Gender Differences in Potentially Inappropriate Medication Use among Older Adults

Pharmaceuticals, Journal Year: 2023, Volume and Issue: 16(6), P. 869 - 869

Published: June 12, 2023

Use of potentially inappropriate medication (PIMs) is a prominent concern that leads to significant medication-related issues among older adults. Notably, women tend utilize more medicines than men; frequently take drugs. In addition, some evidence suggests prescription PIMs vary by gender. This study examines the gender-based variation in prescribing PIM adults Saudi Arabia.A cross-sectional retrospective analysis electronic medical records from large hospital Arabia was carried out. Patients over age 65 who received ambulatory treatment were included study. The utilization assessed based on Beers criteria. Descriptive statistics and logistic regression employed describe patterns identify factors associated with their use. All statistical analyses performed using Version 9.4 Statistical Analysis Software (SAS® 9.4).The comprised 4062 people (age 65) visited care clinics; average (72.6 ± 6.2) years. majority sample (56.8%). Among adults, 44.7% men 58.3% reported having should be avoided, indicating higher prevalence compared men. terms categories used, had much rate cardiovascular gastrointestinal drugs men, use hypertension, ischemic heart disease, asthma, osteoarthritis, cancer, while age, dyslipidemia, chronic kidney osteoporosis.This revealed sex differences adults; common women. Sex exist clinical socioeconomic characteristics related medications. essential areas could targeted further interventions improve drug-prescribing practices at risk PIM.

Language: Английский

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Inappropriate medication prescribing, polypharmacy, potential drug-drug interactions and medication regimen complexity in older adults attending three referral hospitals in Asmara, Eritrea: a cross-sectional study

BMC Geriatrics, Journal Year: 2025, Volume and Issue: 25(1)

Published: Feb. 3, 2025

Older adults often face several chronic illnesses that require them to take multiple medications. The increased number of prescribed medications has led more complex medication regimens, putting older at a higher risk potential drug-drug interactions, inappropriate prescribing, and adverse events. This study aimed assess prescribing practices, polypharmacy, regimen complexity, their determinants in adults. A cross-sectional was conducted among (aged 65 years above) who visited three referral hospitals Asmara, Eritrea, between June August, 2023. stratified random sampling technique used, data were collected from patient prescriptions, medical cards, through interviews with questionnaire. Inappropriate evaluated using STOPP (Screening Tool Person's Prescriptions)/ START Alert Right Treatment) criteria version 3. Potential interactions (pDDIs) complexity (MRC) assessed Lexi-comp drug interaction checker MRC index, respectively. Descriptive statistics, logistic regression, Pearson's correlation coefficient, independent samples t-test, one-way Analysis Variance, paired t-test employed IBM SPSS (version-26.0). total 430 respondents, similar male female ratio, included. prevalence polypharmacy 5.3% (95%CI: 3.2, 7.5). Moreover, the clinically significant pDDI 51% 46, 56). most common medicines involved pDDIs enalapril (n = 179) acetylsalicylic acid 124). presence illness (AOR 7.58, 95%CI: 3.73, 15.39) drugs 2.80, 1.91, 4.10) predictors pDDIs. potentially (PIMs) omissions (PPOs) 27.4% (95% CI: 23.4, 31.8) 13.3% 10.3, 16.7), PIMs long-acting sulfonylureas 63) aldosterone antagonists 19). Besides, proton pump inhibitors (PPIs) 41) cardio-selective beta-blockers 14) PPOs identified. Age (AOR: 0.95, 95% 0.92, 0.98), 1.51, 0.81, 2.80), 2.01, 2.69) factors associated PIM. MRCI score determinant PPO 1.25, 1.14, 1.38). mean (SD) overall 9.1 (3.7), dose frequency being major contributor. (r 0.625, p < 0.001). adults, highlighting need for immediate attention policymakers, program managers, healthcare professionals.

Language: Английский

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Geriatric Medication Management Using STOPP/START Criteria on Polypharmacy in a Multicentre Hospital: A Systematic Review

Published: April 25, 2025

Background: Patients 65 years of age and above are known as a special risk group for drug prescribing. They face high challenges like multi-comorbidities, polypharmacy, Potentially Inappropriate Prescribing, the increasing adverse reactions. The Screening Tool to Alert Doctors Right Treatment (START) Older Persons's Prescriptions (STOPP) criteria widely used detect Prescribing (PIM) prescribing omissions despite their effectiveness this tool is not explored. This systematic review aims assess prevalence PIP, errors, impact START/STOPP interventions on clinical outcomes in older adults.  Methods: From January 2015 2025, search was conducted PubMed, Google Scholar, Cochrane Library, Scopus. Cross-sectional, Observational, Cohort, Randomized controlled trials studies involving patients aged were included. data extraction followed PRISMA guidelines. included PIP prevalence, types hospitalizations. Results: A total 36 articles assessed, number sample size 4,449 patients’ evaluated through analysis 9 latest years. potentially inappropriate medication ranged from 19% 85.1% both national international reports. potential observed 4.2% 81.4% cases, mostly hospital settings. Conclusion: highlights among adults guided by STAT/STOPP criteria. multidisciplinary approach healthcare providers necessary obtain optimization. To achieve future goals integration STOPP/START with electronic prescription systems can automate reviews reduce errors.

