Potentially Inappropriate Medication Use in Older Adults With Multimorbidity in Taiwan.

IF 2.4 4区医学 Q3 PHARMACOLOGY & PHARMACY Pharmacoepidemiology and Drug Safety Pub Date : 2024-09-01 DOI:10.1002/pds.70000

Betty Chia-Chen Chang, I-Hua Lai, Yee-Yung Ng, Shiao-Chi Wu

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Abstract

Background: Medication-related problem is a concerning issue in older adults with multimorbidity due to complexity of disease conditions and polypharmacy, and may lead to increase in risk for adverse health outcomes. This study aims to investigate the prevalence and associated factors of potentially inappropriate medication use among the growing population of older adults with multimorbidity in Taiwan.

Method: The study population was composed of patients who were aged 65 years or older with multimorbidity (two or more chronic diseases) and had at least one outpatient clinic visit with drug prescription in 2018 identified from the Taiwan National Health Insurance Research Database. Potentially inappropriate medication use was defined using the 2019 Beers criteria for drugs to be avoided for older adults. Multiple logistic regression model was conducted to examine patient-related and prescriber-related factors associated with PIM use.

Results: A total of 2 432 416 patients (69.7% of the entire older adult population) had multimorbidity and received at least one drug prescription at the outpatient clinic in Taiwan in 2018. The prevalence of having at least one PIM in this population was found to be 85.6%. Patient-related factors (age, sex, specific chronic diseases, frequency of outpatient visits) and prescriber-related factors (physician characteristics, healthcare setting, total number of medications, prior PIM use) were found to be associated with use of PIM.

Conclusion: High prevalence of PIM use was found in older patients with multimorbidity in Taiwan. Both patient-related and prescriber-related factors had been found to be predictors of PIM use, and should be addressed when trying to improve the medication quality in this population.

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台湾多病老年人潜在的用药不当。

背景：由于疾病的复杂性和多重用药，药物相关问题是多病老年人面临的一个令人担忧的问题，并可能导致不良健康后果风险的增加。本研究旨在调查台湾日益增多的多病老年人群中潜在用药不当的发生率和相关因素：研究人群由台湾国民健康保险研究数据库（Taiwan National Health Insurance Research Database）中识别出的65岁或65岁以上患有多病（两种或两种以上慢性病）且在2018年至少有一次门诊就诊并开具药物处方的患者组成。潜在的不恰当用药是根据2019年Beers关于老年人应避免使用药物的标准定义的。采用多元逻辑回归模型研究与PIM使用相关的患者相关因素和处方相关因素：2018 年，共有 2 432 416 名患者（占整个老年人口的 69.7%）患有多种疾病，并在台湾的门诊诊所接受了至少一次药物处方。该人群中至少有一种 PIM 的患病率为 85.6%。研究发现，患者相关因素（年龄、性别、特定慢性病、门诊就诊频率）和处方者相关因素（医生特征、医疗环境、药物总数、之前使用过 PIM）与 PIM 的使用有关：结论：在台湾，患有多种疾病的老年患者使用 PIM 的比例很高。与患者和开药者相关的因素都是使用 PIM 的预测因素，因此在试图改善这一人群的用药质量时应加以重视。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Pharmacoepidemiology and Drug Safety 医学-药学

CiteScore

4.80

自引率

7.70%

发文量

173

审稿时长

3 months

期刊介绍： The aim of Pharmacoepidemiology and Drug Safety is to provide an international forum for the communication and evaluation of data, methods and opinion in the discipline of pharmacoepidemiology. The Journal publishes peer-reviewed reports of original research, invited reviews and a variety of guest editorials and commentaries embracing scientific, medical, statistical, legal and economic aspects of pharmacoepidemiology and post-marketing surveillance of drug safety. Appropriate material in these categories may also be considered for publication as a Brief Report. Particular areas of interest include: design, analysis, results, and interpretation of studies looking at the benefit or safety of specific pharmaceuticals, biologics, or medical devices, including studies in pharmacovigilance, postmarketing surveillance, pharmacoeconomics, patient safety, molecular pharmacoepidemiology, or any other study within the broad field of pharmacoepidemiology; comparative effectiveness research relating to pharmaceuticals, biologics, and medical devices. Comparative effectiveness research is the generation and synthesis of evidence that compares the benefits and harms of alternative methods to prevent, diagnose, treat, and monitor a clinical condition, as these methods are truly used in the real world; methodologic contributions of relevance to pharmacoepidemiology, whether original contributions, reviews of existing methods, or tutorials for how to apply the methods of pharmacoepidemiology; assessments of harm versus benefit in drug therapy; patterns of drug utilization; relationships between pharmacoepidemiology and the formulation and interpretation of regulatory guidelines; evaluations of risk management plans and programmes relating to pharmaceuticals, biologics and medical devices.