Potentially inappropriate medication prescribed among older patients in a primary care setting in Malaysia

Kua, Kok Pim; Hamzah, Nur N.; Lee, Shaun Wen Huey

doi:10.1002/pds.4945

Cited by 6 publications

(5 citation statements)

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“…Previous international studies have reported older adults' and caregivers' openness to deprescribing, but few have concurrently assessed older adults' and caregivers' attitudes. To our knowledge, only one included French-speaking participants and none have included populations from multiple countries, to increase the external validity of study results regarding perceptions of deprescribing [26,28,[29][30][31][32][33]. The recent validation of the rPATD questionnaire in French [34] allows the assessment of attitudes towards deprescribing in both older adults and caregivers among French speaking countries, and thus may permit to position these French-speaking countries on their openness to deprescribing compared to other countries.…”

Section: Introductionmentioning

confidence: 99%

Attitudes and beliefs of older adults and caregivers towards deprescribing in French-speaking countries: a multicenter cross-sectional study

Roux

Rakheja

Sirois

et al. 2022

Eur J Clin Pharmacol

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Successful deprescribing requires understanding the attitudes of older adults and caregivers towards this process. This study aimed to capture these attitudes in four French-speaking countries, and to investigate associated factors. MethodsA multicenter cross-sectional study was conducted by administrating the French version of the revised Patients' Attitudes Towards Deprescribing (rPATD) questionnaire in Belgium, Canada, France and Switzerland. Community-dwelling or nursing home older adults ≥ 65 years taking ≥ 1 prescribed medications, and caregivers of older adults with similar characteristics were included. Multivariate logistic regressions were carried out to examine factors associated with willingness to deprescribe. ResultsA total of 367 older adults (79.3 ± 8.7 years, 63% community-dwelling, 54% ≥5 medications) and 255 unrelated caregivers (64.4 ± 12.6 years) of care recipients (83.4 ± 7.9 years, 52% community-dwelling, 69% ≥5 medications) answered the questionnaire. Among them, 87.5% older adults and 75.6% caregivers would be willing to stop medications if the physician said it was possible. Reluctance to stop a medication taken for a long time was expressed by 46% of both older adults and caregivers. A low score for the factor "concerns about stopping" [older adults: aOR: 0.

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Section: Introductionmentioning

confidence: 99%

Attitudes and beliefs of older adults and caregivers towards deprescribing in French-speaking countries: a multicenter cross-sectional study

Roux

Rakheja

Sirois

et al. 2022

Eur J Clin Pharmacol

View full text Add to dashboard Cite

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“…Pharmacists are trained traditionally to focus on patient counseling especially on medication-related issues, which are commonly seen among older adults who may have to move from independent living circumstances to long-term care (11,(20)(21)(22). Nevertheless, this process is often considered as ticking a checklist rather than as a two-way communication that involves the empathy needed for delivery of patient-centered care (23).…”

Section: Introductionmentioning

confidence: 99%

“Suiting Up” to Enhance Empathy Toward Aging: A Randomized Controlled Study

Lee

Teh

2020

Front. Public Health

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Background: Healthcare professionals who have a positive attitude and who are more empathetic toward older adults are in a better position to deliver quality healthcare. This study examines the impact of using an aging simulation suit on undergraduate pharmacy students' empathy levels. Methods: One hundred and twenty first-year students enrolled in the Bachelor of Pharmacy course were randomized to either a medication review polypharmacy workshop (control) or an immersive aging simulation suit and medication review polypharmacy workshop (intervention). Intervention participants donned the aging suit and performed a series of tasks, including walking up a flight of stairs and filling up a form to simulate the physical limitations experienced by an older adult. The workshop was delivered at week 10 of semester. Both groups also completed a medication review polypharmacy workshop at week 12 of semester. The primary outcome was a measurement of change on the Jefferson Empathy Scale-Healthcare Professional Questionnaire among both groups at week 12 of semester. Secondary outcomes include the longitudinal impact of intervention after 3 months of the workshop and perceptions on learning. Results: The use of a simulation suit did not increase participants' self-rated empathy compared to control. However, the suit enhanced the ability of participants to understand the physical limitations and visual issues associated with aging. Participants also felt that it enhanced their health advocacy, as it taught them the importance of listening, patience and respect for older adults. Conclusion: The use of an immersive aging suit can be a useful adjunctive tool to help enhance students' understanding of the physical limitations and visual limitations of aging. Further research is needed to understand how these limitations affect other healthcare students. Trial Registration: ClinicalTrials.gov identifier: NCT04133727.

