Potentially Inappropriate Medication Use in Community Residential Care Facilities

2003 ◽  
Vol 37 (7-8) ◽  
pp. 988-993 ◽  
Author(s):  
Shelly L Gray ◽  
Susan C Hedrick ◽  
Ellen E Rhinard ◽  
Anne E Sales ◽  
Jean H Sullivan ◽  
...  
Keyword(s):  
Residential Care ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Use ◽  
Inappropriate Medication Use ◽  
Multiple Drugs ◽  
Inappropriate Medications

OBJECTIVE: To describe the prevalence of potentially inappropriate medication use in community residential care (CRC) facilities at baseline, describe exposure to potentially inappropriate drugs during the 1-year follow-up, and examine characteristics associated with potentially inappropriate use. DESIGN: A cohort study was conducted using 282 individuals aged ≥65 years entering a CRC facility in a 3-county area in the Puget Sound region of Washington State between April 1998 and December 1998 on Medicaid funding. MAIN OUTCOME MEASURE: Use of potentially inappropriate medications as defined by explicit criteria (e.g., drugs that should generally be avoided in the elderly because potential risks outweigh any potential benefits). RESULTS: Sixty-two (22%) residents took a total of 75 potentially inappropriate medications at baseline. The most common agents used at baseline were oxybutynin (3.5%) and amitriptyline (3.5%). The incidence of new use of potentially inappropriate medications was 0.1/100 person-days during the follow-up period. Potentially inappropriate use was related to self-reported fair or poor health (adjusted OR 1.42; 95% CI 1.05 to 1.92) and number of prescription drugs (adjusted OR 1.12; 95% CI 1.05 to 1.19). In the Cox proportional hazard model, no characteristics predicted new potentially inappropriate medication use during the follow-up. CONCLUSIONS: Potentially inappropriate medication use is common among residents in CRC facilities. A comprehensive periodic review may be beneficial for reducing potentially inappropriate use, especially for patients taking multiple drugs.

scholarly journals Use of potentially inappropriate medications among ambulatory home-dwelling elderly patients with dementia: A review of the literature

2017 ◽  
Vol 150 (3) ◽  
pp. 169-183 ◽  
Author(s):  
Tejal Patel ◽  
Karen Slonim ◽  
Linda Lee
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Adverse Events ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Adverse Outcomes ◽  
Potentially Inappropriate Medication ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medication Use ◽  
Inappropriate Medications

Background: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use. Methods: MEDLINE, EMBASE, CINAHL, and International Pharmaceutical Abstracts were searched between 1946 and 2014 for articles that referenced potentially inappropriate medication use and types of dementia. One reviewer screened all titles and abstracts from the initial search and full-text articles after the initial screen for eligibility, then 2 reviewers independently abstracted data from included studies. Results: Searches yielded 81 articles, of which 7 met inclusion criteria. Prevalence of potentially inappropriate medication use varied from 15% to 46.8%. No single drug or drug class was reported consistently across all studies as the most frequent potentially inappropriate medication, but anticholinergics and benzodiazepines, drugs that affect cognition, were among the most common medications or pharmacological classes listed. Discussion: Older adults with dementia may be particularly vulnerable to potentially inappropriate medications because of cognitive impairment from their condition and the greater likelihood of experiencing adverse events from medications. Given this population’s greater susceptibility to adverse events, more intense medication and patient monitoring may be warranted, especially among those taking anticholinergics and benzodiazepines, as these drugs can contribute to cognitive impairment.

scholarly journals Polypharmacy among Underserved Older African American Adults

2017 ◽  
Vol 2017 ◽  
pp. 1-8 ◽  
Author(s):  
Mohsen Bazargan ◽  
James Smith ◽  
Masoud Movassaghi ◽  
David Martins ◽  
Hamed Yazdanshenas ◽  
...  
Keyword(s):  
African American ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Community Dwelling ◽  
Potentially Inappropriate Medication ◽  
Inappropriate Drug ◽  
Potentially Inappropriate Medications ◽  
African American Adults ◽  
Inappropriate Medication Use ◽  
Inappropriate Medications

The purpose of the present study was to examine correlates of polypharmacy among underserved community-dwelling older African American adults. Methods. This study recruited 400 underserved older African Americans adults living in South Los Angeles. The structured face-to-face interviews collected data on participants’ characteristics and elicited data pertaining to the type, frequency, dosage, and indications of all medications used by participants. Results. Seventy-five and thirty percent of participants take at least five and ten medications per day, respectively. Thirty-eight percent of participants received prescription medications from at least three providers. Inappropriate drug use occurred among seventy percent of the participants. Multivariate analysis showed that number of providers was the strongest correlate of polypharmacy. Moreover, data show that gender, comorbidity, and potentially inappropriate medication use are other major correlates of polypharmacy. Conclusions. This study shows a high rate of polypharmacy and potentially inappropriate medication use among underserved older African American adults. We documented strong associations between polypharmacy and use of potentially inappropriate medications, comorbidities, and having multiple providers. Polypharmacy and potentially inappropriate medications may be attributed to poor coordination and management of medications among providers and pharmacists. There is an urgent need to develop innovative and effective strategies to reduce inappropriate polypharmacy and potentially inappropriate medication in underserved elderly minority populations.

