scholarly journals Prevalence and determinants of potentially inappropriate medication use in Hong Kong older patients: a cross-sectional study

BMJ Open ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. e051527
Author(s):  
Huanyu Zhang ◽  
Eliza LY Wong ◽  
Samuel YS Wong ◽  
Patsy YK Chau ◽  
Benjamin HK Yip ◽  
...  
Keyword(s):  
Older Adults ◽  
Regression Analysis ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Sectional Study ◽  
Cross Sectional

ObjectivesTo assess the prevalence of potentially inappropriate medication (PIM) use in Hong Kong older patients visiting general outpatient clinics (GOPCs) between 2006 and 2014 and to identify factors associated with PIM use among older adults visiting GOPCs in 2014.DesignCross-sectional study.SettingGOPC.ParticipantsTwo study samples were constructed including a total of 844 910 patients aged 65 and above from 2006 to 2014 and a cohort of 489 301 older patients in 2014.MeasurementsTwo subsets of the 2015 American Geriatrics Society Beers criteria—PIMs independent of diagnosis and PIMs due to drug–disease interactions—were used to estimate the prevalence of PIM use over 12 months. PIMs that were not included in the Hospital Authority drug formulary or with any specific restriction or exception in terms of indication, dose or therapy duration were excluded. Characteristics of PIM users and non-PIM users visiting GOPCs in 2014 were compared. Independent associations between patient variables and PIM use were assessed by stepwise multivariable logistic regression analysis.ResultsThe 12-month period prevalence of PIM use decreased from 55.56% (95% CI 55.39% to 55.72%) in 2006 to 47.51% (95% CI 47.37% to 47.65%) in 2014. In the multivariable regression analysis, the strongest factor associated with PIM use was the number of different drugs prescribed (adjusted OR, AOR 23.01, 95% CI 22.36 to 23.67). Being female (AOR 0.89, 95% CI 0.85 to 0.87 for males vs females) and having a greater number of GOPC visits (AOR 1.83, 95% CI 1.78 to 1.88) as well as more than six diagnoses (AOR 1.43, 95% CI 1.36 to 1.52) were associated with PIM use.ConclusionsThe overall prevalence of PIM use in older adults visiting GOPCs decreased from 2006 to 2014 in Hong Kong although the prevalence of PIM use was still high in 2014. Patients with female gender, a larger number of medications prescribed, more frequent visits to GOPCs, and more than six diagnoses were at higher risk for PIM use.

scholarly journals Comparison of adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing potentially inappropriate medication use in Hong Kong older patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huanyu ZHANG ◽  
Eliza L. Y. WONG ◽  
Samuel Y. S. WONG ◽  
Patsy Y. K. CHAU ◽  
Benjamin H. K. YIP ◽  
...  
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Female Gender ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Beers Criteria ◽  
Medical Conditions ◽  
Cross Sectional

Abstract Background The Hong Kong-specific criteria have been established in 2019 to assess potentially inappropriate medication (PIM) use in older adults and improve the local prescribing quality. The aim of this study was to compare the adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing the prevalence and correlates of PIM use in Hong Kong older patients. Methods A cross-sectional study was performed from January 1, 2014 to December 31, 2014 using the Hospital Authority (HA) database. A total of 489,301 older patients aged 65 years and older visiting general outpatient clinics (GOPCs) during the study period were included in the study. Two categories of PIM use included in the Hong Kong-specific criteria and 2015 Beers criteria, i.e. PIMs independent of diagnoses and PIMs considering specific medical conditions, were adapted to assess the prevalence of PIM use among the study sample. Characteristics of PIM users and the most frequently prescribed PIMs were investigated for each set of the criteria. Factors associated with PIM use were identified using the stepwise multivariable logistic regression analysis. Results The adaptive Hong Kong-specific criteria could detect a higher prevalence of patients exposed to at least one PIM than that assessed by the adaptive Beers criteria (49.5% vs 47.5%). Meanwhile, the adaptive Hong Kong-specific criteria could identify a higher rate of patients exposed to PIMs independent of diagnoses (48.1% vs 46.8%) and PIMs considering specific medical conditions (7.3% vs 4.9%) compared with that of the adaptive Beers criteria. The most frequently prescribed PIMs detected by the adaptive Beers criteria were all included in the adaptive Hong Kong-specific criteria. The strongest factor associated with PIM use was number of different medications prescribed. Patients with female gender, aged 65 ~ 74 years, a larger number of GOPC visits, and more than six diagnoses were associated with greater risk of PIM use, whereas advancing age was associated with lower risk of PIM use. Conclusions The adaptive Hong Kong-specific criteria could detect a higher prevalence of PIM use than the adaptive Beers criteria in older adults visiting GOPCs in Hong Kong. It is necessary to update the prevalence and correlates of PIM use regularly in older adults to monitor the burden of PIM use and identify vulnerable patients who need further interventions.

scholarly journals Prevalence and Determinants of Multimorbidity, Polypharmacy, and Potentially Inappropriate Medication Use in the Older Outpatients: Findings from EuroAgeism H2020 ESR7 Project in Ethiopia

2021 ◽  
Vol 14 (9) ◽  
pp. 844
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Mohammed Assen Seid ◽  
Aynishet Adane ◽  
Eyob Alemayehu Gebreyohannes ◽  
Jovana Brkic ◽  
...  
Keyword(s):  
Older Adults ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Routine Practice ◽  
Cross Sectional ◽  
Inappropriate Medication Use ◽  
High Prevalence ◽  
Sliding Scale

