AI Article Synopsis
- Older adults often face declining organ function and changes in how their bodies process medications, making them more vulnerable to medication-related problems in emergency situations.
- A study at Universitas Airlangga Teaching Hospital found that 55% of older patients admitted to the emergency department received at least one potentially inappropriate medication (PIM), and the overall complexity of their medication regimens was high, with an average complexity index score of 17.23.
- Risk factors for receiving PIMs included polypharmacy and specific health issues like circulatory, endocrine, and digestive diseases, while respiratory diseases and polypharmacy were linked to greater medication complexity.
Article Abstract
Background: Older adults experience progressive decline in various organs and changes in pharmacokinetics and pharmacodynamics of the drugs in the body which lead to an increased risk of medication-related problems. Potentially inappropriate medications (PIMs) and medication complexity are key factors contributing to adverse drug events in the emergency department (ED).
Objective: To estimate the prevalence and investigate the risk factors of PIMs and medication complexity among older adults admitted to the ED.
Methods: A retrospective observational study was conducted among patients aged > 60 years admitted to the ED of Universitas Airlangga Teaching Hospital in January - June 2020. PIMs and medication complexity were measured using the 2019 American Geriatrics Society Beers Criteria® and Medication Regimen Complexity Index (MRCI), respectively.
Results: A total of 1005 patients were included and 55.0% (95% confidence interval [CI]: 52 - 58%) of them received at least one PIM. Whereas, the pharmacological therapy prescribed to older adults had a high complexity index (mean MRCI 17.23 + 11.15). Multivariate analysis showed that those with polypharmacy (OR= 6.954; 95% CI: 4.617 - 10.476), diseases of the circulatory system (OR= 2.126; 95% CI: 1.166 - 3.876), endocrine, nutritional, and metabolic diseases (OR= 1.924; 95% CI: 1.087 - 3.405), and diseases of the digestive system (OR= 1.858; 95% CI: 1.214 - 2.842) had an increased risk of receiving PIM prescriptions. Meanwhile, disease of the respiratory system (OR = 7.621; 95% CI: 2.833 - 15.150), endocrine, nutritional and metabolic diseases (OR = 6.601; 95% CI: 2.935 - 14.847), and polypharmacy (OR = 4.373; 95% CI: 3.540 - 5.401) were associated with higher medication complexity.
Conclusion: In our study, over one in every two older adults admitted to the ED had PIMs, and a high medication complexity was observed. Endocrine, nutritional and metabolic disease was the leading risk factors for receiving PIMs and high medication complexity.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9891774 | PMC |
| http://dx.doi.org/10.18549/PharmPract.2022.4.2735 | DOI Listing |
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