Language: Английский

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Prevalence and prognostic value of malnutrition in patients with acute coronary syndrome and chronic kidney disease

Frontiers in Nutrition, Journal Year: 2023, Volume and Issue: 10

Published: July 14, 2023

Background Malnutrition is a rising global health issue associated with unfavorable outcomes of variety disorders. Currently, the prevalence and prognostic significance malnutrition to patients acute coronary syndrome (ACS) chronic kidney disease (CKD) remained largely unclear. Methods A total 705 diagnosed ACS CKD in First Affiliated Hospital Wenzhou Medical University between 2013 2021 were included this retrospective cohort study. was assessed by Controlling Nutritional Status (CONUT), Geriatric Risk Index (GNRI), Prognostic (PNI), respectively. The relationships all-cause mortality major cardiovascular events (MACEs) analyzed. Results During median follow-up 31 months, 153 (21.7%) died, 165 (23.4%) had MACEs. 29.8, 80.6, 89.8% for PNI, CONUT, GNRI, All indexes correlated each other ( r = 0.77 GNRI −0.72 −0.88 PNI all p &lt; 0.001). Compared normal nutrition, independently an increased risk (adjusted hazard ratio moderate severe degrees malnutrition, respectively: 7.23 [95% confidence interval (CI): 2.69 19.49] 17.56 CI: 5.61 55.09] CONUT score, 2.18 0.93 5.13] 3.16 1.28 7.79] 2.52 1.62 3.94] 3.46 2.28 5.25] score. values lower than 0.05 nutritional indexes, except value 0.075). As MACEs, similar results observed PNI. scores could improve predictive ability Global Registry Acute Coronary Events (GRACE) score both Conclusion common regardless screening tools used, facilitate stratification prognosis assessment.

Language: Английский

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Evaluation of medication safety assessment tools for pharmacist-led medication reviews: the Eastern European pilot project

Frontiers in Pharmacology, Journal Year: 2024, Volume and Issue: 15

Published: Feb. 16, 2024

Background: Pharmacist-led medication reviews (MR) are one of the key methods to support safety in polypharmacy patients. The aims this study were pilot MRs Eastern European community pharmacies, describe use patients, and evaluate usability assessment tools. Methods: MR was undertaken Estonia, Latvia, Poland, Hungary, Romania, Bulgaria. Patients who used at least five medicines directed service by their GPs. Data on drug-related problems (DRPs) adherence collected pharmacists through structured patient interviews. Databases for identification potential drug-drug interactions (pDDIs) adverse drug reactions (ADRs) named Inxbase/Riskbase, as well an integrated tool comprising potentially inappropriate (PIMs) lists EU(7)-PIM EURO-FORTA, applied retroactively data investigate possibilities risks population. Results: A total 318 patients included study, 250 them elderly (≥65 years). One hundred eighty (56.6%) participants had a 504 pDDIs based Inxbase analysis. On average, there 1.6 per participant. Twenty-five (5.0%) high-risk category. 279 (87.7%) ADR 10 Riskbase categories. fifty-four (20.8%) ADRs Twenty-seven 68 documented DRPs during not databases. Using EU(7)-PIM/EURO-FORTA PIM list, 816 PIMs found 240 (96%) (on average 3.4 participant). Seventy-one (29.6%) using PIMs. Twenty-one percent 13.8% medium-risk pilot. Conclusion: Medication tools can be useful guiding decision-making MRs; however, these cannot replace interviews monitoring. Tools that include thorough explanation easy more beneficial MRs.

Language: Английский

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Potentially Inappropriate Medications Use among Older Adults with Dyslipidaemia

Journal of Clinical Medicine, Journal Year: 2023, Volume and Issue: 12(12), P. 4063 - 4063

Published: June 15, 2023

Background: Since older patients with dyslipidemia frequently receive many prescriptions, medication errors are typical and expected in this population. This risk has increased by using potentially inappropriate medications. The 2019 Beers criteria were used study to investigate use among individuals dyslipidemia. Methods: A cross-sectional retrospective analysis data from electronic medical records an ambulatory-care environment. Patients who adults (>65 years old) included. To describe find potential determinants of usage, descriptive statistics logistic regression employed. Results: included 2209 (age ≥ 65) mean age was 72.1 ± 6.0 years, the majority sample had hypertension (83.7%) diabetes (61.7%), around 80.0% polypharmacy. prevalence medications be avoided 48.6%. high usage found polypharmacy comorbid diabetes, ischemic heart disease, anxiety. Conclusions: showed that number prescribed presence concurrent chronic health conditions important indicators ambulatory

Language: Английский

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Application of STOPP/START criteria in older patients in primary care using RStudio®

BMC Geriatrics, Journal Year: 2024, Volume and Issue: 24(1)

