Potentially Inappropriate Medication Use Among Older Hospitalized Patients in a Brazilian General Hospital

Abstract

Potentially inappropriate medication use among elderly patients from a Brazilian general hospital Uso de medicamentos potencialmente inadequados entre idosos em um hospital geral brasileiro ABSTRACTThe aim of this study was to determine the profile of the pharmacotherapy used by hospitalized elderly. A cross-sectional study was conducted at a Brazilian charitable general hospital. Drug prescriptions for hospitalized elderly patients (age≥60 years), dated from May to September 2010, were the source of data for this study and retrospectively analyzed (n=1,783). Polypharmacy (use of 5 or more drugs) and potentially inappropriate medications (PIMs -according to the Beers Criteria) were identified. Associations between sex, age, admission for cardiovascular disease or hospital stay and polypharmacy or PIM prescription were studied using univariate analysis (Pearson's Chi-square test). The association between polypharmacy and PIM prescription was also evaluated. A total of 204 elderly were hospitalized (mean age = 75 years) during the study period. The most commonly prescribed drugs acted on the cardiovascular system (29%) and the alimentary tract and metabolism (26%). Around 90% of the elderly were submitted to polypharmacy and 59% had, at least, one prescription of PIMs. A hospital stay of five days or more was associated with polypharmacy and PIM prescription. This study revealed a worrying drug utilization profile of high PIM use and polypharmacy practice. There is a need to implement strategies to improve geriatric prescribing.

Drug Related Problems among Older Inpatients at a Tertiary Care Setting

“…With regard to PIM use, most hospitalized older patients in the study (67.8%) were likely to experience at least 1 PIM, in agreement with studies by Silva et al [ 120 ] and Varavithya et al [ 121 ]. Nevertheless, the prevalence of PIMs varies according to healthcare settings, population structures and PIM assessment tools, including the AGS Beers Criteria ® , the STOPP/START criteria, the PRISCUS list and the Laroche list [ 56 , 58 , 122 , 123 ].…”

“…Nevertheless, the prevalence of PIMs varies according to healthcare settings, population structures and PIM assessment tools, including the AGS Beers Criteria ® , the STOPP/START criteria, the PRISCUS list and the Laroche list [ 56 , 58 , 122 , 123 ]. In accordance with a recent study [ 120 ], the most common PIMs in older population involve medications for treatment diseases of the gastrointestinal (GI) and central nervous systems. According to the 2019 AGS Beers Criteria ® , the most common medications implicated in PIMs are PPIs [ 120 , 121 ], followed by benzodiazepines [ 120 ].…”

“…In accordance with a recent study [ 120 ], the most common PIMs in older population involve medications for treatment diseases of the gastrointestinal (GI) and central nervous systems. According to the 2019 AGS Beers Criteria ® , the most common medications implicated in PIMs are PPIs [ 120 , 121 ], followed by benzodiazepines [ 120 ]. The 2019 AGS Beers Criteria ® also indicate that older adults with long-term PPI use are susceptible to adverse events, such as Clostridium difficile infection, vitamin B12 deficiency, community-acquired pneumonia, fractures, and bone loss [ 58 , 124 , 125 , 126 , 127 , 128 ].…”

“…In accordance with a recent study [120], the most common PIMs in older population involve medications for treatment diseases of the gastrointestinal (GI) and central nervous systems. According to the 2019 AGS Beers Criteria ® , the most common medications implicated in PIMs are PPIs [120,121], followed by benzodiazepines [120].…”

Hubungan Jumlah Peresepan Obat Terhadap Potensially Inapropriate Medications Berdasarkan Beers Criteria 2019 Pasien Diabetes Mellitus

“…Sedangkan sebanyak 14 (7,18%) pasien diabetes mellitus tidak mengalami PIMs, hal tersebut dapat terjadi karena pengobatan yang dilakukan pada pasien sudah tepat. Penelitian yang dilakukan oleh Silva et al (2016) diketahui dari 90% pasien geriatri yang mendapatkan peresepan obat (polifarmasi), 59% diantaranya mengalami PIMs [12].…”