Potentially inappropriate medications among the elderly in primary care in Thailand from three different sets of criteria

Vatcharavongvan, Pasitpon; Puttawanchai, Viwat

doi:10.18549/pharmpract.2019.3.1494

Cited by 30 publications

(29 citation statements)

References 27 publications

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“…The previous study conducted in the same clinic 2 years ago reported 53.3% of polypharmacy and 59% of PIMs according to the Beers 2015 criteria. 9 Our current study found that the prevalence of polypharmacy and PIMs was still high, though it was lower than the previous study. The most PIMs prescribed for the patients were anticholinergics, omeprazole, and NSAIDs, which were different from the previous study.…”

Section: Discussioncontrasting

confidence: 70%

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Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

Vatcharavongvan

Puttawanchai

2021

J Prim Care Community Health

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Background Most older adults with comorbidities in primary care clinics use multiple medications and are at risk of potentially inappropriate medications (PIMs) prescription. Objective This study examined the prevalence of polypharmacy and PIMs using Thai criteria for PIMs. Methods This study was a retrospective cross-sectional study. Data were collected from electronic medical records in a primary care clinic in 2018. Samples were patients aged ≥65 years old with at least 1 prescription. Variables included age, gender, comorbidities, and medications. The list of risk drugs for Thai elderly version 2 was the criteria for PIMs. The prevalence of polypharmacy and PIMs were calculated, and multiple logistic regression was conducted to examine associations between variables and PIMs. Results Of 2806 patients, 27.5% and 43.7% used ≥5 medications and PIMs, respectively. Of 10 290 prescriptions, 47% had at least 1 PIM. The top 3 PIMs were anticholinergics, proton-pump inhibitors, and nonsteroidal anti-inflammatory drugs (NSAIDs). Polypharmacy and dyspepsia were associated with PIM prescriptions (adjusted odds ratio 2.48 [95% confident interval or 95% CI 2.07-2.96] and 3.88 [95% CI 2.65-5.68], respectively). Conclusion Prescriptions with PIMs were high in the primary care clinic. Describing unnecessary medications is crucial to prevent negative health outcomes from PIMs. Computer-based clinical decision support, pharmacy-led interventions, and patient-specific drug recommendations are promising interventions to reduce PIMs in a primary care setting.

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Section: Discussioncontrasting

confidence: 70%

“… 7 In Thailand, orphenadrine, dimenhydrinate, and benzodiazepine are the most common PIMs prescribed according to the 2015 Beers criteria, while benzodiazepine and first-generation antihistamine were common in STOPPv2. 9 …”

Section: Introductionmentioning

confidence: 99%

Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

Vatcharavongvan

Puttawanchai

2021

J Prim Care Community Health

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“…International studies have shown prevalence rates of 43% in Canada [ 15 ], 42,7% in New Zealand [ 11 ], and 46.1% in Portugal [ 41 ]. In Asian countries, the prevalence was 12.7% in Oman [ 42 ], 34.0% in India [ 43 ], 39.4% in Indonesia [ 44 ], 53,1% in Kuwait [ 14 ], and 59.3% in Thailand [ 45 ]…”

Section: Discussionmentioning

confidence: 99%

Potentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up

et al. 2020

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Introduction Pharmacological therapy plays an important role in disease control in the elderly; unfortunately, this comes with a high prevalence in the use of medications classified as potentially inappropriate. Objective To analyze the incidence, risk factors, and survival of elderly people using potentially inappropriate medications (PIM). Method A ten-year follow-up assessment of elderly participants residing in a capital of Central Brazil was conducted. The initial assessment (baseline) included 418 elderly people. Data were collected through home interviews guided by a questionnaire covering socioeconomic, demographic, living conditions, and health variables. The medication information obtained comprised active ingredient, dosage, route, and regimen for the medications. The PIMs were classified according to 2019 Beers Criteria. The analyses were performed using STATA 15.0. For survival analysis, a Cox Regression was performed with the respective Kaplan Meier curve. Results The incidence of PIM was 44.1 cases (95% CI: 35.2–54.7) per 1,000 people a year. The most used PIMs were nifedipine, glibenclamide, and sodium diclofenac. The risk factors were polypharmacy (aRR: 3.00; 95% CI: 1.31–6.88) and diabetes mellitus (aRR: 1.57; 95% CI: 1.03–2.39). We identified no statistically significant association between survival and the use of PIM. Conclusion The study highlights the high consumption of PIM among the elderly causing polypharmacy risks. Health professionals working in drug treatment need to be alert to polypharmacy risks to ensure the rational use of medications to prevent adverse reactions and other health problems.

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“… 14 , 15 Indeed, polypharmacy was a strong predictor for PIP in most published research worldwide. 21 , 22 …”

Section: Discussionmentioning

confidence: 99%

Prevalence of potentially inappropriate prescriptions in primary care and correlates with mild cognitive impairment

Harasani¹,

Xhafaj²,

Begolli³

et al. 2020

Pharm Pract (Granada)

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Background: Potentially inappropriate prescribing is clearly associated with adverse health consequences among older people. Nevertheless, scarce evidence exists regarding the prevalence of potentially inappropriate prescriptions (PIP) in Albania, a Western Balkans country. Objective: The aim of this study was to assess the prevalence of PIP among older Albanian patients in primary care and to determine the associated sociodemographic and medical factors, including the presence of mild cognitive impairment (MCI). Methods: Cross-sectional study in two primary healthcare centers located in two different cities of Albania, a middle-income country in the Western Balkans. The Montreal Cognitive Assessment (MoCA) tool was applied to evaluate MCI. PIPs were assessed by two trained pharmacists using the Beers criteria 2019 update. Multivariate logistic regression analysis was conducted for possible risk factors predicting PIP in the study population. Results: At least one PIP was identified among 40.23 % of the participants (174 older patients) and 10.35 % had more than one PIP. MCI was detected among 79.31 % of the patients. The most commonly represented drug groups in PIP were diuretics (24.71 %), benzodiazepines in the presence of MCI and antidepressants (both 8.62 %). The lack of electrolytes monitoring was the most common reason for PIP. According to the multivariate analysis, the only statistically significant association observed was between PIP and number of drugs prescribed [three to four drugs (OR 3.34; 95% CI 1.65:6.76), five or more than five drugs (OR 4.08; 95% CI 1.42:11.69)]. Conclusions: About four out of 10 older Albanian patients experience PIP in primary care. Further studies are needed for a comprehensive estimation of the prevalence and factors associated with PIP, particularly among elderly with mild cognitive impairment.

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Potentially inappropriate medications among the elderly in primary care in Thailand from three different sets of criteria

Cited by 30 publications

References 27 publications

Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

Elderly Patients in Primary Care are Still at Risks of Receiving Potentially Inappropriate Medications

Potentially inappropriate medications for the elderly: Incidence and impact on mortality in a cohort ten-year follow-up

Prevalence of potentially inappropriate prescriptions in primary care and correlates with mild cognitive impairment

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