Volume 15, Issue 4 (Winter 2021)
Salmand: Iranian Journal of Ageing 2021, 15(4): 440-457 |
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Dadashihaji A, Rahimi A, Hosseini S R, Moghadamnia A A, Bijani A. Inappropriate Medication Use and Related Factors in the Elderly Living in Northern Iran. Salmand: Iranian Journal of Ageing 2021; 15 (4) :440-457
URL: http://salmandj.uswr.ac.ir/article-1-2059-en.html
URL: http://salmandj.uswr.ac.ir/article-1-2059-en.html
Afsaneh Dadashihaji1 
, Atena Rahimi * 2, Seyed Reza Hosseini3 , Ali Akbar Moghadamnia1 , Ali Bijani3
, Atena Rahimi * 2, Seyed Reza Hosseini3 , Ali Akbar Moghadamnia1 , Ali Bijani3
1- Department of Pharmacology and Toxicology, School of Medical, Babol University of Medical Sciences, Babol, Iran.
2- Department of Pharmacology and Toxicology, School of Medical, Babol University of Medical Sciences, Babol, Iran. ,atena.rahimi@yahoo.com
3- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
2- Department of Pharmacology and Toxicology, School of Medical, Babol University of Medical Sciences, Babol, Iran. ,
3- Social Determinants of Health Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran.
Abstract: (3420 Views)
Objectives: Older people are more prone to chronic diseases and are being treated than other age groups; as a result, they use more drugs that may be inappropriate and lead to adverse drug reactions. This study aimed to determine the rate of inappropriate drug use using the Beers criterion among the elderly in Amirkola City.
Methods & Materials: The current descriptive-analytical study is part of the comprehensive plan "Study of the health status of the elderly in the Amirkola City” AHAP" (No.: 892917) which has been conducted as a Cohort study since 2011 on all people aged 60 and over in the Amirkola City, north of Iran. Necessary information was collected by a trained person using standard questionnaires that included the number, type and duration of drug use. The collected data were analyzed after entering the SPSS statistical software using Chi-square, Fisher's Exact Test, and Logistic Regression to evaluate the status of inappropriate drug. P-value=0.05 was considered as a significant level.
Results: The Mean±SD age of the elderly was 69.71±7.47 years. Prevalence of inappropriate drug use and drugs that should use by caution among the elderly was 37.58% and 29.85%, respectively. Glibenclamide (12.7%), Diclofenac (8.8%) and Clidinium C (5.4%) were among the most inappropriate drugs used in this population. The highest drug-drug interaction was related to the simultaneous use of two anticholinergic drugs. There was a statistically significant relationship between inappropriate drug use with gender, age, education level, employment status and marriage status (P<0.05).
Conclusion: The rate of inappropriate drug use among the elderly in Amirkola is high compared to many other studies that expose the elderly to adverse drug reactions.
Methods & Materials: The current descriptive-analytical study is part of the comprehensive plan "Study of the health status of the elderly in the Amirkola City” AHAP" (No.: 892917) which has been conducted as a Cohort study since 2011 on all people aged 60 and over in the Amirkola City, north of Iran. Necessary information was collected by a trained person using standard questionnaires that included the number, type and duration of drug use. The collected data were analyzed after entering the SPSS statistical software using Chi-square, Fisher's Exact Test, and Logistic Regression to evaluate the status of inappropriate drug. P-value=0.05 was considered as a significant level.
Results: The Mean±SD age of the elderly was 69.71±7.47 years. Prevalence of inappropriate drug use and drugs that should use by caution among the elderly was 37.58% and 29.85%, respectively. Glibenclamide (12.7%), Diclofenac (8.8%) and Clidinium C (5.4%) were among the most inappropriate drugs used in this population. The highest drug-drug interaction was related to the simultaneous use of two anticholinergic drugs. There was a statistically significant relationship between inappropriate drug use with gender, age, education level, employment status and marriage status (P<0.05).
Conclusion: The rate of inappropriate drug use among the elderly in Amirkola is high compared to many other studies that expose the elderly to adverse drug reactions.
