Potentially inappropriate medications among the elderly in primary care in Thailand from three different sets of criteria
| Autor: | Pasitpon Vatcharavongvan, Viwat Puttawanchai |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
medicine.medical_specialty
mesh:Multivariate Analysis Potentially Inappropriate Medication List Cross-sectional study mesh:Potentially Inappropriate Medication List lcsh:RS1-441 Pharmaceutical Science Inappropriate Prescribing Pharmacy 030226 pharmacology & pharmacy mesh:Electronic Health Records: Cross-Sectional Studies lcsh:Pharmacy and materia medica 03 medical and health sciences 0302 clinical medicine Electronic Health Records: Cross-Sectional Studies Interquartile range Internal medicine mesh:Outpatients mesh:Polypharmacy hemic and lymphatic diseases Outpatients medicine Medical prescription Cross-Sectional Studies [Electronic Health Records] mesh:Primary Health Care Original Research Polypharmacy mesh:Inappropriate Prescribing Primary Health Care business.industry Medical record lcsh:RM1-950 Odds ratio Thailand Confidence interval lcsh:Therapeutics. Pharmacology mesh:Thailand Multivariate Analysis business |
| Zdroj: | Pharmacy Practice (Granada), Volume: 17, Issue: 3, Article number: 1494, Published: 25 NOV 2019 Pharmacy Practice Pharmacy Practice, Vol 17, Iss 3, p 1494 (2019) Pharmacy Practice (Granada) v.17 n.3 2019 SciELO España. Revistas Científicas Españolas de Ciencias de la Salud instname |
| Popis: | Objective: The primary objective was to examine potentially inappropriate medications (or PIMs) in the elderly using three different criteria: Beers 2015, STOPP version 2, and Winit-Watjana (for Thai elderly patients). The secondary objective was to examine PIM-related factors. Methods: This is a retrospective cross-sectional study. Eligible patients were aged ≥65 years in a primary care unit. Demographic data, medical prescriptions in the past year, clinical data and diagnoses were collected from electronic medical records. PIMs, including the use of ≥2 medications, were identified using the three criteria. Descriptive and analytical statistics were conducted. The type I error was 0.05. Multiple logistic regression analysis was used to examine associations between PIMs and other factors. Results: A total of 400 patients were recruited, and 1,640 prescriptions were reviewed. The median age was 70.5 years, and the median numbers of diseases, medications, and prescriptions were 3 (interquartile range or IQR=2), 11 (IQR=20), and 3 (IQR=4), respectively. Of all the patients, 213 (53.3%) showed a use of ≥5 medications, and 301 (75.3%) were prescribed PIMs. Of the 1,640 prescriptions, 60% had at least one PIM. The Winit-Watjana criteria, Beers 2015 criteria and STOPP version 2 identified 66.8%, 59.0% and 40.3% of the patients receiving PIMs, respectively. Approximately 16% of the patients showed at least one potential drug-drug interaction. The use of duplicate drug classes accounted for the highest proportion of potential drug-drug interactions (41.3%). Polypharmacy (odds ratio or OR 3.93, 95% confidence interval or 95%CI 2.17-71.2) and the presence of ≥4 diseases (OR 2.78, 95%CI 1.39-5.56) were associated with PIMs. Conclusions: PIMs are common among the elderly patients in primary care in Thailand. Prescriptions of the elderly with polypharmacy or multiple concurrent diagnoses should be reviewed for PIMs because they have a high chance of receiving PIMs. |
| Databáze: | OpenAIRE |
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