Few studies have been conducted on multimorbidity (two or more chronic diseases) and rational geriatric prescribing in Africa. This study examined the prevalence and determinants of multimorbidity, polypharmacy (five or more long-term medications), and potentially inappropriate medication (PIM) use according to the 2019 Beers criteria among the older adults attending chronic care clinics from a single institution in Ethiopia. A hospital-based cross-sectional study was conducted among 320 randomly selected older adults from 12 March 2020 to 30 August 2020. A multivariable logistic regression analysis was performed to identify the predictor variables. The prevalence of multimorbidity, polypharmacy, and PIM exposure was 59.1%, 24.1%, and 47.2%, respectively. Diuretics (10%), insulin sliding scale (8.8%), amitriptyline (7.8%), and aspirin (6.9%) were among the most frequently prescribed PIMs. Older patients experiencing pain flare-ups were more likely to have multimorbidity (adjusted odds ratio (AOR): 1.64, 95% confidence intervals: 1.13–2.39). Persistent anger (AOR: 3.33; 1.71–6.47) and use of mobility aids (AOR: 2.41, 1.35–4.28) were associated with polypharmacy. Moreover, cognitive impairment (AOR: 1.65, 1.15–2.34) and health deterioration (AOR: 1.61, 1.11–2.32) increased the likelihood of PIM exposure. High prevalence of multimorbidity and PIM use was observed in Ethiopia. Several important determinants that can be modified by applying PIM criteria in routine practice were also identified.

scholarly journals Cross sectional study on the prevalence of polypharmacy and potentially inappropriate medications among elderly patients in a tertiary care centre in central Kerala

2021 ◽  
Vol 8 (3) ◽  
pp. 1415
Author(s):  
Jubina Bency Anthoorathodi ◽  
Aqueen Joju ◽  
Ann Mereena Reji ◽  
Anupama Pallivalappil Asokan ◽  
Anzeem Naseem ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Clinical Care ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Cross Sectional

Background: Polypharmacy or the concurrent use of multiple medications, is on the rise, especially in the elderly population as they suffer from multiple co-morbidities. Polypharmacy has been reported to increase the risks for inappropriate medication intake. Objectives: The aim was to investigate the prevalence of polypharmacy and usage of potentially inappropriate medication using Beer’s criteria and to find out the various risk factors of polypharmacy in hospitalised elderly.Methods: A cross sectional study was done in patients aged 60 years and above using a pre designed semi structured questionnaire and from their case records to assess the pattern of polypharmacy by different socio-demographic characteristics and also to found out the risk factors of polypharmacy.Results: 50 patients aged 60 and above were involved in our study out of which, 46% were females and 54% were males. Mean age of our study population was 71.5±8.3. Among them, 30 were hypertensive, 27 were diabetic, 9 of them had dyslipidaemia and 8 of them had coronary artery disease Mean number of medication use was 5.1±4.1. Polypharmacy was observed in 42% of the patients. 20% patients received potentially inappropriate drugs from Beer’s list. We also found significant association of polypharmacy with diabetes mellitus and hypertension.Conclusions: The present study has shown polypharmacy and usage of potentially inappropriate medication as an emerging public health concern. Diabetes mellitus and hypertension were found to be risk factors of polypharmacy. Deprescription should be integrated into clinical care and prescribers need to be educated about Beers criteria and encouraged for rational prescription.

scholarly journals Anaemia Prevalence and Contributory Factors among Children in Uttarakhand, India

2020 ◽  
pp. 41-51
Author(s):  
Shweta Suri ◽  
Anuradha Dutta ◽  
Rita Singh Raghuvanshi ◽  
Anupama Singh ◽  
C. S. Chopra
Keyword(s):  
Logistic Regression ◽  
Regression Analysis ◽  
Logistic Regression Analysis ◽  
Cross Sectional Study ◽  
Health Concern ◽  
Multivariable Logistic Regression Analysis ◽  
Sectional Study ◽  
Cross Sectional ◽  
Multivariable Logistic Regression ◽  
History Of

Background: In India, Anaemia among children is still one of the major nutritional problems of public health concern. Aim of the Study: The aim of the present study was to assess the prevalence of anaemia among Anganwadi children (3-6 years of age) and to determine the important risk factors associated with anaemia. Study Design: Cross-sectional study. Place and Duration of Study: Study was conducted among 390 Anganwadi children of Udham Singh Nagar district of Uttarakhand, during April, 2019- August, 2019. Methodology: In this cross sectional study, data on socio-demographic, socioeconomic, hygiene and dietary practices were collected using a self-structured questionnaire. Hemoglobin (Hb) and anthropometric measurements were carried out. Multivariable logistic regression analysis was employed to estimate the adjusted odds ratio (AOR). Results: A majority, 70.54% of the Anganwadi children were found to be anaemic, with higher prevalence among male children (51.30%) as compared to female children (48.70%). The mean hemoglobin concentration of children was 9.91 (±1.9 g/dl). Stunting was higher among males (54.83%) as compared to females (45.17%).Multivariable logistic regression analysis showed that anaemia was significantly associated with monthly income of family AOR (95% CI) 3.25(2.49, 4.00), mother's illiteracy AOR (95% CI) 1.98 (1.49, 2.46), history of anaemia in mother AOR (95% CI) 1.60(0.67, 2.52 ), history of worms in child's stool AOR (95% CI) 3.17(2.26,4.03), barefoot walking AOR (95% CI) 3.08(2.11,4.04) and lack of habit of hand washing AOR (95% CI) 1.55(0.98, 2.11). Conclusion: The prevalence of anaemia among children was high. Iron supplementation, nutrition education among mothers and overall personal hygiene are important to ameliorate their iron status.

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