Potentially inappropriate medications in older individuals with diabetes: A population-based study in Quebec, Canada

Gagnon, Mélanie; Sirois, Caroline; Simard, Marc; Roux, Barbara; Plante, Céline

doi:10.1016/j.pcd.2020.03.003

Cited by 19 publications

(20 citation statements)

References 43 publications

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“…First, the absolute decrease in PIM exposure in 2017 might be associated with continuing attention to PIMs and the 2017 publication of criteria of potentially inappropriate medications for older adults in China ( 4 ). Second, the prevalence of PIMs in this study significantly differed from results of a population-based study performed in Canada (56.1%) and a repeated cross-sectional study of outpatient prescriptions in The Netherlands (24.9%), both using 2015 Beers criteria ( 24 , 25 ). However, the study conducted in The Netherlands evaluated only 24 PIM items and lacked clinical information such as specific medical information and clinical lab data.…”

Section: Discussioncontrasting

confidence: 96%

“…Several surveys conducted in different health care settings showed that older adults with diabetes were the most commonly exposed to PIMs ( 5 , 17 , 21 – 23 ). Studies found that 24.9, 56.1, and 39.9% of older adults with diabetes had at least one PIM in The Netherlands, Canada and United States, respectively ( 22 , 24 , 25 ). A previous retrospective cohort analysis conducted in Beijing, which included 506,214 older adults in outpatient settings, found a prevalence of PIM of 38.07% ( 17 ), but knowledge of the prevalence of PIMs in older people with diabetes is lacking in China.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Yao²,

Chen

et al. 2022

Front. Public Health

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AimsPotentially inappropriate medications had been found associated with adverse drug events such as falls, emergency department admissions and hospital readmissions. There is lack of information about the prevalence of potentially inappropriate medications and associated chronic conditions in older patients with diabetes in China. This study aimed to assess the prevalence of potentially inappropriate medications in older adults with diabetes in an outpatient visitation setting and the association with polypharmacy due to comorbidities.Materials and methodsThis was a 3-year repeated cross-sectional study which conducted in outpatient setting of 52 hospitals in Shenzhen, China, using 2019 Beers criteria. The prevalence of potentially inappropriate medications, polypharmacy and comorbidities in older adults with diabetes in an outpatient setting was expressed as percentages. Logistic models were used to investigate the association between potentially inappropriate medication exposure and age, sex, polypharmacy and comorbidities.ResultsAmong the 28,484 older adults with diabetes in 2015, 31,757 in 2016 and 24,675 in 2017, the prevalence of potentially inappropriate medications was 43.2%, 44.88% and 42.40%, respectively. The top five potentially inappropriate medications were diuretics (20.56%), benzodiazepines (13.85%), androgens (13.18%), non-steroidal anti-inflammatory drugs (12.94%) and sulfonylureas (6.23%). After adjustment for age and polypharmacy, the probability of potentially inappropriate medication exposure was associated with chronic gastrointestinal diseases, followed by osteoarthritis and rheumatoid arthritis, chronic pulmonary disease, chronic kidney disease, tumor, dementia, chronic liver disease, hypertension, cardiovascular disease, cerebrovascular disease and hyperlipemia.ConclusionPotentially inappropriate medications were common in older patients with diabetes in an outpatient visitation setting. Higher probability of potentially inappropriate medication exposure was associated with the comorbidity chronic gastrointestinal diseases as well as osteoarthritis and rheumatoid arthritis. To ensure that iatrogenic risks remain minimal for older adults with diabetes, the clinical comorbidities should be considered.