Type of Study: Research |
Subject:
Pharmacy
Received: 2020/07/15 | Accepted: 2020/11/29 | Published: 2021/01/01
Received: 2020/07/15 | Accepted: 2020/11/29 | Published: 2021/01/01
References
1. Lim Y-J, Kim H-Y, Choi J, Lee JS, Ahn A-L, Oh E-J, et al. Potentially inappropriate medications by beers criteria in older outpatients: prevalence and risk factors. Korean journal of family medicine. 2016;37(6):329. [DOI:10.4082/kjfm.2016.37.6.329] [PMID] [PMCID]
2. Nishtala PS, Narayan SW, Wang T, Hilmer SN. Associations of drug burden index with falls, general practitioner visits, and mortality in older people. Pharmacoepidemiology and drug safety. 2014;23(7):753-8. [DOI:10.1002/pds.3624] [PMID]
3. Al-Azayzih A, Alamoori R, Altawalbeh SM. Potentially inappropriate medications prescribing according to Beers criteria among elderly outpatients in Jordan: a cross sectional study. Pharmacy Practice (Granada). 2019;17(2). [DOI:10.18549/PharmPract.2019.2.1439] [PMID] [PMCID]
4. Grina D, Karpavičiūtė J, Minkutė R, Briedis V. Impact of hospitalization on potentially inappropriate prescribing: a cross-sectional study in an acute geriatric hospital in Lithuania. International Journal of Clinical Pharmacy. 2020:1-8. [DOI:10.1007/s11096-020-01035-y] [PMID]
5. Chang CM, Liu PYY, Yang YHK, Yang YC, Wu CF, Lu FH. Use of the Beers criteria to predict adverse drug reactions among first‐visit elderly outpatients. Pharmacotherapy: The Journal of Human Pharmacology and Drug Therapy. 2005;25(6):831-8. [DOI:10.1592/phco.2005.25.6.831] [PMID]
6. Perri III M, Menon AM, Deshpande AD, Shinde SB, Jiang R, Cooper JW, et al. Adverse outcomes associated with inappropriate drug use in nursing homes. Annals of Pharmacotherapy. 2005;39(3):405-11. [DOI:10.1345/aph.1E230] [PMID]
7. Beers MH, Ouslander JG, Rollingher I, Reuben DB, Brooks J, Beck JC. Explicit criteria for determining inappropriate medication use in nursing home residents. Archives of internal medicine. 1991;151(9):1825-32.
https://doi.org/10.1001/archinte.1991.00400090107019 [DOI:10.1001/archinte.151.9.1825] [PMID]
8. Awad A, Hanna O. Potentially inappropriate medication use among geriatric patients in primary care setting: A cross-sectional study using the Beers, STOPP, FORTA and MAI criteria. PloS one. 2019;14(6):e0218174. [DOI:10.1371/journal.pone.0218174] [PMID] [PMCID]
9. Christopher A, Pranita V, Mathews KP, Surekha V, Gopinath K, Gowri M. Potentially Inappropriate Medication use in the Elderly in a Tertiary Care Centre in South India. Journal of the Indian Academy of Geriatrics. 2018;14(3). [DOI:10.35262/jiag.v14i3.130-135]
10. Davidoff AJ, Miller GE, Sarpong EM, Yang E, Brandt N, Fick DM. Prevalence of potentially inappropriate medication use in older adults using the 2012 Beers criteria. Journal of the American Geriatrics Society. 2015;63(3):486-500. [DOI:10.1111/jgs.13320] [PMID] [PMCID]
11. Vali L, Pour Reza A, Rahimi Foroushani A, Ahmadi B, Akbari Kamrani AA. Analysis of Inappropriate Medication Use in Older Adults Discharged From Hospitals Affiliated With Tehran University of Medical Sciences (TUMS) Using the Beers Criteria in 2010. Salmand: Iranian Journal of Ageing. 2011;6(3):56-65.
12. Heidari S, Aliabadi A, Naebi A, Khoramirad A. Frequency of Use of Potentially Inappropriate Medications and Its Associated Factors in Elderly People in Qom City, 2012, Iran. Qom Univ Med Sci J. 2014;8(4):44-52.
13. Hosseini SR, Bayani MA, Mohammadi K, Mohammadi E, Bijani A. Correlation between anthropometric indexes and risk factors of cardiovascular diseases among the elderly population in Amirkola. Feyz Journal of Kashan University of Medical Sciences. 2017;21(3):272-9.
14. Campanelli CM. American Geriatrics Society updated beers criteria for potentially inappropriate medication use in older adults: the American Geriatrics Society 2012 Beers Criteria Update Expert Panel. Journal of the American Geriatrics Society. 2012;60(4):616. [DOI:10.1111/j.1532-5415.2012.03923.x] [PMID] [PMCID]
15. Niwata S, Yamada Y, Ikegami N. Prevalence of inappropriate medication using Beers criteria in Japanese long-term care facilities. BMC geriatrics. 2006;6(1):1. [DOI:10.1186/1471-2318-6-1] [PMID] [PMCID]
16. Raji MA, Ostir GV, Markides KS, Espino DV, Goodwin JS. Potentially inappropriate medication use by elderly Mexican Americans. Annals of Pharmacotherapy. 2003;37(9):1197-202. [DOI:10.1345/aph.1C480] [PMID]
17. Andrews H, Betz M, Chihuri S, DiGuiseppi C, Eby D, Gordon A, et al. Prevalence of Potentially Inappropriate Medication Use in Older Drivers: AAA LongROAD Study. 2018.
