Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

JAMA Network Open, Journal Year: 2023, Volume and Issue: 6(8), P. e2326910 - e2326910

Published: Aug. 2, 2023

Importance The use of potentially inappropriate medications (PIMs) is widespread yet continues to receive little attention in outpatient services. Objective To estimate the overall prevalence PIM Data Sources PubMed, Embase, and Web Science were searched identify relevant studies published from January 1, 1990, November 21, 2022. Study Selection Observational that reported among older patients services screened. Extraction Synthesis Two reviewers independently selected eligible articles, extracted data, assessed risk bias. A random-effects meta-analysis was conducted pool estimates. Main Outcomes Measures global patterns estimated, temporal trends regional differences investigated. Results total 94 articles with 132 estimates analyzed, including nearly 371.2 million participants 17 countries. Overall, pooled 36.7% (95% CI, 33.4%-40.0%). Africa had highest (47.0%; 95% 34.7%-59.4%), followed by South America (46.9%; 35.1%-58.9%), Asia (37.2%; 32.4%-42.2%), Europe (35.0%; 28.5%-41.8%), North (29.0%; 22.1%-36.3%), Oceania (23.6%; 18.8%-28.8%). In addition, low-income areas. Use PIMs has become increasingly prevalent past 2 decades. Conclusions Relevance This study different groups, such as geographic regions World Bank countries, suggests noticeable environment economic income burden Furthermore, high trend decades indicates be worthy attention.

Language: Английский

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Global prevalence of polypharmacy and potentially inappropriate medication in older patients with dementia: a systematic review and meta-analysis

Frontiers in Pharmacology, Journal Year: 2023, Volume and Issue: 14

Published: Aug. 24, 2023

Background: Older patients with dementia always need multiple drugs due to comorbidities and cognitive impairment, further complicating drug treatment increasing the risk of potentially inappropriate medication. The objective our study is estimate global prevalence polypharmacy medication (PIM) explore factors PIM for older dementia. Methods: We searched PubMed, Embase (Ovid), Web Science databases identify eligible studies from inception 16 June 2023. conducted a meta-analysis observational reporting in using random-effect model. associated were meta-analyzed. Results: Overall, 62 included, which 53 reported 28 polypharmacy. pooled was 43% (95% CI 38–48) 62% 52–71), respectively. Sixteen referred use, 15 pooled. Polypharmacy (2.83, 95% 1.80–4.44), diabetes (1.31, 1.04–1.65), heart failure (1.17, 1.00–1.37), depression (1.45, 1.14–1.88), history cancer (1.20, 1.09–1.32), hypertension (1.46, 1.05–2.03), ischemic disease (1.55, 0.77–3.12), any cardiovascular (1.11, 1.06–1.17), vascular (1.09, 1.03–1.16), chronic obstructive pulmonary (1.39, 1.13–1.72), psychosis (1.91, 1.04–3.53) are positively use. Conclusion: highly prevalent Among different regions, use varied widely. Increasing closely For other such as diabetes, prescribing should be cautioned.

Language: Английский

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Patient‐Related Factors Associated With the Initiation of Potentially Inappropriate Medication in Home Care: An Observational Study Based on Resident Assessment Instrument Data

Basic & Clinical Pharmacology & Toxicology, Journal Year: 2025, Volume and Issue: 136(2)

Published: Jan. 8, 2025

ABSTRACT Background The harmful outcomes of potentially inappropriate medications (PIMs) are highlighted among multimorbid older home care clients using several medicines. aim this study was to identify patient‐related factors associated with the initiation PIMs. Methods This register‐based used Resident Assessment Instrument‐Home Care (RAI‐HC) assessments ( n = 6176) from year 2014 2015. PIMs were identified according Beers criteria. Generalised estimating equations Findings A total 228 (11.3%) initiated during follow‐up (mean 13 months). Factors higher odds initiate education (OR 1.36, 95% CI 1.02–1.82), cognitive impairment 1.70, 1.02–2.82), reduced social interaction 1.50, 1.06–2.13), independent activity outdoors 1.72, 1.18–2.51), diabetes 1.47, 1.12–1.94), Parkinson's disease 3.42, 1.86–6.27) and longer interval between RAI 1.09 per month, 1.02–1.18). Conclusions Incidence common. results help healthcare professionals focus more attention on susceptible PIM prescribing. Preventing use is essential, especially adults impairment, prevent further decline health status admission long‐term care.

