Polypharmacy in Elderly Out Patients

Панова, Е.А.; Serov, V. A.; Shutov, A. M.; Bakumtseva, N.N.; Kuzovenkova, Marina

doi:10.34014/2227-1848-2019-2-16-22

Cited by 9 publications

(3 citation statements)

References 7 publications

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“…Our results is greater than the average prevalence of PIP (43%), and 2 times greater than the average prevalence of PIP in European countries (22%) [11], [12]. Our results are comparable to the prevalence of PIP in Russia (30-45%) [14], [21], which is most likely due to a similar health care system. The results of the study show that 56% of elderly patients at the primary care level have a risk of a potential adverse medicine reaction that can lead to complications.…”

Section: Discussionsupporting

confidence: 51%

“…In the United States of America, a long population study revealed determined that about 80% of older people regularly took at least two medicines, and 36% took at least five medicines [22]. In Russia, according to one study at the primary care level, about 52% of elderly patients take 4 or more medicines [14], and according to another, 37% take 5 or more medicines [21], the level of polypharmacy in Kazakhstan is higher. The statistical relationship that we have identified between the number of medicines taken and the presence of PIP also indicates the importance of preventing polypharmacy in elderly patients to prevent the occurrence of ADR.…”

Section: Discussionmentioning

confidence: 99%

“…According to 82 studies, the prevalence of PIP in Europe is 22.6% on average [13]. The prevalence of PIP at the primary care level in Russia was 43% [14]. In Kazakhstan, in 2015, the prevalence of PIP was studied in terms of Bierce's criteria at the hospital level, which was 64% [15].…”

Section: Introductionmentioning

confidence: 99%

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The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

Ibysheva

Muldaeva

Arystan

et al. 2021

Open Access Maced J Med Sci

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BACKGROUND: These potentially inappropriate prescribing is associated with the development of undesired medical reactions in elderly patients, and increase the frequency of hospitalizations, the number of aggravations and the cost of treatment. All of these adverse events are preventable. For detection of PIP and to prevent the adverse drug reactions (ADRs) in elderly patients, it is necessary to screen for potentially inappropriate prescribing. AIM: The aim of the study is to study the prevalence of PIP and the factors associated with these prescriptions at the level primary link in Kazakhstan. METHODS: A prospective descriptive study was carried out at the primary care level, in five clinics in Kazakhstan. The study involved 205 patients over 65 years old who received regular outpatient treatment for chronic diseases. Patients’ current diagnoses and prescription medicines were reviewed and the STOPP and START tools applied. RESULT: The prevalence of PIP in terms of STOPP criteria was 54% (114 patients). In general, we have identified 181 cases of PIP. The most commonly prescribed PIP were moxonidine (20%), glimeperide (16.5%), and PPI (20%). The prevalence of prescribing omissions in terms of START criteria was 22% (48 patients). Overall 66 cases of prescribing omissions were identified. The most commonly prescribed omissions were statins (6%) and ACE inhibitors (4%). Comparative analysis revealed a statistically significant effect of polymorbidity on the prevalence of PIP (p < 0.001) and number of prescribed medicines on the prevalence of PIP (p < 0.05). We have found a statistically significant effect of age on the presence of prescribing omissions of patients. (p < 0.001) CONCLUSION: Our results showed a high prevalence of potentially inappropriate prescribing at the primary care level in Kazakhstan. Screening tools should be incorporated into the everyday practice of primary care doctors.

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Section: Discussionsupporting

confidence: 51%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

Ibysheva

Muldaeva

Arystan

et al. 2021

Open Access Maced J Med Sci

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Polypragmasy and the basics of personalized rational pharmacotherapy selection in older patients with obesity and type 2 diabetes mellitus

Troshina,

Barysheva,

Umarkhadzhieva

2024

Obes. metabol.

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Increasing life expectancy and, as a consequence, a large number of comorbidities lead to a multitude of medications prescribed by physicians of different specialties. Patients with obesity and carbohydrate metabolism disorders, especially with type 2 diabetes mellitus (DM2), are at particular risk of polypragmasy, which is associated with the use of potentially nonrecommended medications. Prescribing errors can cause significant harm to the patient’s health and increase the risk of rehospitalization and healthcare costs. Identification of probably not recommended drugs in this category of patients will improve understanding of prevalence and risk factors of their use, develop strategies to prevent and limit the burden of taking inappropriate drugs and promote development of personalized and patient-oriented treatment options. Tools exist to assess potentially inappropriate therapy (PIT) in the elderly and new tools and criteria are often created. However, they are not specifically aimed at people with obesity and carbohydrate metabolism disorders. Thus, these criteria usually include only a few items related to DM2. Consequently, there is a clear need for a modern tool that can be used to address PIT specifically in older adults with obesity and carbohydrate metabolism disorders.

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Experience of using Beers criteria in clinical practice (according to Russian literature)

Cherniaeva,

Rozhkova,

Kazakova

et al. 2024

Farmakoèkonomika

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Objective: analysis of domestic scientific literature to identify ways of applying the Beers criteria, frequency of prescriptions and the structure of potentially inappropriate medications (PIMs) in elderly patients.Material and methods. The search for publications was carried out in Google Scholar abstract database, as wel as in eLibrary and CyberLeninka information-bearing networks for the period from 2013 to 2023. In total, 34 articles were found, among which 18 sources used Beers criteria as a tool for identifying PIMs.Results. In inpatient therapeutic departments, the maximum frequency of PIMs prescriptions according to the Beers criteria was 66.6% of cases, in surgical departments – 70%, in psychiatric departments – 90.4%, and in outpatient treatment settings – 28%. Non-steroidal anti-inflammatory drugs at different diseases were the most prescribed group of PIMs in both inpatients and outpatients. Surgical hospitals took the leading position in prescribing these drugs; specifically, more than 2/3 of elderly patients (75%) received them. According to two studies describing clinical cases of drug-induced falls in patients, the Beers criteria were effective in identifying drugs that can provoke this condition. One of papers presented application of Beers criteria to assess the economic affordability of replacing PIMs with safer new generation drugs.Conclusion. An analysis of domestic literature data has shown various ways of applying the Beers criteria, the frequency of prescriptions, and the most common PIMs. This information will help healthcare workers to be more wary of such drugs and think over applying the Beers criteria in routine practice of geriatric patients, which will further prevent or reduce the number of adverse drug reactions.

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Polypharmacy in Elderly Out Patients

Cited by 9 publications

References 7 publications

The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

Polypragmasy and the basics of personalized rational pharmacotherapy selection in older patients with obesity and type 2 diabetes mellitus

Experience of using Beers criteria in clinical practice (according to Russian literature)

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