Potentially inappropriate medications in Chinese community-dwelling older adults

Huang, Ya-Min; Zhang, Lu; Huang, Xinjian; Liu, Keke; Yu, Yangyong; Xiao, Jian

doi:10.1007/s11096-020-00980-y

Cited by 25 publications

(42 citation statements)

References 15 publications

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“…Moreover, poor compliance in the elderly caused by polypharmacy could lead to therapeutic failure (28). Our results show that approximately 20% of community-dwelling elderly patients are taking 5 or more medications and polypharmacy was a strong predictor of PIMs, consistent with the results of previous studies in China (14,29).…”

Section: Discussionsupporting

confidence: 90%

“…Consistent with previous studies, the Chinese criteria detected significantly more PIMs than the 2019 Beers criteria (14). Therefore, the Chinese criteria was used to research the related medications and risk factors.…”

Section: Discussionsupporting

confidence: 55%

“…Consistent with the results of reviews performed in the USA, a European systematic literature review estimated the overall prevalence of potentially inappropriate prescribing to be 22.6% in community-dwelling older people ( 17) and another showed that almost one out of two community-dwelling older adults use a PIM in Canada (18). The Xiangya hospital study was the first to report the use of PIMs in community-dwelling older adults in China and using the Chinese criteria detected the prevalence of PIMs per person to be 50.6% (14).…”

Section: Discussionmentioning

confidence: 99%

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Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Li¹,

Hu²,

Gao³

et al. 2021

Ann Palliat Med

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Background: To assess the prevalence and associated risk of potentially inappropriate medications (PIMs) prescribing in community-dwelling elderly patients in China and to examine the most frequently used PIMs. This will provide a reference for the formulation of medication manuals for the community-dwelling elderly and further standardize the use of medications in elderly patients.Methods: We conducted a cross-sectional retrospective study from April 1, 2020 to April 30, 2020. Data from elderly patients aged ≥65 years were collected from the Hengjie (N=2,294), Loujiang (N=3,972), and Tongxing communities (N=1,969) in Suzhou. The frequency of PIMs was detected using the 2019 Beers criteria and the 2017 Chinese criteria. Chi-square (for categorical variables), ANOVA (for continuous variables as applicable), and logistic regression were used to describe and identify potential predictors of PIMs.Results: A total of 8,235 elderly patients were examined. Using the Chinese criteria, the prevalence of PIMs was 37.07%, which was slightly higher than that found using the 2019 Beers criteria (32.16%).The most prescribed PIMs were estazolam (21.53%) and insulin (4.60%) based on the Chinese criteria.Logistic regression analysis showed that advanced age, polypharmacy, and comorbid disease of patients were associated with a high risk of PIMs. Furthermore, the educational background and professional title of physicians were also associated with PIMs.Conclusions: Given the high prevalence of PIMs in the Chinese community-dwelling elderly population, the implementation of evidence-based interventions to promote rational clinical drug use could improve their quality of life.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionsupporting

confidence: 55%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Li¹,

Hu²,

Gao³

et al. 2021

Ann Palliat Med

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“…When clopidogrel was removed, similar PIMs were found between the Chinese criteria and the Beers criteria. 39 In comparison with the PIMs based on Chinese criteria, Beers-defined PIMs engendered more substantial adverse outcomes, such as rehospitalization. 8 One additional consideration is that the Chinese criteria were revised in 2017, and it may need to be updated with new information about currently available drugs.…”

Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Medication and Associated Factors Among Older Patients with Chronic Coronary Syndrome at Hospital Discharge in Beijing, China

Zhao¹,

Song²,

Zheng³

et al. 2021

CIA

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Medication therapy is crucial in the management of chronic coronary syndrome (CCS). The use of potentially inappropriate medications (PIMs) contributes to poor outcomes in older patients, making it a major public health concern. However, few studies are available on PIMs use in older Chinese CCS patients. To investigate the frequency of prescribed PIMs at discharge and explore risk factors in older adults with CCS. Patients and Methods: The cross-sectional study was conducted in a tertiary hospital in China over three months, from 1st October to 31st December, 2019. CCS patients aged over 60 years who were discharged alive were recruited. Information on demographics and medications at discharge was collected. Clinical data including diagnoses, frailty status, New York Heart Association (NYHA) class and age-adjusted Charlson Comorbidity Index (ACCI) were evaluated in each patient. PIMs were identified using the 2019 Beers criteria. Binary logistic regression was performed to recognize variables related to PIMs. Results: A total of 447 eligible patients with 2947 medications were included. The prevalence of PIMs use was 38%. Medications to be avoided, to be used with caution, and with drug-drug interactions were 38.4%, 48.9% and 12.7% of the PIMs, respectively. Medications with drug-disease/syndrome interactions and those adjusted for kidney function were not identified. The common PIMs were diuretics (37.1%), benzodiazepines and benzodiazepine receptor agonist hypnotics (15.2%), glimepiride (13.1%), and co-prescription of potassiumsparing diuretics and renin-angiotensin system (RAS) inhibitors (9.7%). Individuals with frailty syndrome, polypharmacy, multiple comorbidities, atrial fibrillation, psychiatric disorders and greater NYHA class severity were more likely to receive PIMs. Conclusion: Prescription of PIMs was a common burden in older adults. A CCS multidisciplinary team is needed to control PIMs, especially in vulnerable older patients.

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“…The Beers Criteria is used to classify PIM; the list is constantly updated, with new insights into medications that can interfere with and cause divergences to their expected outcomes. To date, two studies have relied on the Beers 2019 criteria [ 22 , 23 ]. One study involved a three-month follow-up and identified that PIMs cause mortality in hospitalized elderly [ 22 ] and the other study investigated PIM use in a community-dwelling population [ 23 ].…”

Section: Introductionmentioning

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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Potentially inappropriate medications in Chinese community-dwelling older adults

Cited by 25 publications

References 15 publications

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Prevalence and determinants of potentially inappropriate medications prescribing in elderly patients in Chinese communities

Potentially Inappropriate Medication and Associated Factors Among Older Patients with Chronic Coronary Syndrome at Hospital Discharge in Beijing, China

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

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