Language: Английский

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Risk of falls or fall-related injuries associated with potentially inappropriate medication use among older adults with dementia

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

Published: Aug. 23, 2024

Potentially inappropriate medications (PIMs) are prevalent in older adults with dementia and subsequent falls or fall-related injuries. The present study determined the risk of injuries associated PIM use dementia. National Health Insurance Service-Elderly Cohort Database 2.0 (NHIS-ECDB 2.0) was used for this self-controlled case series (SCCS) study. This included 1430 participants who went through exposure non-exposure periods application among patients experienced outcome events between January 2016 December 2019. incidence during post-exposure compared that period. Beers Criteria were to define PIMs Negative binomial regression conducted. rate ratio (IRR) determine During which occurred, mean number 3.76 (SD = 2.99), most commonly first-generation antihistamines (n 283; 59.1%). Compared period, adjusted IRR period 1.57 (95% CI 1.39–1.76). increased when initiated (1–14 days: 2.76, 95% 2.31–3.28; 15–28 1.95, 1.48–2.56; ≥ 29 1.17, 1.01–1.35). Especially, an greater Among dementia, significantly increase Therefore, strategies should be developed manage prescriptions prevent falls.

Language: Английский

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Use of Electronic Medical Records (EMR) in Gerontology: Benefits, Considerations and a Promising Future

Clinical Interventions in Aging, Journal Year: 2023, Volume and Issue: Volume 18, P. 2171 - 2183

Published: Dec. 1, 2023

Electronic medical records (EMRs) have many benefits in clinical research gerontology, enabling data analysis, development of prognostic tools and disease risk prediction. EMRs also offer a range advantages practice, such as comprehensive records, streamlined communication with healthcare providers, remote access, rapid retrieval test results, ultimately leading to increased efficiency, enhanced patient safety, improved quality care which includes like reduced medication use better history taking physical examination assessments. The artificial intelligence (AI) machine learning (ML) approaches on can further improve diagnosis, symptom classification, support decision-making. However, there are challenges related quality, entry errors, well the ethics safety using AI healthcare. This article discusses future gerontology application ML research. Ethical legal issues surrounding sharing need for professionals critically evaluate integrate these technologies emphasized. concludes by discussing their primary intended use, daily practice.

Language: Английский

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Identifying longitudinal healthcare pathways and subsequent mortality for people living with dementia in England: an observational group-based trajectory analysis

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

Published: Feb. 14, 2024

Abstract Background The number of people living with dementia (PLWD) continues to increase, particularly those severe symptomatology. Severe symptoms and greater ill-health result in more acute care need. Early healthcare interventions can prove beneficial. Healthcare use has not been analysed as a holistic set interlinked events. This study explores different pathways among PLWD, social or spatial inequalities subsequent mortality risk. Methods Group-based trajectory models (GBTM) were applied electronic records. We generated clusters PLWD similar five-year, post-diagnosis trajectories rates primary secondary use. Potential variations examined. Cox Proportional Hazards used explore variation risk between clusters. Results Four identified both early- ( n = 3732) late-onset 6224) populations. noted; consistent diminishing was associated lower Increasing increased Descriptive analyses indicated cluster membership. Conclusion help indicate changing need need, differential patterns initial post-diagnosis, producing Care needs be accessible appropriate, catered specific needs. Better continuity awareness enhance prospects for PLWD. Research further illuminate including health use, care, outcomes.