Published: Sept. 25, 2024

Language: Английский

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Investigation of the relationship between nutrition and coronary slow flow-coronary ectasia in patients with acute coronary syndrome

Journal of Cardiology & Cardiovascular Surgery, Journal Year: 2024, Volume and Issue: 2(4), P. 89 - 95

Published: Dec. 29, 2024

Aims: It is known that malnutrition associated with various diseases and poor prognosis, but the relationship of this condition slow coronary flow ectasia not clearly known. In our study, we tried to examine between flow-coronary in ACS (acute syndrome) patients. Methods: We examined CONUT score, NRI score PNI patients who underwent angiography due were found have ectasia-slow flow. Results: According Conut was detected 57% patients, mild 30%, moderate 10% severe 1 patient; according 61% 19%, 18% flow-ectasia 44% these (p=0.003, p=0.002) Conclusion: Malnutrition acute syndrome. Nutritional assessment corrective measures are vital for patient group. Clinical studies needed prospectively evaluate

Language: Английский

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Evaluating potentially inappropriate medications in elderly patients in a pharmacy setting in Bulgaria: A pilot study utilizing the EU (7)-PIM List

Pharmacia, Journal Year: 2023, Volume and Issue: 70(4), P. 1249 - 1255

Published: Oct. 30, 2023

Objective : The primary aim of this study was to evaluate, for the first time, use EU-7 PIM List in identifying potentially inappropriate medications among older patients. Researchers have firmly established connection between drug-related problems, which include increased morbidity and mortality rates heightened utilization healthcare services. While previous studies focused on methodologies Bulgaria, further research is warranted explore applicability widely recognized EU(7)- List. Materials methods A prospective review conducted patient prescriptions aligned with National Health Insurance Fund, explicitly focusing patients aged over 65 years from a single pharmacy Veliko Turnovo City, Bulgaria. spanned November 2022 April 2023. analyzed exclusively comprised covered by insurance fund. manager provided prescription data coded form, included information patients’ age, corresponding medications, accompanying ICD codes. Results sample 255 Healthcare providers prescribed 2,623 61.96% had polypharmacy, taking more than five daily. Among population, 67% polypharmacy at least one based EU (7)-PIM criteria. In total, 173 (PIMs) were identified. main PIMs categorized into four groups: alimentary tract metabolism, blood blood-forming organs, cardiovascular system (CVS), nervous system. Most (75.72%) ATC Within CVS category, 11 associated digoxin intake antiarrhythmics such as propafenone, flecainide, amiodarone. addition, trimetazidine linked 9 PIMs, centrally acting antiadrenergic agents 22 moxonidine being most prevalent (n=16). Peripherally primarily doxazosin. identified 24 related diuretics, specifically spironolactone, 18 selective calcium channel blockers verapamil. antithrombotic agent category highest share, 30 including acenocoumarol, dabigatran, rivaroxaban, apixaban. Furthermore, examination codes confirmed that occurred within CVS, having I11.0 I11.9 40 47 respectively. Conclusion This highlights many diseases. Using pilot demonstrates its effectiveness managing adult conditions. Given significant role deprescribing strategies there need prescribers, educators, drug regulatory institutions show interest measures specific aspects use. important because demographic trend population ageing continues, organizations increasingly focus elderly population.

Language: Английский

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Prevalence of potentially inappropriate medications among elderly patients with diabetes – study based on STOPP/START criteria

Pharmacia, Journal Year: 2023, Volume and Issue: 70(3), P. 817 - 823

Published: Sept. 19, 2023

Objective : The prevalence of drug-related problems in elderly patients is a concerning issue that can lead to elevated morbidity, mortality, and health care resource utilisation. This study focuses on the significance addressing diabetes context an ageing population, where individuals face higher risks comorbidities mortality. main objective this was assess potentially inappropriate medications (PIMs) potential prescribing omissions (PPOs) among with Bulgaria, using explicit STOPP/START criteria, version 2. By evaluating appropriateness drug prescriptions specific patient aims shed light areas require optimisation enhance safety treatment outcomes. Materials methods A national prospective questionnaire conducted Bulgaria aged over 65 years. research 25 randomly selected pharmacies. supports use criteria based clinical information provided. total 133 T1DM or T2DM participated study. evaluation performed 131 patients. sStatistical differences demographics medication numbers between without PIMs PPOs were assessed Chi-square test, p-value ≤ 0.05 considered statistically significant. Results pharmacotherapy assessed, it found 57% them had polypharmacy. Among 90 identified, indicating 66% prescribing. Notably, associated long-acting sulfonylureas (n=10) beta-blockers (n=13). Applying START revealed 67 patients, representing 50% population. However, no detected pharmacotherapy. Furthermore, significant relationship observed number PIMs, as evidenced by chi-square test result close zero, statistical significance. Conclusion high Bulgaria. Endocrine disorders contribute 26% PIMs. As Bulgaria’s population faces increasing challenges, effective management strategies are crucial. These findings underscore practises disease control prevent complications.

Language: Английский

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