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Section: Discussioncontrasting

confidence: 96%

Section: Introductionmentioning

confidence: 99%

Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Yao²,

Chen

et al. 2022

Front. Public Health

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“…Bazargan et al, in their cross-sectional study among 193 older adults with hypertension, found that one out of two participants had inappropriate medication use [ 19 ]. Published studies among older adults in the outpatient setting reported that about one-third to two-thirds of older adults are prescribed PIMs [ 7 – 9 , 20 – 23 ]. The rate of PIMs use in this study is considerably higher than the previously reported PIMs use among older adults.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, individuals with anxiety and IHD are more likely to use PIMs. Anxiety disorder has been identified as a predictor of PIMs use in other published studies [ 9 , 23 , 25 ]. One of the most likely factors associated with PIMs use in this study was using five or more medications.…”

Section: Discussionmentioning

confidence: 99%

Potentially Inappropriate Medications Use among Older Adults with Comorbid Diabetes and Hypertension in an Ambulatory Care Setting

Alwhaibi

2022

Journal of Diabetes Research

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Objective. This study aims to estimate the prevalence of PIMs use and its associated factors among older adults with comorbid diabetes and hypertension. Methods. A cross-sectional retrospective study was used, including 1,853 older adults (age ≥65 years) with diabetes and hypertension who visited an ambulatory care setting. The study objectives were to estimate the prevalence and factors associated with PIMs use based on the 2019 American Geriatric Society (AGS) Beers criteria. Results. Almost one out of two individuals had PIMs used, with the average number of medications taken being seven. The most commonly prescribed PIMs were the use of gastrointestinal and endocrine medications. High risk of PIMs use was among those with ischemic heart disease, anxiety, and polypharmacy. Conclusions. Given the higher PIMs use among older adults with diabetes and hypertension comorbidities, tailored strategies and interventions to minimize PIMs use in this population are warranted.

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“…Some studies have shown that older adults with DM consume multiple medications in greater proportions [37][38][39][40][41][42], which in consequence may increase the risk of using some type of PIM. A recent study in Quebec showed that more than half of the people with DM used at least one PIM in a year [43]. Furthermore, people with DM have more comorbidities than the general population.…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Potentially Inappropriate Medication Use in Older Adults: A 10-Year Cohort Study with Generalized Estimating Equation Models

Araújo

Silveira

Mota

et al. 2022

Preprint

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BackgroundMuch of the knowledge on the use of potentially inappropriate medications (PIM) in older adults is derived from cross-sectional studies, with little known about the risk factors over time. AimLongitudinal analysis was applied to estimate the occurrence and risk factors of PIM use among older adults in a 10-year follow-up.Methods Longitudinal study with 418 older adult residents of a capital city of Central-West Brazil. The PIM were classified according to the Beers criteria 2019. The usage rate was calculated at baseline (2008) and at the 10-year follow-up moment (2018). Analysis of predictors (sociodemographic, self-rated health, hospitalization, number of comorbidities, polypharmacy, diabetes, hypertension, hypercholesterolemia and nutritional status) was performed using Generalized Estimating Equation (GEE) models.ResultsMean age at baseline was 70.6 years (SD 7.1) and 76% were women; 221 older adults took part in the follow up. The rate of PIM use was 50.4% at baseline and 57.5% at the 10-year follow-up. Multiple analysis showed that PIM use in the cohort was statistically higher in the older adults with a history of hospitalization (RRadj: 1.20; 95%CI: 1.01-1.40), with three or more diseases (RRadj: 1.41; 95%CI: 1.14-1.74), with polypharmacy (RRadj: 1.81; 95%CI: 1.47-2.24) and with diabetes mellitus (RRadj: 1.24; 95%CI: 1.05-1.47).ConclusionA high level of potentially inappropriate medication use was observed, reaching 50% of the older adults, with a 7% increase in the prevalence over the 10-year follow-up period. Hospitalization, multimorbidities, polypharmacy and diabetes mellitus were associated with the use of these medications. Interventions for surveillance of the deprescribing process need to be encouraged to avoid potential harm caused by the use of medications.

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Potentially inappropriate medications in older individuals with diabetes: A population-based study in Quebec, Canada

Cited by 19 publications

References 43 publications

Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Prevalence of potentially inappropriate medications and association with comorbidities in older adults with diabetes in an outpatient visitation setting

Potentially Inappropriate Medications Use among Older Adults with Comorbid Diabetes and Hypertension in an Ambulatory Care Setting

Risk Factors for Potentially Inappropriate Medication Use in Older Adults: A 10-Year Cohort Study with Generalized Estimating Equation Models

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