have also experienced heart failure

Lai, Yung‐Rung; Yang, Yi‐Sun; Tsai, Min-Ling; Lu, Yingli; Kornelius, Edy; Huang, Chien‐Ning; Chiou, Jeng‐Yuan

doi:10.1111/ggi.12606

Cited by 16 publications

(29 citation statements)

References 31 publications

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“…In Taiwan, a higher percentage of HF patients were having at least one PIM ranging from 81.2% to 89.1% between 2005 and 2010. [ 12 ] However, the interpretation of this high PIM percentage should be done carefully because not all PIMs are recommended to be avoided in this sample, some could be used but with caution. This high consumption of PIMs needs to be controlled by multi‐pronged approaches to limit its long‐term effects on the patient.…”

Section: Discussionmentioning

confidence: 99%

“…All patients who attended the outpatient cardiology clinics of a tertiary care center between November 2017 and December 2018 were screened for their eligibility to be included in the study. Since there is no estimate of the percentage of PIMs in elderly HF patients in Lebanon, the percentage was assumed to be 86% based on the findings of Lai et al [ 12 ] who used the same PIM identification criteria. A sample size of 125 was able to estimate the percentage of PIMs with a margin of error of 6% and 95% confidence interval.…”

Section: Methodsmentioning

confidence: 99%

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Potentially inappropriate medications in elderly patients with heart failure: Beers Criteria-based study

Zahwe

Skouri

Rachidi

et al. 2020

International Journal of Pharmacy Practice

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Objectives Primary objectives were to evaluate the use of potentially inappropriate medication (PIM) use in elderly heart failure (HF) patients and the factors associated with the number of PIMs. Secondary objectives were to test for the correlation between PIMs and quality of life (QOL) and depression. Methods A cross‐sectional study was conducted among 125 elderly Lebanese HF patients with left ventricular ejection fraction <50%. Data on socio‐demographics, clinical data and medications were collected. Patients were interviewed with Minnesota living with Heart Failure Questionnaire (MLHFQ) and Patient Health Questionnaire‐9 (PHQ‐9). Medication profile per patient was evaluated for PIMs using Beers Criteria. The correlations between the number of PIMs and the MLHFQ, PHQ‐9 and the number of medications were tested using Pearson’s correlation. Linear regression was done to predict the factors associated with the number of PIMs. Key findings Patients were taking a total of 1035 medications with a mean of 8.28 ± 3.14 medications. In total, 80.0% of patients were taking at least one PIM. Diuretics (55.2%) and proton pump inhibitors (41.6%) were most commonly prescribed PIMs. The number of PIMs was moderately correlated with the number of medications and the MLHFQ score. Linear regression showed that the number of medications, age ≥85 years, chronic kidney disease and HF with New York Heart Association III were associated with more PIMs. Conclusions A high percentage of PIMs was found among a sample of elderly Lebanese HF patients. HF multidisciplinary team is needed to control the prescription of PIMs in this vulnerable population.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Potentially inappropriate medications in elderly patients with heart failure: Beers Criteria-based study

Zahwe

Skouri

Rachidi

et al. 2020

International Journal of Pharmacy Practice

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“…PIMs in particular have been associated with adverse events due to drug-disease and drug-drug interactions 6 , and patients with many diseases are generally treated with many prescriptions, which probably include PIMs. Many countries have developed strategies and criteria for identifying and screening PIMs ; however, while one systematic review associated PIMs with readmission 7 , a cohort study on HF patients using the Beers criteria found no such association 8 . Therefore, the role of PIMs in readmissions of HF patients is still controversial.…”

Section: Introductionmentioning

confidence: 99%

Five Prognostic Factors for Readmission in Patients Over 75 Years Old with Worsening Heart Failure

