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Factors Associated with Potentially Inappropriate Medication Use in Older Adults in China applying 2019 Updated Beers Criteria
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  • Ming-ming Yan,
  • Shu-Shan Wu,
  • Jing Li,
  • Nang Lu,
  • Xiao-Yan Qiu,
  • Ming-Kang Zhong
Ming-ming Yan
Huashan Hospital Fudan University
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Shu-Shan Wu
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Xiao-Yan Qiu
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Ming-Kang Zhong
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Peer review status:POSTED

22 May 2020Submitted to Journal of Evaluation in Clinical Practice
29 May 2020Assigned to Editor
29 May 2020Submission Checks Completed

Abstract

Objectives This study aimed to measure the prevalence of potentially inappropriate medications (PIMs) in Chinese elderly population according to the 2019 Beers Criteria and to evaluate the associative factors of PIMs. Methods Prescriptions of patients aged over 65 years who were hospitalized during January 2017 to December 2017 were retrieved from Hospital Prescription Analysis Cooperation Project, covering seventy-six facilities in six cities in China. PIMs were identified by 2019 Beers Criteria. Results In total, 40.1% elderly patients were treated with at least one PIM independent of their diagnoses or conditions according to the 2019 Beers Criteria. The most frequently prescribed inappropriate medications independent of diagnoses or conditions were proton-pump inhibitors (12.9%). Diuretics (8.2%) and central nervous system medications (6.9%) also showed a relatively high prevalence among the investigated patients. Based on the Beers Criteria’s lists of drug-disease interactions, elderly patients with central nervous system conditions (including delirium, dementia or cognitive impairment) or with a history of falls or fractures were most commonly exposed to PIMs. Logistic regression revealed that inappropriate medication use was associated with age (≥80 years old), number of conditions (≥5), number of medications prescribed (≥10) and class of healthcare facilities. Conclusion This study was able to confirm that the phenomenon of prescribing potentially inappropriate medications was common in China. Our findings support the importance of developing explicit criteria to detect PIMs in China and implementing effective interventions to promote better quality of prescribing for elderly patients.