Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department

Nightingale, Ginah; Scopelliti, Emily M.; Casten, Robin J.; Woloshin, Monica; Xiao, Shu Dong; Kelley, Megan; Chang, Anna Marie; Hollander, Judd E.; Leiby, Benjamin E.; Peterson, Andrew M.; Pizzi, Laura T.; Rising, Kristin L.; White, Neva; Rovner, Barry W.

doi:10.1177/08982643211045546

Cited by 7 publications

(17 citation statements)

References 47 publications

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“…PIMs have been found associated with adverse health outcomes and prevalent in older adults with diabetes outside China ( 6 , 22 , 23 ). In light of the large number of older adults with diabetes in China and the complexity of chronic conditions in this population, we need to evaluate the prevalence and related clinical features of PIM exposure in China ( 11 , 12 ).…”

Section: Discussionmentioning

confidence: 99%

“…(95% CI 78.98-82.98), which was higher than in 2015 (76.43%, 95%CI 74.64-78. 22) and 2016 (76.40, 95%CI 74.68-78.12%) (Table 1).…”

Section: Figurementioning

confidence: 99%

“…Several surveys conducted in different health care settings showed that older adults with diabetes were the most commonly exposed to PIMs (5,17,(21)(22)(23). Studies found that 24.9, 56.1, and 39.9% of older adults with diabetes had at least one PIM in The Netherlands, Canada and United States, respectively (22,24,25 Because of the high prevalence of older adults with diabetes in China and high prevalence of PIMs in older adults with diabetes, more research is needed to evaluate the quality of medication use and assess the association between comorbidities and PIMs in Chinese older people with diabetes in outpatient settings. The two major questions of this study were to evaluate the prevalence of PIMs in older adults with diabetes in outpatient settings in China and to explore the association between PIMs and polypharmacy due to comorbidities in older adults with diabetes in outpatient visitation settings.…”

Section: Introductionmentioning

confidence: 99%

“…Several surveys conducted in different health care settings showed that older adults with diabetes were the most commonly exposed to PIMs ( 5 , 17 , 21 – 23 ). Studies found that 24.9, 56.1, and 39.9% of older adults with diabetes had at least one PIM in The Netherlands, Canada and United States, respectively ( 22 , 24 , 25 ). A previous retrospective cohort analysis conducted in Beijing, which included 506,214 older adults in outpatient settings, found a prevalence of PIM of 38.07% ( 17 ), but knowledge of the prevalence of PIMs in older people with diabetes is lacking in China.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Yao²,

Chen

et al. 2022

Front. Public Health

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AimsPotentially inappropriate medications had been found associated with adverse drug events such as falls, emergency department admissions and hospital readmissions. There is lack of information about the prevalence of potentially inappropriate medications and associated chronic conditions in older patients with diabetes in China. This study aimed to assess the prevalence of potentially inappropriate medications in older adults with diabetes in an outpatient visitation setting and the association with polypharmacy due to comorbidities.Materials and methodsThis was a 3-year repeated cross-sectional study which conducted in outpatient setting of 52 hospitals in Shenzhen, China, using 2019 Beers criteria. The prevalence of potentially inappropriate medications, polypharmacy and comorbidities in older adults with diabetes in an outpatient setting was expressed as percentages. Logistic models were used to investigate the association between potentially inappropriate medication exposure and age, sex, polypharmacy and comorbidities.ResultsAmong the 28,484 older adults with diabetes in 2015, 31,757 in 2016 and 24,675 in 2017, the prevalence of potentially inappropriate medications was 43.2%, 44.88% and 42.40%, respectively. The top five potentially inappropriate medications were diuretics (20.56%), benzodiazepines (13.85%), androgens (13.18%), non-steroidal anti-inflammatory drugs (12.94%) and sulfonylureas (6.23%). After adjustment for age and polypharmacy, the probability of potentially inappropriate medication exposure was associated with chronic gastrointestinal diseases, followed by osteoarthritis and rheumatoid arthritis, chronic pulmonary disease, chronic kidney disease, tumor, dementia, chronic liver disease, hypertension, cardiovascular disease, cerebrovascular disease and hyperlipemia.ConclusionPotentially inappropriate medications were common in older patients with diabetes in an outpatient visitation setting. Higher probability of potentially inappropriate medication exposure was associated with the comorbidity chronic gastrointestinal diseases as well as osteoarthritis and rheumatoid arthritis. To ensure that iatrogenic risks remain minimal for older adults with diabetes, the clinical comorbidities should be considered.