18. Miller GE, Sarpong EM, Davidoff AJ, Yang EY, Brandt NJ, Fick DM. Determinants of potentially inappropriate medication use among community‐dwelling older adults. Health services research. 2017;52(4):1534-49. [DOI:10.1111/1475-6773.12562] [PMID] [PMCID]
19. Blozik E, Rapold R, von Overbeck J, Reich O. Polypharmacy and potentially inappropriate medication in the adult, community-dwelling population in Switzerland. Drugs & aging. 2013;30(7):561-8. [DOI:10.1007/s40266-013-0073-0] [PMID]
20. Fialová D, Topinková E, Gambassi G, Finne-Soveri H, Jónsson PV, Carpenter I, et al. Potentially inappropriate medication use among elderly home care patients in Europe. Jama. 2005;293(11):1348-58. [DOI:10.1001/jama.293.11.1348] [PMID]
21. Nightingale G, Hajjar E, Swartz K, Andrel-Sendecki J, Chapman A, editors. Evaluation of a pharmacist-led medication assessment used to identify prevalence of and associations with polypharmacy and potentially inappropriate medication use among ambulatory senior adults with cancer2015: American Society of Clinical Oncology. [DOI:10.1200/JCO.2014.58.7550] [PMID]
22. Wessell AM, Nietert PJ, Jenkins RG, Nemeth LS, Ornstein SM. Inappropriate medication use in the elderly: results from a quality improvement project in 99 primary care practices. The American journal of geriatric pharmacotherapy. 2008;6(1):21-7. [DOI:10.1016/j.amjopharm.2008.02.001] [PMID]
23. Lai H-Y, Hwang S-J, Chen Y-C, Chen T-J, Lin M-H, Chen L-K. Prevalence of the prescribing of potentially inappropriate medications at ambulatory care visits by elderly patients covered by the Taiwanese National Health Insurance program. Clinical therapeutics. 2009;31(8):1859-70. [DOI:10.1016/j.clinthera.2009.08.023] [PMID]
24. Ghadimi H, Esmaily HM, Wahlstrom R. General practitioners' prescribing patterns for the elderly in a province of Iran. Pharmacoepidemiology and drug safety. 2011;20(5):482-7. [DOI:10.1002/pds.2106] [PMID]
25. de Oliveira Baldoni A, Ayres LR, Martinez EZ, Dewulf NdLS, dos Santos V, Pereira LRL. Factors associated with potentially inappropriate medications use by the elderly according to Beers criteria 2003 and 2012. International journal of clinical pharmacy. 2014;36(2):316-24. [DOI:10.1007/s11096-013-9880-y] [PMID]
26. Goulding MR. Inappropriate medication prescribing for elderly ambulatory care patients. Archives of internal medicine. 2004;164(3):305-12. [DOI:10.1001/archinte.164.3.305] [PMID]
27. Alhmoud E, Khalifa S, Bahi AA. Prevalence and predictors of potentially inappropriate medications among home care elderly patients in Qatar. International journal of clinical pharmacy. 2015;37(5):815-21. [DOI:10.1007/s11096-015-0125-0] [PMID]
28. Dhalla IA, Anderson GM, Mamdani MM, Bronskill SE, Sykora K, Rochon PA. Inappropriate prescribing before and after nursing home admission. Journal of the American Geriatrics Society. 2002;50(6):995-1000. [DOI:10.1046/j.1532-5415.2002.50252.x] [PMID]
29. Onder G, Landi F, Cesari M, Gambassi G, Carbonin P, Bernabei R. Inappropriate medication use among hospitalized older adults in Italy: results from the Italian Group of Pharmacoepidemiology in the Elderly. European journal of clinical pharmacology. 2003;59(2):157-62. [DOI:10.1007/s00228-003-0600-8] [PMID]
30. Cannon KT, Choi MM, Zuniga MA. Potentially inappropriate medication use in elderly patients receiving home health care: a retrospective data analysis. The American journal of geriatric pharmacotherapy. 2006;4(2):134-43. [DOI:10.1016/j.amjopharm.2006.06.010] [PMID]
31. Vanier A, Paille C, Abbey H, Berrut G, Lombrail P, Moret L. Assessment of inappropriate prescribing in the elderly subject during acute care hospitalisation. Gériatrie et Psychologie Neuropsychiatrie du Vieillissement. 2011;9(1):51-7. [DOI:10.1684/pnv.2011.0256] [PMID]
32. Zhang Y-J, Liu W-W, Wang J-B, Guo JJ. Potentially inappropriate medication use among older adults in the USA in 2007. Age and ageing. 2011;40(3):398-401. [DOI:10.1093/ageing/afr012] [PMID]
33. Oliveira MG, Amorim WW, de Jesus SR, Rodrigues VA, Passos LC. Factors associated with potentially inappropriate medication use by the elderly in the Brazilian primary care setting. International journal of clinical pharmacy. 2012;34(4):626-32. [DOI:10.1007/s11096-012-9656-9] [PMID]
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