Potentially inappropriate medication including drug-drug interaction and the risk of frequent falling, hospital admission, and death in older adults - results of a large cohort study (getABI)

Abstract

Introduction: With growing age, multiple chronic diseases may result in polypharmacy. Drugs that should be avoided in older adults are called potentially inappropriate medications (PIM). Beyond PIM, drug-drug interactions (DDI) are known to be related to adverse drug events. This analysis examines the risk of frequent falling, hospital admission, and death in older adults associated with PIM and/or DDI (PIM/DDI) prescription.Materials and methods: This post hoc analysis used data of a subgroup of the getABI study participants, a large cohort of community-dwelling older adults. The subgroup comprised 2120 participants who provided a detailed medication report by telephone interview at the 5-year getABI follow-up. The risks of frequent falling, hospital admission, and death in the course of the following 2 years were analysed by logistic regression in uni- and multivariable models with adjustment for established risk factors.Results: Data of all 2,120 participants was available for the analysis of the endpoint death, of 1,799 participants for hospital admission, and of 1,349 participants for frequent falling. The multivariable models showed an association of PIM/DDI prescription with frequent falling (odds ratio (OR) 1.66, 95% confidence interval (CI) 1.06–2.60, p = 0.027) as well as with hospital admission (OR 1.29, 95% CI 1.04–1.58, p = 0.018), but not with death (OR 1.00, 95% CI 0.58–1.72, p = 0.999).Conclusion: PIM/DDI prescription was associated with the risk of hospital admission and frequent falling. No association was found with death by 2 years. This result should alert physicians to provide a closer look at PIM/DDI prescriptions.

Pharmacological treatments and medication-related problems in nursing homes in Catalonia: a multidisciplinary approach

“…The results showed a high prevalence of HRP in all patients, with a mean of 8.22 prescribed drugs per patient. This is similar to other studies in Europe ( Pasina et al, 2020 ; Reinhild Haerig et al, 2023 ). More than 80% of the patients received recommendations, and for 50%, at least one drug was recommended to be withdrawn due to MRPs.…”

“…Increased exposure to complex drug regimens involving ≥5 drugs, known as polypharmacy, or excessive polypharmacy, as in patients treated with 10 or more medications concomitantly, raises the risk of adverse events ( Stuhec et al, 2021 ). Polypharmacy can also affect drug safety due to potentially inappropriate medications (PIMs), adverse drug reactions (ADRs), and the risk of interactions ( Burato et al, 2021 ; Zhang et al, 2022 ; Doumat et al, 2023 ; Reinhild Haerig et al, 2023 ).…”

Potentially inappropriate medication use as predictors of hospitalization for residents in nursing home

“…Few studies have assessed the associations between DDI-PIM and hospitalization in NH residents. However, a previous study reported the risk of hospitalization were increased in community-dwelling older adults exposed to DDI-PIM, including concurrent use of antiplatelets and NSAIDs without PPI, multiple antiplatelets without PPI, antiplatelets plus oral anticoagulants without PPI, and ACE inhibitors/ARB with NSAID [ 28 ].…”

Potentially inappropriate medications in the elderly

“…Investigators recently conducted a retrospective analysis to evaluate the association between risk of frequent falling, hospitalization, and mortality in older adults with PIM and/or DDI (Haerig et al, 2023).…”