Prevalence of Use of Potentially Inappropriate Medications Among Older Adults Worldwide

JAMA Network Open, Год журнала: 2023, Номер 6(8), С. e2326910 - e2326910

Опубликована: Авг. 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.

Язык: Английский

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Optimising prescribing in older adults with multimorbidity and polypharmacy in primary care (OPTICA): cluster randomised clinical trial

BMJ, Год журнала: 2023, Номер unknown, С. e074054 - e074054

Опубликована: Май 24, 2023

To study the effects of a primary care medication review intervention centred around an electronic clinical decision support system (eCDSS) on appropriateness and number prescribing omissions in older adults with multimorbidity polypharmacy compared discussion about line usual care.Cluster randomised trial.Swiss care, between December 2018 February 2021.Eligible patients were ≥65 years age three or more chronic conditions five long term medications.The to optimise pharmacotherapy eCDSS was conducted by general practitioners, followed shared making practitioners patients, practitioners.Primary outcomes improvement Medication Appropriateness Index (MAI) Assessment Underutilisation (AOU) at 12 months. Secondary included medications, falls, fractures, quality life.In 43 practitioner clusters, 323 recruited (median 77 (interquartile range 73-83) years; 45% (n=146) women). Twenty one 160 assigned group 22 163 control group. On average, recommendation stop start reported be implemented per patient. At months, results intention-to-treat analysis (odds ratio 1.05, 95% confidence interval 0.59 1.87) (0.90, 0.41 1.96) inconclusive. The same case for protocol analysis. No clear evidence found difference safety month follow-up, but fewer events than six months.In this trial adults, inconclusive as whether use led reduction months care. Nevertheless, could safely delivered without causing any harm patients.NCT03724539Clinicaltrials.gov NCT03724539.

Язык: Английский

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Impact of Chinese criteria on potentially inappropriate medication use in China

Journal of Global Health, Год журнала: 2025, Номер 15

Опубликована: Фев. 6, 2025

In 2018, China issued a set of criteria for effectively identifying and managing potentially inappropriate medication (PIM) use in older adults. However, there is currently lack evidence regarding the impact these on PIM among Chinese We used interrupted time series analysis prescription data outpatients from 59 hospitals six major geographic regions to compare changes overall prevalence use, stratified by different numbers PIMs, top five PIMs (i.e. clopidogrel, estazolam, zolpidem, sliding-scale insulin, alprazolam) 2015 (before) 2021 (after) release 2018. included 982 605 outpatients. Compared with trends prior publication criteria, were significant decreases coefficient change slope (β = -0.607; 95% confidence interval (CI) -0.881, -0.482; P < 0.001), single -0.368; CI -0.465, -0.272; multiple -0.104; -0.173, -0.080; 0.019), clopidogrel -0.342; -0.463, -0.227; 0.006), estazolam -0.077; -0.124, -0.037; 0.009) post-publication. Conversely, was increase after released 0.030; 0.002, 0.057; 0.036). found that has had positive effect its China.

Язык: Английский

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Tuberculosis in older adults: challenges and best practices in the Western Pacific Region

The Lancet Regional Health - Western Pacific, Год журнала: 2023, Номер 36, С. 100770 - 100770

Опубликована: Апрель 20, 2023

Язык: Английский

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Risk of Polypharmacy and Its Outcome in Terms of Drug Interaction in an Elderly Population: A Retrospective Cross-Sectional Study

Journal of Clinical Medicine, Год журнала: 2023, Номер 12(12), С. 3960 - 3960

Опубликована: Июнь 10, 2023

The simultaneous use of multiple drugs-termed 'polypharmacy'-is often required to manage physiological and biological changes the interplay between chronic disorders that are expected increase in association with ageing. However, by increasing number medications consumed, risk undesirable medication reactions drug interactions also increases exponentially. Hence, knowledge prevalence polypharmacy potentially serious drug-drug (DDIs) elderly patients should be considered a key topic interest for public health care professionals. Methods: Prescription demographic data were collected from electronic files who aged ≥ 65 years attended Al-Noor Hospital Makkah, Saudi Arabia, 2015 2022. Lexicomp® DDI-checking platform was used evaluate patients' regimens any potential interactions. Results: A total 259 included study. among cohort 97.2%: 16 (6.2%) had minor polypharmacy, 35 (13.5%) moderate 201 (77.6%) major polypharmacy. Of taking two or more simultaneously, 221 (85.3%) at least one DDI (pDDI). most frequently reported pDDI under category X avoided interaction clopidogrel esomeprazole found 23 (18%). D therapeutic modification enoxaparin aspirin, which 28 (12%). Conclusions: It is necessary take several simultaneously diseases. Clinicians distinguish suitable, appropriate unsuitable, inappropriate this criterion closely examined when establishing plan.