scholarly journals Potentially Inappropriate Medication Use in the Elderly

2021 ◽  
pp. 1-8
Author(s):  
Lesley Charles ◽  
Elena Kumar ◽  
Eimad Elghol ◽  
Bonnie Dobbs ◽  
Peter George Jaminal Tian ◽  
...  
Keyword(s):  
Older Patients ◽  
Community Hospital ◽  
Inappropriate Medication ◽  
Medication Use ◽  
The Elderly ◽  
Potentially Inappropriate Medications ◽  
Rehabilitation Hospital ◽  
Oral Medications ◽  
Inappropriate Medication Use ◽  
Inappropriate Medications

Abstract It is estimated that approximately half of adults, older than 65 years of age, have been prescribed potentially inappropriate medications (PIMs). This study’s objective was to determine the prevalence of PIM use among older patients. Two retrospective chart reviews were performed on 200 and 164 older patients who underwent comprehensive geriatric assessments (CGAs) at outpatient geriatrics clinics at the Glenrose Rehabilitation Hospital (Glenrose) in 2012–13 and at the Misericordia Community Hospital (Misericordia) in 2016–17, respectively. Outcome measures included demographics; prevalence of PIM use; common PIMs used; whether PIM use was addressed, and if so, how; and total number of oral medications. At the Glenrose, the prevalence of PIM use was 45 per cent (90/200). Of the 90 patients who had used PIMs, 46.7 per cent (42/90) had at least one of their medications stopped or modified. At the Misericordia, the prevalence of PIM use was 57.3 per cent (94/164). Of the 94 patients who used PIMs, 47.9 per cent (45/94) had at least one of their medications stopped or modified. These results suggest that an increased awareness of PIM among physicians is needed to further decrease PIM use.

scholarly journals Potentially inappropriate medication use in a city of Southeast Brazil

2012 ◽  
Vol 48 (1) ◽  
pp. 79-86 ◽  
Author(s):  
Mauro Cunha Xavier Pinto ◽  
Felipe Ferré ◽  
Marcos Luciano Pimenta Pinheiro
Keyword(s):  
Drug Interactions ◽  
Inappropriate Medication ◽  
Medication Use ◽  
The Elderly ◽  
Cardiovascular Drugs ◽  
Potentially Inappropriate Medication ◽  
Self Medication ◽  
Inappropriate Use ◽  
Inappropriate Medication Use ◽  
Socio Economic Variables

Potentially inappropriate medication use by the Diamantina (Minas Gerais State) population was investigated by analyzing medicine consumption, self-medication, polypharmacy and drug interactions of medicines prescribed among those interviewed. Level of knowledge about rational drug use and its relationship to socio-economic variables was also evaluated using a semi-structured questionnaire. This survey was based on stratified sampling of 423 individuals selected randomly. The prevalence of prescription drug consumption was 42.32% (n=179) and cardiovascular drugs were the most prescribed. Drug interactions were found in 45.81% (n=82) of prescriptions and 92.68% (n=76) of these interactions were moderate, with co-administration of cardiovascular drugs occurring in more than half of the cases. The inappropriate use of medication, according to Beers criteria, occurred in 44.73% of prescriptions to the elderly. The prevalence of self-medication was 63.34% (n=268) while 21.99% (n=91) of individuals administered medications to their children without formal prescriptions, where this practice was associated to analgesic/antipyretic consumption. The population showed a high prevalence of inappropriate use of drugs across all strata of society, representing an issue requiring effective actions to promote rational use of medicines.

scholarly journals Analysis of Potentially Inappropriate Medication Use in 372 Old Adult Inpatients

2021 ◽  
Author(s):  
Xian Zhang ◽  
Xiao-juan WANG ◽  
Jing-jing TIAN ◽  
Xi-ling ZHU
Keyword(s):  
Retrospective Analysis ◽  
Clinical Medicine ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medications ◽  
Old Adults ◽  
Inappropriate Medication Use ◽  
Rational Drug ◽  
Old Adult ◽  
Inappropriate Medications

Abstract Background: In 2017, China published the "Criteria for Potentially Inappropriate Medications use for the old adults in China". There is no medical institution in Huainan that has conducted investigations on PIMs for the old adults until now. The survey investigated the PIMs for the old adults in our hospital, and also tested the applicability and practicability of the 72 drugs included in the "Criteria for Potentially Inappropriate Medications use for the old adults in China".Methods: According to the Criteria for Potentially Inappropriate Medications use for the old adults in China (2017 Edition), a retrospective analysis of the medications in 372 old adult inpatients aged 65 years and above was performed to evaluate the occurrence of their PIMs use. Results: The average age of the 372 inpatients was (74.67±6.95) years old, the average Inpatient days was (11.96±8.5) days, and the average number of illnesses per person was (4.92±2.55). Of 372 inpatients, 62.63% (233) inpatients had PIMs in the China-PIM list for the old adults , and 17.20% (64) inpatients had PIMs related to their diseases. Conclusion: The proportion of PIMs among old adult inpatients in our hospital is relatively high. The hospital should pay attention to it and actively take measures to reduce the risk of PIMs for the old adults and ensure rational drug use in clinical medicine.

