Volume 16, Issue 3 (Autumn 2021)
Salmand: Iranian Journal of Ageing 2021, 16(3): 330-347 |
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Heidari S, Abdi B, Abbasi M. Prevalence of Potentially Inappropriate Medications Among Older People in Qom, Iran Based on STOPP Criteria and Its Association With the Health-Related Quality of Life. Salmand: Iranian Journal of Ageing 2021; 16 (3) :330-347
URL: http://salmandj.uswr.ac.ir/article-1-1941-en.html
URL: http://salmandj.uswr.ac.ir/article-1-1941-en.html
1- Department of Nursing Internal Surgery, School of Nursing and Midwifery, Qom University of Medical Sciences, Qom, Iran.
2- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences Tehran Iran. ,mohamad_abbasi55@yahoo.com
2- Department of Medical Surgical Nursing, School of Nursing and Midwifery, Iran University of Medical Sciences Tehran Iran. ,
Abstract: (5441 Views)
Objectives: Aging is associated with an increased prevalence of chronic diseases and multidrug therapy, which increases the risk of drug side effects and changes in quality of life. With the increase of the world’s aging proportion, the quality and safety of prescribing drugs has become a global health concern. This study aims to determine the prevalence of Potentially Inappropriate Medications (PIMs) in the elderly in Qom, Iran according to STOPP (Screening Tool of Older Persons’ Prescriptions) criteria and its association with their Health-Related Quality of Life (HRQOL).
Methods & Materials: In this cross-sectional and descriptive-analytical study, participants were 783 older patients hospitalized in internal and surgical wards of selected hospitals affiliated to Qom University of Medical Sciences who were selected using a convenience sampling method. The instruments were a demographic/ health information form, Charlson Comorbidity Index (CCI), STOPP version 2, and the 15 D HRQOL questionnaire. The data were analyzed in SPSS v. 20 software using descriptive statistics and logistic regression analysis.
Results: The Mean±SD number of medications used by the elderly was 7.21±3.16, and 79.57% of patients had multidrug use. The CCI score of 29.9% was 4. The prevalence of PIM was 46.10% and the most common category of PIM were Drugs that adversely affect those prone to falls (13.79%), Duplicate Drug Class (12.39%), Central Nervous System and Psychotropics (5.36%). The Mean±SD score of HRQOL was 0.85± 0.12. Logistic regression analysis results showed that HRQOL (95%CI: 0.030-0.307, OR= 0.096), multidrug use (95%CI: 4.780-14.966, OR=8.46), and CCI (95%CI: 1.36-3.17, OR=2.079) had significant association with PIM use by the elderly (P<0.001).
Conclusion: The use of PIM is a common health problem among the elderly and is associated with HRQOL, multidrug use, and CCI. Nurses should evaluate the elderly’s medication regimen to identify PIMs.
Methods & Materials: In this cross-sectional and descriptive-analytical study, participants were 783 older patients hospitalized in internal and surgical wards of selected hospitals affiliated to Qom University of Medical Sciences who were selected using a convenience sampling method. The instruments were a demographic/ health information form, Charlson Comorbidity Index (CCI), STOPP version 2, and the 15 D HRQOL questionnaire. The data were analyzed in SPSS v. 20 software using descriptive statistics and logistic regression analysis.
Results: The Mean±SD number of medications used by the elderly was 7.21±3.16, and 79.57% of patients had multidrug use. The CCI score of 29.9% was 4. The prevalence of PIM was 46.10% and the most common category of PIM were Drugs that adversely affect those prone to falls (13.79%), Duplicate Drug Class (12.39%), Central Nervous System and Psychotropics (5.36%). The Mean±SD score of HRQOL was 0.85± 0.12. Logistic regression analysis results showed that HRQOL (95%CI: 0.030-0.307, OR= 0.096), multidrug use (95%CI: 4.780-14.966, OR=8.46), and CCI (95%CI: 1.36-3.17, OR=2.079) had significant association with PIM use by the elderly (P<0.001).
Conclusion: The use of PIM is a common health problem among the elderly and is associated with HRQOL, multidrug use, and CCI. Nurses should evaluate the elderly’s medication regimen to identify PIMs.