Language: Английский

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Polypharmacy and associated factors in South Korean elderly patients with dementia: An analysis using National Health Insurance claims data

PLoS ONE, Journal Year: 2024, Volume and Issue: 19(4), P. e0302300 - e0302300

Published: April 25, 2024

Dementia is accompanied by several symptoms, including cognitive function decline, as well behavioral and psychological symptoms. Elderly patients with dementia often experience polypharmacy, the concurrent use of multiple medications, due to chronic comorbidities. However, research on polypharmacy in limited. This study aimed characterize associated factors among elderly South Korea, compare characteristics without patients.

Language: Английский

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The Prevalence of Prescribing Inappropriate Medications Among Older Adults in Saudi Arabia with Dementia Based on Beers Criteria: A Retrospective Study

International Journal of General Medicine, Journal Year: 2024, Volume and Issue: Volume 17, P. 2801 - 2808

Published: June 1, 2024

Background: Dementia is a common neurogenerative disease among older adults. Therefore, they are more prone to potentially inappropriate medication (PIM), which that causes harm rather than protecting the health of an individual. Hence, American Geriatrics Society (AGS) has recognized risk certain classes on this population and released PIM according Beers criteria, helpful guide for clinicians ensure safety before it prescribed. The aim study assess prevalence use adults with dementia as factor in comparison other without dementia. Methods: A retrospective was conducted outpatient setting tertiary hospital targeting elderly patients aged 65 years old or over from January 2020 September 2022. total 598 were screened, 270 met inclusion criteria. eligible then divided into two groups: 168 non-dementia group 102 group. Results: reported most prescribed comprised atypical antipsychotics both However, higher quetiapine (75% vs 24% respectively), olanzapine (82% 17% respectively) risperidone (92% 7%, respectively). Anticholinergics highly adult compared patient statistically significant solifenacin (96% vs.3.6% amitriptyline (88% 11% Conclusion: Among care settings, considered high antipsychotics, while benzodiazepine anticholinergics found patients. Keywords: beers medication, dementia, adults, Saudi Arabia

Language: Английский

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Real-World Data-Derived Pharmacovigilance on Drug-Induced Cognitive Impairment Utilizing a Nationwide Spontaneous Adverse Reporting System

Medicina, Journal Year: 2024, Volume and Issue: 60(7), P. 1028 - 1028

Published: June 23, 2024

: Despite high incidences of cognitive impairment with aging, evidence on the prevalence and seriousness drug-induced is limited. This study aims to evaluate severity investigate clinical predictors increased hospitalization risk from serious impairment.

Language: Английский

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Estudo sobre a prevalência de consumo do Zolpidem em jovens de 15 a 24 anos em Cascavel – PR

Research Society and Development, Journal Year: 2024, Volume and Issue: 13(11), P. e102131147427 - e102131147427

Published: Nov. 16, 2024

O Zolpidem é um medicamento hipnótico, prescrito para o tratamento da insônia, cujo início de ação rápido, promovendo sono em cerca 15 a 30 minutos após administração. Embora seja eficaz, não está isento efeitos adversos. Contudo, uso abusivo representa uma preocupação significativa vez que prolongado ou doses maiores do as prescritas podem causar dependência. Nesse contexto, este estudo teve como objetivo avaliar prevalência consumo entre jovens 24 anos Cascavel, PR. delineamento metodológico seguiu transversal retrospectivo, no qual foram avaliados os dados dos registros vendas Zolpidem, com idade anos, ambos sexos, por farmácia comercial privada localizada Cascavel-PR. Com isso, foi possível inferir perfil nessa faixa etária e região, mais prevalente adultos meia idade, demanda significativamente menor idosos acima 80 anos. Além disso, houve variação 5mg, 6,25mg, 10mg 12,5 mg, sendo concentração predominante indivíduos dose 10 mg amplamente utilizada outras. Tais resultados mostram importância estabelecer ações controle sensibilização pelas autoridades sanitárias, bem fornecem informações valiosas orientar políticas saúde pública intervenções educativas voltadas à prevenção indevido Zolpidem.

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