Saitô

Miyake

Taki

et al. 2020

Showa Univ J Med Sci

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Heart failure HF is a common disease in elderly patients, particularly in those presenting as readmission for worsening HF. While recent studies have revealed mortality-associated factors in this population, little is known about prognostic factors associated with worsening HF. To investigate this clinical evidence gap in patients aged over 75 years, we retrospectively investigated 165 patients hospitalized for HF at Showa University Hospital, of whom 65 39.4 were readmitted for worsening HF. We extracted the candidate variables based on univariate analysis, and then elucidated the independent prognostic factors by multivariate analysis. Compared with non-readmitted patients, readmitted patients with worsening HF had lower left ventricular ejection fraction LVEF 39 vs. 50 , P 0.002 and body mass index BMI 19.9 kg/m 2 vs. 21.4 kg/m 2 , P 0.007 , higher levels of B-type natriuretic peptide BNP 478 pg/ml vs. 198 pg/ml, P 0.001 , and heart rate HR 71.0 beats/min vs. 67.0 beats/min, P 0.021 upon discharge during the primary admission. Multivariate logistic analysis identi ed LVEF 40 , BMI 21 kg/m 2 , BNP ≥ 500 pg/ml, Charlson score ≥ 3, and HR ≥ 70 beats/min upon initial discharge as independent prognostic factors. Based on these factors, readmission for worsening HF was more frequent in those with our proposed risk score of ≥ 3.0 than in those with a risk score 3.0 P 0.001 , and we suggested ve prognostic factors for HF patients over 75 years old. Our proposed risk score combines these factors and might predict readmission for worsening HF in the elderly population.

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“…For example, in the case of diabetes, a higher continuity of medication is able to more successfully reduce the readmission rate, emergency room usage, and medical costs. [22–26] In the case of asthma, a higher continuity of outpatient care is able to more effectively decrease next-year emergency room usage in children. [26] Elderly asthmatic patients with a lower continuity of outpatient care have a significantly higher likelihood of having an asthma-related emergency room visit.…”

Section: Discussionmentioning

confidence: 99%

Association between continuity of care and long-term mortality in Taiwanese first-ever stroke survivors: An 8-year cohort study

Yang

Cheng

et al. 2019

PLoS ONE

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Background Continuity of care is considered to be an important principle of stroke care; however, few analyses of empirically related outcomes have been reported. Objective This study examined the correlation between the continuity of care for outpatients after a stroke event and the survival of stroke patients over the year following hospital discharge. Research design Data from the Taiwan National Health Insurance Database were used in this study. We defined stroke as the ICD-9-CM codes 430 to 437, and all patients were followed up regarding their survival for at least one year. The modified modified continuity index (MMCI) was used as the indicator of continuity of care. Cox proportional hazard models with robust sandwich variance estimates were employed to analyze the correlation between continuity of care and stroke-related death. Results A total of 9,252 stroke patients were included in the analysis. Those patients who had a high and a completed COC had a higher percentage of survival (97.25% and 95.39%) compared to the other two groups. After controlling for other variables, compared with the low-level continuity of care group, the moderate-level, high-level and completed continuity of care groups still showed a significantly lower risk of death HR (95% CI) were: 0.63 (0.49–0.80), 0.56 (0.40–0.79) and 0.50 (0.39–0.63), respectively. Conclusion Continuity of care may increase the survival among stroke patients and therefore plays an important role in management of stroke after survival.

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Impact of potentially inappropriate medication and continuity of care in a sample of Taiwan elderly patients with diabetes mellitus who have also experienced heart failure

Abstract: Among elderly DM patients with HF, COC had positive effects on healthcare outcomes. Improving COC and reducing PIM duration for elderly DM patients with HF seems warranted. Geriatr Gerontol Int 2016; 16: 1117-1126.

Cited by 16 publications

References 31 publications

Potentially inappropriate medications in elderly patients with heart failure: Beers Criteria-based study

Potentially inappropriate medications in elderly patients with heart failure: Beers Criteria-based study

Five Prognostic Factors for Readmission in Patients Over 75 Years Old with Worsening Heart Failure

Association between continuity of care and long-term mortality in Taiwanese first-ever stroke survivors: An 8-year cohort study

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