Prevalence and factors associated with potentially inappropriate medication and medication complexity for older adults in the emergency department of a secondary teaching hospital in Indonesia.
Khusnul Fitri Hamidah, Mahardian Rahmadi, Farah Meutia, Prihatma Kriswidyatomo, Firman Suryadi Rahman, Zamrotul Izzah, Bambang Subakti Zulkarnain, Leopold N Aminde, Christopher Paul Alderman, Yulistiani, Budi Suprapti
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引用次数: 0
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.
期刊介绍：
Pharmacy Practice is a free full-text peer-reviewed journal with a scope on pharmacy practice. Pharmacy Practice is published quarterly. Pharmacy Practice does not charge and will never charge any publication fee or article processing charge (APC) to the authors. The current and future absence of any article processing charges (APCs) is signed in the MoU with the Center for Pharmacy Practice Innovation (CPPI) at Virginia Commonwealth University (VCU) School of Pharmacy. Pharmacy Practice is the consequence of the efforts of a number of colleagues from different Universities who belief in collaborative publishing: no one pays, no one receives. Although focusing on the practice of pharmacy, Pharmacy Practice covers a wide range of pharmacy activities, among them and not being comprehensive, clinical pharmacy, pharmaceutical care, social pharmacy, pharmacy education, process and outcome research, health promotion and education, health informatics, pharmacoepidemiology, etc.
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