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“…Although the evaluation of medication appropriateness in older patients is of utmost importance, there is a lack of data on potentially inappropriate medication (PIM) use among this population in the different healthcare settings in Malaysia. To the best of authors’ knowledge, there is only a recent study that reported the PIM use among Malaysian primary care patients (21.3%) while no studies have reported on inappropriate medication use among Malaysian patients receiving secondary or tertiary care 10 . Therefore, having a study at a larger set‐up (tertiary care) would be advantageous as it could provide a better sampling of the variety of the diseases and patients, which could be taken as a better representation of the Malaysian population receiving medical care.…”

Section: Introductionmentioning

confidence: 95%

“…To the best of authors' knowledge, there is only a recent study that reported the PIM use among Malaysian primary care patients (21.3%) while no studies have reported on inappropriate medication use among Malaysian patients receiving secondary or tertiary care. 10 Therefore, having a study at a larger set-up (tertiary care) would be advantageous as it could provide a better sampling of the variety of the diseases and patients, which could be taken as a better representation of the Malaysian population receiving medical care. Moreover, the studies exploring the association between medication inappropriateness and patient-reported outcomes (PROs) are largely conducted in aged care settings and very rarely in outpatient or inpatient hospital settings.…”

Section: Introductionmentioning

confidence: 99%

Use of potentially inappropriate medications among older outpatients and inpatients in a tertiary care hospital in Malaysia

et al. 2020

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Background Older individuals are seemingly having more medical conditions, which predispose them to a greater risk of polypharmacy. Potentially inappropriate medications (PIMs), including those having anticholinergic and sedative properties, are common in their prescriptions, often associated with functional decline and negative health outcomes. Thus, this study reports proportions of inappropriate drugs and drug burden exposures and its correlation with patient‐reported outcomes (PROs) among cognitively intact older adults admitted to a ward or visiting the outpatient clinic at a tertiary care hospital in Malaysia. Methods This cross‐sectional study included data from 344 older (173 inpatients and 171 outpatients) patients, aged 60 years and above, through validated questionnaires. Medication appropriateness was assessed via Medication Appropriateness Index (MAI) tool, whereas Beers and Screening Tool of Older Person's Potentially Inappropriate Prescribing (STOPP) criteria were used to evaluate PIMs and potentially inappropriate prescribing (PIP), respectively. The Drug Burden Index (DBI) and polypharmacy, as well as PROs, included Groningen Frailty Indicator (GFI), Katz Index of Independence in Activities of Daily Living (Katz ADL) and Older People's Quality of Life (OPQOL) were also evaluated. Results Overall, inpatients received significantly higher medications (6.90 ± 2.70 vs 4.49 ± 3.20) than outpatients. A significantly higher proportion of inpatients received at least one PIM (65% vs 57%) or PIP (57.4% vs 17.0%) and higher mean MAI score (1.76 ± 1.08 and 1.10 ± 0.34) and DBI score (2.67 ± 1.28 vs 1.49 ± 1.17) than outpatients. Inpatients had significantly higher total OPQOL (118.53 vs 79.95) and GFI score (5.44 vs 3.78) than outpatients. We only found significant correlations between GFI and DBI and total OPQOL and the number of PIMs. Conclusions Proportions of PIMs and DBI exposure were significantly higher in an inpatient setting. No significant correlations between exposures to inappropriate medications or drug burden and PROs were observed.

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Potentially inappropriate medication prescribed among older patients in a primary care setting in Malaysia

Cited by 6 publications

References 5 publications

Attitudes and beliefs of older adults and caregivers towards deprescribing in French-speaking countries: a multicenter cross-sectional study

Attitudes and beliefs of older adults and caregivers towards deprescribing in French-speaking countries: a multicenter cross-sectional study

“Suiting Up” to Enhance Empathy Toward Aging: A Randomized Controlled Study

Use of potentially inappropriate medications among older outpatients and inpatients in a tertiary care hospital in Malaysia

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