Язык: Английский

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Prescribing rate, healthcare utilization, and expenditure of older adults using potentially inappropriate medications in China: A nationwide cross-sectional study

Chinese Medical Journal, Год журнала: 2025, Номер unknown

Опубликована: Янв. 23, 2025

Abstract Background: The use of potentially inappropriate medications (PIMs) is a major concern for medication safety as it may entail more harm than potential benefits older adults. This study aimed to explore the prescribing rate, healthcare utilization, and expenditure adults using PIMs in China. Methods: A cross-sectional analysis was conducted national representative database all medical insurance beneficiaries across China, extracting ambulatory visit records aged 65 years above between 2015 2017. Descriptive measure rate patients exposed PIM, each average annual outpatient visits per patient, total costs visit, cost patient. Generalized linear model with logit link function binomial distribution used examine adjusted associations independent variables. Results: In total, 845,278 (33.2%) participants were identified be at least one PIM. Patients 75–84 (38.1%) ≥85 (37.9%) likely prescribed PIMs. Beneficiaries Urban Employee Basic Medical Insurance (UEBMI) living eastern southern regions frequently Compared without PIM exposure (7.5 visits, drug RMB 1545.0 Yuan), showed higher number (10.7 β = 3.228, 95% confidence interval [CI] 3.196–3.261) (RMB 2461.8 Yuan, Coef. 916.864, CI 906.292–927.436 Yuan). Conclusions: results that among common suggests represents clear target, pending multidimensional efforts, promote rational

Язык: Английский

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Prevalence and Factors with Potentially Inappropriate Prescribing among Older Surgical Outpatients in China: A Nationwide Cross-sectional Study in 100 Hospitals

Journal of Epidemiology and Global Health, Год журнала: 2025, Номер 15(1)

Опубликована: Март 12, 2025

Older outpatients face a heightened risk of potentially inappropriate prescribing (PIP). However, there is paucity evidence evaluating PIP in older attending surgical outpatient departments China using Chinese-specific criteria. This study aimed to assess the prevalence and identify associated factors within this population. A cross-sectional design was employed, utilizing prescription data from across 100 hospitals seven Chinese cities between January December 2021. assessed based on criteria, multivariate logistic regression analysis performed factors. Trends were analyzed average annual percent change (AAPC) via joinpoint regression. total 357,135 prescriptions for analyzed. The according criteria 13.06%. five most commonly identified medications (PIMs) doxazosin, clopidogrel, tolterodine, estazolam, concurrent use more than two NSAIDs, which together accounted 52.73% all PIMs. From December, exhibited slight decrease, 13.29 13.21% (AAPC: -0.278%). Logistic revealed that such as tertiary-level hospital status, polypharmacy, pain, sleep disorders, hypertension, benign prostatic hyperplasia, stone disease positively with outpatients. found while among relatively low, attention needed widespread certain Although numerous studies have explored (PIP) patients, contributing remain unclear. Additionally, specific group are not well defined. reveals top account Furthermore, being treated hospital, age ≥ 80, polypharmacy be

Язык: Английский

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Prevalence of Polypharmacy in Chinese Community‐Dwelling Older Adults and Forecast by 2035: A Systematic Review and Meta‐Analysis

Pharmacoepidemiology and Drug Safety, Год журнала: 2025, Номер 34(4)

Опубликована: Март 26, 2025

We aimed to derive a pooled polypharmacy prevalence estimate and forecast the total cases by 2035 in Chinese community-dwelling older adults. searched for studies three databases (CNKI, Scopus PubMed). selected according pre-defined inclusion exclusion criteria. assessed study quality using modified Newcastle-Ottawa Scale. Polypharmacy our was defined as concurrent use of at least five different medications. Pooled estimated overall regions, time periods, other important factors. fitted Bayesian random-effects logit models synthesize single reported 95% uncertainty interval (95UI). A 25 were finally included. The be 31.04% (95UI: 18.16 ~ 47.66). highest east region (37.98%, 95UI: 21.92 57.69), followed middle (33.53%, 4.89 84.46) west (25.85%, 8.78 50.74). 31.10% 15.54 52.72) latest 5 years (2017-2021) 30.88% 11.53 60.56) beyond (2005-2016). per cent change annualized forecasted from 2022 3.69%, with 131.7 million 77.1 202.2) 2035. Our suggests that is notably prevalent adults, highlighting need development delivery community-based interventions targeted this population.

Язык: Английский

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Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases: A report from Iran

Health Science Reports, Год журнала: 2024, Номер 7(3)

Опубликована: Фев. 28, 2024

A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses greater risk of harm than potential benefit to elderly patients. This study aimed detect PIMs and their factors in hospitalized patients with kidney disease.

Язык: Английский

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Postoperative Multimodal Analgesia Strategy for Enhanced Recovery After Surgery in Elderly Colorectal Cancer Patients

Pain and Therapy, Год журнала: 2024, Номер 13(4), С. 745 - 766

Опубликована: Июнь 5, 2024

Enhanced Recovery After Surgery (ERAS) protocols have substantially proven their merit in diminishing recuperation durations and mitigating postoperative adverse events geriatric populations undergoing colorectal cancer procedures. Despite this, the pivotal aspect of pain control has not garnered commensurate attention it deserves. Typically, employing a multimodal analgesia regimen that weaves together nonsteroidal anti-inflammatory drugs, opioids, local anesthetics, nerve blocks stands paramount curtailing surgical complications facilitating reduced convalescence within hospital confines. Nevertheless, this integrative strategy is devoid pitfalls; specter organ dysfunction looms over cohort, rooted abuse analgesics or complex interplay polypharmacy. Revolutionary research delving into alternative delivery release modalities, seeking to allay inadvertent consequences thereby potentially elevating outcomes for elderly post-colorectal surgery populace. This review examines dual aspects regimens by comparing established benefits with potential limitations offers insight evolving strategies drug administration release.

Язык: Английский

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