Prevalence, determinants, and health outcomes of potentially inappropriate medication use according to the 2023 beers criteria among hospitalised older patients

Background

This study aims to determine the prevalence, determinants, and rehospitalisation outcomes of potentially inappropriate medication (PIM) use among hospitalised older patients.

Design and participants

This retrospective cohort study analysed older patients admitted to a tertiary care hospital from 2021 to 2023. We evaluated PIM prescriptions using the 2023 Beers criteria, classifying the patients as PIM users or non-users. We assessed the prevalence of PIM use, identified its determinants, and investigated the association between PIM use and rehospitalisation for any reason within one year of discharge, as well as the related length of stay and total medical costs.

Results

The study comprised 20,629 hospitalised older patients with a mean age of 71.17 ± 8.14 years, 50.21% of whom were women. PIM usage was prevalent among 91.32% of the patients. The determinants of PIM use included being female, having a longer hospital stay, an increasing number of prescribed drugs, and three or more chronic conditions. However, the use of PIM did not significantly increase the risk of rehospitalisation (adjusted hazard ratios = 1.02; 95% CI = 0.87–1.19), length of stay (adjusted mean difference [aMD] = 0.35 days; 95% CI = -1.31 to 2.01 days), or cost of medical care (aMD = 2,039 Baht; 95% CI = -9,824 to 13,901 Baht).

Conclusions

The use of PIMs among hospitalised older patients remains alarmingly high and is strongly correlated with the number of prescribed drugs. However, no significant link was found between PIM use and rehospitalisation outcomes within a one-year period.