Type of Study: Research |
Subject:
nursing
Received: 2019/12/15 | Accepted: 2020/05/17 | Published: 2021/10/11
Received: 2019/12/15 | Accepted: 2020/05/17 | Published: 2021/10/11
References
1. Shakeel F, Aamir M, Khan AF, Khan TN, Khan S. Epidemiology of potential drug-drug interactions in elderly population admitted to critical care units of Peshawar, Pakistan. BMC Pharmacol Toxicol. 2018;19(1):85. [DOI:10.1186/s40360-018-0276-4] [PMID] [PMCID]
2. Van Der Stelt CA, Vermeulen Windsant-van den Tweel AM, Egberts AC, van den Bemt PM, Leendertse AJ, Hermens WA et-al. The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients: A Nested Case Control Study. Drug Saf. 2016;39(1):79-87. [DOI:10.1007/s40264-015-0361-1] [PMID]
3. Saboor M, Kamrani AA, Momtaz YA, Sahaf R. Prevalence and associated factors of potentially inappropriate medications among Iranian older adults. Med Glas (Zenica). 2019; 16(1):121-127.
4. Canter PH, Ernst E. Herbal supplement use by persons aged over 50 years in Britain: frequently used herbs, concomitant use of herbs, nutritional supplements and prescription drugs, rate of informing doctors and potential for negative interactions. Drugs Aging. 2004;21(9):597-605. [DOI:10.2165/00002512-200421090-00004] [PMID]
5. Riker GI, Setter SM. Polypharmacy in older adults at home: what it is and what to do about it-implications for home healthcare and hospice, part 2. Home Healthc Nurse. 2013; 31(2): 65-77; quiz 78-9. [DOI:10.1097/NHH.0b013e31827f43b2] [PMID]
6. Barry PJ, Gallagher P, Ryan C, O'mahony D. START (screening tool to alert doctors to the right treatment)- an evidence-based screening tool to detect prescribing omissions in elderly patients. Age Ageing. 2007; 36(6):632-8. [DOI:10.1093/ageing/afm118] [PMID]
7. Gallagher P1, Baeyens JP, Topinkova E, Madlova P, Cherubini A, Gasperini B, et-al. Inter-rater reliability of STOPP (Screening Tool of Older Persons' Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment) criteria amongst physicians in six European countries. Age Ageing. 2009; 38(5):603-6. [DOI:10.1093/ageing/afp058] [PMID]
8. Griebling TL. American Geriatrics Society 2019 Updated AGS Beers Criteria® for Potentially Inappropriate Medication Use in Older Adults. J Urol. 2019; 202(3):438. [DOI:10.1097/JU.0000000000000409] [PMID]
9. Zhang S, Meng L, Qiu F, Yang JD, Sun S. Medication-related risk factors associated with health-related quality of life among community-dwelling elderly in China. Patient Prefer Adherence. 2018; 12: 529-537. [DOI:10.2147/PPA.S156713] [PMID] [PMCID]
10. Vieira de Lima TJ, Garbin CA, Garbin AJ, Sumida DH, Saliba O. Potentially inappropriate medications used by the elderly: prevalence and risk factors in Brazilian care homes. BMC Geriatr. 2013; 13:52. [DOI:10.1186/1471-2318-13-52] [PMID] [PMCID]
11. Boeker EB, de Boer M, Kiewiet JJ, Lie-A-Huen L, Dijkgraaf MG, Boermeester MA. Occurrence and preventability of adverse drug events in surgical patients: a systematic review of literature. BMC Health Serv Res. 2013;13:364. [DOI:10.1186/1472-6963-13-364] [PMID] [PMCID]
12. Curtin D, Gallagher PF, O'Mahony D. Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences. Ther Adv Drug Saf. 2019, 10: 1-10 [DOI:10.1177/2042098619829431] [PMID] [PMCID]
13. Yayla ME, Bilge U, Binen E, Keskin A. The use of START/STOPP criteria for elderly patients in primary care. Scientific World Journal. 2013: 1-4. [DOI:10.1155/2013/165873] [PMID] [PMCID]
14. Anrys P, Boland B, Degryse JM, De Lepeleire J, Petrovic M, Marien S et al. STOPP/START version 2-development of software applications: easier said than done? Age Ageing. 2016; 45(5):589-92. [DOI:10.1093/ageing/afw114] [PMID]
15. Bo M, Gibello M, Brunetti E, Boietti E, Sappa M, Falcone Y. Prevalence and predictors of inappropriate prescribing according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria in older patients discharged from geriatric and internal medicine wards: A prospective observational multicenter study. Geriatr Gerontol Int. 2019; 19(1):5-11. [DOI:10.1111/ggi.13542] [PMID]
