rishabh Sharma

and 5 more

Background: There is limited information available on the use of PIP medication in older adults having psychiatric illness. Objective: To determine the prevalence of PIP medications, and assess its predictors in older adults with psychiatric illness. Methods: A cross-sectional study was carried out at a tertiary care hospital on 456 patients of either sex, with a median age of 65 years attending the psychiatry outpatient department. Evaluation of PIP medication was done using Beers criteria 2019 and STOPP criteria 2015. Bivariate logistic regression was used to find out the predictors of PIP prescribing. Results: Results of the study reflect that a staggering number of older adults, (more than 91% and 73%) out of total of 456 patients were prescribed with at least one PIP medication identified by Beers criteria and STOPP criteria, respectively. Long-acting benzodiazepine (LABZD) like clonazepam was identified as one of the most commonly prescribed PIP medications by both set of criteria. Further analysis revealed that older adults from rural background (Odds Ratio (OR) 2.60, 95% Confidence Interval (CI) 1.20-5.65; P=0.015), TCA (OR 0.30, 95% CI 0.12- 0.75; P= 0.010), LABZD (OR 33.72, 95% CI 11.27-100.85; P=<0.001), atypical antipsychotics (OR 22.35, 95% CI 5.31- 93.99; P= <0.001) use were most common predictors for PIP medication prescribing. Conclusion: The use of PIP medication is highly prevalent among older adults according to Beers criteria and STOPP criteria. The study reflects a more comprehensive and sturdy nature of Beer criteria as it significantly detects more PIP medication than STOPP criteria.

rishabh Sharma

and 3 more

Introduction: There are a lack of potentially inappropriate medications (PIMs) predictors among the geriatric population with cardiovascular disease (CVD). Objective: This study was focussed on finding out the predictors and prevalence of PIMs use in the older adult patients hospitalized with cardiovascular disease. Methods: This prospective cross-sectional study included 250 older adult patients (mean age 69.03± 5.76 years) with the CVD having age 65 years or more, admitted in the cardiology/medicine department of a tertiary care hospital. PIMs were identified as per Beers criteria 2019. Binary Logistic regression analysis was used to determine the predictors of PIMs use in older adult patients. Results: Results indicate a very high PIM prescription rate of more than 62.4% (n= 156) with Proton pump inhibitor, short acting insulin according to sliding scale, Enoxaparin <30ml/min as the most commonly prescribed PIMs. On Binary logistic regression, important predictors for PIMs use were found to be females (odds ratio [OR] 2.36, 95% confidence interval (CI) 1.36- 4.09, P= 0.002), three diagnosis (OR 4.29, 95% CI 1.31- 14.0, P= 0.016), ≥4 diagnosis (OR 4.8, 95% CI 1.49- 15.44, P= 0.009), 7-9 days of hospital stay (OR 4.74, 95% CI 1.07- 20.96, P= 0.04), ≥ 9 medications per day (OR 0.09, 95% CI 0.01- 0.50, P= 0.006). Conclusion: The prevalence of PIMs in older adults with cardiovascular disease is very high, and females with CVD have emerged as a potential PIM indicator. The study also indicates a lack of awareness towards Beer criteria in health care workers (physicians/pharmacists/nursing staff) leading to PIM.