Prevalence of Potentially Inappropriate Medications Use Among Recently Admitted Geriatric Patients in Rural Hospitals
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Date
2014-12-11
Authors
Al-Shamri, Haya Mukhlef
Journal Title
Journal ISSN
Volume Title
Publisher
University of Waterloo
Abstract
Potentially inappropriate medications (PIMs) are prescribed most often to elderly patients and can cause serious adverse effects. Older adults tend to use multiple medications, and age-related physiological changes can make some medications inappropriate. The aims of this study are to determine the prevalence of PIMs use for older patients admitted to rural hospitals; to identify the most frequently prescribed PIMs in this population; to compare the number of PIMs identified using two tools, STOPP criteria and Beers’ criteria; and to identify the total number of PIMs identified when using both sets of criteria. Secondly, this study explores the factors associated with PIMs use in this group. These objectives were examined through an observational study design involving patients aged 65 years and above at rural hospitals. Of the 178 patients enrolled, the median age was 80 and 93 participants (52.2%) were female. The collected data included demographic patient information, medical histories and current diagnoses, number and type of PIMs, and total number of prescribed medications. Using Beers’ criteria, the prevalence of taking at least one PIM was 62.92% among the population, with 112 older adults using 202 PIMs. Using the STOPP criteria, the prevalence of receiving at least one PIM was 69.10%, with 123 patients using 240 PIMs. When both sets of criteria were applied, the proportion using one or more PIMs increased to 73.03%, representing 130 patients using 330 PIMs. Bivariate logistic regression models showed no predictable associations between PIM use and gender, number of illnesses, or age when using both the STOPP and combined criteria models. In contrast, a positive association was found between PIM use and the number of medications, the presence of neurological or urogenital diseases, and age using Beers’ criteria. This study provided insight into the higher prevalence of PIMs in rural healthcare settings. The higher prevalence and number of PIMs under STOPP criteria compared to the Beers criteria were due to differences in their features, while these variances were eliminated when both criteria were concurrently applied. The continued use of PIMs among older patients is a crucial issue that requires further research to discover the underlying reasons of continued prescription of PIMs particularly in rural regions, and to determine an ideal approach that prevents PIM-related problems.
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Keywords
Pharmacy, Potentially inappropriate medications, STOPP criteria, Beers’ criteria, older adults, rural hospitals