16. Onatade R, Auyeung V, Scutt G, Fernando J. Potentially Inappropriate Prescribing in Patients on Admission and Discharge from an Older Peoples' Unit of an Acute UK Hospital. Drugs Aging. 2013; 30(9): 729-37. [DOI:10.1007/s40266-013-0097-5] [PMID]
17. Dalleur O, Spinewine A, Henrard S, Losseau C, Speybroeck N, Boland BInappropriate prescribing and related hospital admissions in frail older persons according to the STOPP and START criteria. Drugs Aging. 2012; 29(10):829-37. [DOI:10.1007/s40266-012-0016-1] [PMID]
18. Cahir C, Bennett K, Teljeur C, Fahey T. Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients. Br J Clin Pharmacol. 2014;77(1):201-10. [DOI:10.1111/bcp.12161] [PMID] [PMCID]
19. Frély A, Chazard E, Pansu A, Beuscart JB, Puisieux F. Impact of acute geriatric care in elderly patients according to the Screening Tool of Older Persons' Prescriptions/Screening Tool to Alert doctors to Right Treatment criteria in northern France. Geriatr Gerontol Int. 2016; 16(2): 272-8. [DOI:10.1111/ggi.12474] [PMID]
20. Moriarty F, Bennett K, Cahir C, Kenny RA, Fahey T. Potentially inappropriate prescribing according to STOPP and START and adverse outcomes in community-dwelling older people: a prospective cohort study. Br J Clin Pharmacol. 2016; 82(3):849-57. [DOI:10.1111/bcp.12995] [PMID] [PMCID]
21. Brown JD,. Hutchison LC, Li C, Painter JT, Martin BC. Predictive Validity of the Beers and Screening Tool of Older Persons' Potentially Inappropriate Prescriptions (STOPP) Criteria to Detect Adverse Drug Events, Hospitalizations, and Emergency Department Visits in the United States. J Am Geriatr Soc. 2016; 64(1): 22-30. [DOI:10.1111/jgs.13884] [PMID] [PMCID]
22. Akkawi ME, Nik Mohamed MH, Md Aris MA.Does inappropriate prescribing affect elderly patients' quality of life? A study from a Malaysian tertiary hospital. Qual Life Res. 2019; 28(7):1913-1920. [DOI:10.1007/s11136-019-02153-5] [PMID]
23. Glasheen WP, Cordier T, Gumpina R, Haugh G, Davis J, Renda A. Charlson Comorbidity Index: ICD-9 Update and ICD-10 Translation. Am Health Drug Benefits. 2019; 12(4): 188-197.
24. Sintonen H. The 15D instrument of health-related quality of life: properties and applications. Ann Med 2001; 33: 328-36. [DOI:10.3109/07853890109002086] [PMID]
25. Abegaz TM, Birru EM, Mekonnen GB. Potentially inappropriate prescribing in Ethiopian geriatric patients hospitalized with cardiovascular disorders using START/STOPP criteria. PLoS One. 2018;13(5). [DOI:10.1371/journal.pone.0195949] [PMID] [PMCID]
26. Blanco-Reina E, García-Merino MR, Ocaña-Riola R, Aguilar-Cano L, Valdellós J, Bellido-Estévez I et al. Assessing Potentially Inappropriate Prescribing in Community-Dwelling Older Patients Using the Updated Version of STOPP-START Criteria: A Comparison of Profiles and Prevalences with Respect to the Original Version. PLoS One. 2016; 11(12). [DOI:10.1371/journal.pone.0167586] [PMID] [PMCID]
27. O Riordan D, Aubert CE, Walsh KA, Van Dorland A, Rodondi N, Du Puy RS. Prevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional study. BMJ Open. 2018; 8(3):e019003. [DOI:10.1136/bmjopen-2017-019003] [PMID] [PMCID]
28. Formiga F, Vidal X, Agustí A, Chivite D, Rosón B, Barbé J. Inappropriate prescribing in elderly people with diabetes admitted to hospital. Diabet Med. 2016; 33(5):655-62. [DOI:10.1111/dme.12894] [PMID]
29. San-José A, Agustí A, Vidal X, Formiga F, Gómez-Hernández M, García J et al. Inappropriate prescribing to the oldest old patients admitted to hospital: prevalence, most frequently used medicines, and associated factors. BMC Geriatr. 2015; 15:42. [DOI:10.1186/s12877-015-0038-8] [PMID] [PMCID]
30. Lucchetti G, Lucchetti AL. Inappropriate prescribing in older persons: A systematic review of medications available in different criteria. Arch Gerontol Geriatr. 2017: 68; 55-61. [DOI:10.1016/j.archger.2016.09.003] [PMID]
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