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Section: Discussionmentioning

confidence: 99%

“…(95% CI 78.98-82.98), which was higher than in 2015 (76.43%, 95%CI 74.64-78. 22) and 2016 (76.40, 95%CI 74.68-78.12%) (Table 1).…”

Section: Figurementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Yao²,

Chen

et al. 2022

Front. Public Health

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“…The 94 studies were conducted across 17 countries. Forty-one studies were conducted in Asia, followed by 22 studies 11, in Europe, 14 studies [79][80][81][82][83][84][85][86][87][88][89][90][91][92] in North America, 8 studies [93][94][95][96][97][98][99][100] in South America, 7 studies [101][102][103][104][105][106][107] in Africa, and 2 studies 108,109 in Oceania. Between 1999 and 2021, a total of 51 studies 11,[37][38][39][40][41][42][79][80][81][82][83][84][85][86][87][88][89][90][91]…”

Section: Study Characteristicsmentioning

confidence: 99%

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

Tian,

Chen,

Zeng

et al. 2023

JAMA Netw Open

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ImportanceThe use of potentially inappropriate medications (PIMs) is widespread yet continues to receive little attention in outpatient services.ObjectiveTo estimate the overall prevalence of PIM use in outpatient services.Data SourcesPubMed, Embase, and Web of Science were searched to identify relevant studies published from January 1, 1990, to November 21, 2022.Study SelectionObservational studies that reported the prevalence of PIM use among older patients in outpatient services were screened.Data Extraction and SynthesisTwo reviewers independently selected eligible articles, extracted data, and assessed the risk of bias. A random-effects meta-analysis was conducted to pool the prevalence estimates.Main Outcomes and MeasuresThe global patterns in the prevalence of PIM use among older patients in outpatient services were estimated, and the temporal trends and regional differences in PIM use were investigated.ResultsA total of 94 articles with 132 prevalence estimates were analyzed, including nearly 371.2 million older participants from 17 countries. Overall, the pooled prevalence of PIM use was 36.7% (95% CI, 33.4%-40.0%). Africa had the highest prevalence of PIM use (47.0%; 95% CI, 34.7%-59.4%), followed by South America (46.9%; 95% CI, 35.1%-58.9%), Asia (37.2%; 95% CI, 32.4%-42.2%), Europe (35.0%; 95% CI, 28.5%-41.8%), North America (29.0%; 95% CI, 22.1%-36.3%), and Oceania (23.6%; 95% CI, 18.8%-28.8%). In addition, the prevalence of PIM use is highest in low-income areas. Use of PIMs among older patients has become increasingly prevalent in the past 2 decades.Conclusions and RelevanceThis study of patterns of PIM use by different groups, such as geographic regions and World Bank countries, suggests noticeable geographic environment and economic income differences in the burden of PIMs in outpatient services. Furthermore, the high prevalence trend in the past 2 decades indicates that the global burden of PIM use continues to be worthy of attention.

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Potentially Inappropriate Medication Use Among Older Patients with Diabetes in a Chinese Community

Xing-xing

et al. 2023

Exp Clin Endocrinol Diabetes

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Background Potentially inappropriate medications (PIMs) are frequently prescribed to older people with diabetes. This study aimed to assess the prevalence of PIM use in older people with diabetes and identify potential risk factors influencing the development of PIM use. Methods This was a cross-sectional study conducted in an outpatient setting in Beijing, China, using Chinese criteria. The prevalence of PIM use, polypharmacy, and comorbidities in older adults with diabetes in an outpatient setting was measured. Logistic models were employed to investigate the association among polypharmacy, comorbidities, and PIM use. Results The prevalence of PIM use and polypharmacy was 50.1% and 70.8%, respectively. The most common comorbidities were hypertension (68.0%), hyperlipemia (56.6%), and stroke (36.3%), and the top three inappropriately used medications were insulin (22.0%), clopidogrel (11.9%), and eszopiclone (9.81%). Age (OR 1.025; 95% CI 1.009, 1.042), the number of diagnoses (OR 1.172; 95% CI 1.114, 1.232), coronary heart disease (OR 1.557; 95% CI 1.207, 2.009), and polypharmacy (OR 1.697; 95% CI 1.252, 2.301) were associated with PIM use. Conclusions Given the higher rate of PIM use among older adults with diabetes, strategies and interventions targeting this population are needed to minimize PIM use.

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Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department

Cited by 7 publications

References 47 publications

Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

Potentially Inappropriate Medication Use Among Older Patients with Diabetes in a Chinese Community

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