scholarly journals Potentially inappropriate medication use among older adult patients on follow-up at the chronic care clinic of a specialized teaching hospital in Ethiopia. A cross-sectional study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Behailu Terefe Tesfaye ◽  
Mihret Terefe Tessema ◽  
Mengist Awoke Yizengaw ◽  
Dula Dessalegn Bosho
Keyword(s):  
Older Adult ◽  
Screening Tool ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Adult Patients ◽  
Potentially Inappropriate Medication ◽  
Cross Sectional ◽  
Care Clinic ◽  
Inappropriate Medication Use

Abstract Background Older adult patients are prone to potentially inappropriate medication use (PIMU); its use has been associated with multiple adverse consequences. As a result, it is crucial to determine the magnitude and factors associated with PIMU. The present study was mainly aimed to determine and assess the magnitude and predictors of potentially inappropriate medication use in older adult patients on follow-up at the chronic care clinic of Jimma medical center. Methods A retrospective cross-sectional study was conducted involving 219 patients aged 65 years and above on treatment follow-up. Data was collected using a checklist. The 2019 updated American Geriatric Society (AGS) Beers Criteria® and Screening Tool of Older People’s Potentially Inappropriate Prescriptions criteria and Screening Tool to Alert Doctors to Right Treatment (STOPP/START) criteria (version 2) were employed to assess PIMU. SPSS IBM (v22) was used for data entry and analysis. Categorical variables were described using frequency and percentage, whereas continuous variables were described using mean with standard deviation (SD) or median with interquartile range (IQR). Logistic regression was conducted to identify predictors of PIMU. Results The average number of medications prescribed per patient was 4.0 (IQR = 2.0). At least one PIMU was identified in 182 (83.1%) and 99 (45.2%) patients, based on Beers and STOPP criteria, respectively. Additionally, potential prescription omission (PPO) was observed in 24 (10.9%) patients. The risk of Beers PIMU was increased with age [AOR = 1.21, p <  0.001], hypertension [AOR = 4.17, p <  0.001], and polypharmacy [AOR = 14.10, p <  0.001], while a decrease in the risk was noted in patients with a diagnosis of ischemic stroke [AOR = 0.133, p = 0.01] and asthma [AOR = 0.03, p <  0.001]. Using STOPP criteria, hypertension [AOR = 2.10, p = 0.04], diabetes mellitus [AOR = 2.26, p = 0.04], ischemic heart disease [AOR = 2.84, p = 0.04], peripheral neuropathy [AOR = 10.61, p <  0.001], and polypharmacy [AOR = 6.10, p <  0.001] significantly increased the risk of PIMU. Conclusions Regardless of the screening tool used to assess, the present study revealed PIMU in the large proportion of the participants. Multiple medication use and certain disease condition had increased the probability of PIMU. Hence, it is imperative to use screening tools for reviewing medications prescribed in older adult patients to ensure safety of medication therapy.

Polypharmacy and Potentially Inappropriate Medication Use in Older Blacks with Diabetes Mellitus Presenting to the Emergency Department

2021 ◽  
pp. 089826432110455
Author(s):  
Ginah Nightingale ◽  
Emily M. Scopelliti ◽  
Robin Casten ◽  
Monica Woloshin ◽  
Shu Xiao ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Emergency Department ◽  
Controlled Trial ◽  
Inappropriate Medication ◽  
Medication Use ◽  
Potentially Inappropriate Medication ◽  
Cross Sectional ◽  
Randomized Controlled ◽  
Inappropriate Medication Use ◽  
Sectional Analysis

Background: Medication-related problems in older Blacks with diabetes mellitus (DM) are not well established. Objectives: To describe the frequency of medication-related problems in older Blacks with DM presenting to the emergency department (ED). Methods: The study was a cross-sectional analysis of baseline data from a randomized controlled trial evaluating Blacks aged ≥60 years of age presenting to the ED. Polypharmacy, potentially inappropriate medication (PIM) use, and anticholinergic score were evaluated. Results: Of 168 patients (median age = 68, range 60–92), most ( n = 164, 98%) were taking ≥5 medications, and 67 (39.9%) were taking a PIM. A majority ( n = 124, 74%) were taking a medication with an anticholinergic score ≥1. Number of medications was correlated with number of PIMs ( r = .22, p = .004) and anticholinergic score ( r = .50, p < .001). Conclusion: Polypharmacy and PIM use was common in older Blacks with DM.

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