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Comparison of the prevalence and nature of potentially inappropriate medication use in geriatric outpatients between tertiary and community healthcare settings: a multicenter cross-sectional study

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Abstract

Background Geriatric outpatients with polypharmacy have a high risk of potentially inappropriate medication (PIM) use. Aim To identify differences in both prevalence and patterns of PIMs and drug-related problems (DRPs) in older outpatients who visited the tertiary hospitals (THs) and community health centers (CHCs) and analyze associated factors. Method A prospective cross-sectional study was conducted in five THs and five CHCs from September 2018 to November 2019 in Beijing, China. Data were collected from outpatients aged ≥ 65 years with chronic diseases and polypharmacy. PIMs were evaluated using the 2015 and 2019 Beers Criteria and the Screening Tool of Older Persons' Prescriptions (STOPP) criteria. DRPs were classified using the Helper-Strand DRP Classification. The prevalence and types of PIMs and DRPs were compared, and relevant factors were analyzed. Results The prevalence of PIMs based on the 2015 Beers Criteria was higher in patients from the THs, while PIMs based on the 2019 Beers Criteria did not show a significant difference. PIM prevalence based on STOPP Criteria and DRPs was higher in patients from CHCs. Visiting CHCs was an independent factor of PIMs based on the 2015 Beers Criteria (OR 0.774, 95% CI 0.604–0.992) and the STOPP Criteria (OR 2.427, 95% CI 1.883–3.128), and DRPs (OR 3.612, 95% CI 2.682–4.865). Conclusion Differences in PIM and DRP might be due to the patients and settings. Specific measures to improve the appropriateness of medications in both settings should be used.

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Acknowledgements

The authors would like to thank Yingmei Deng and Hao Huang for their contribution to the standardization of the diagnosis.

Funding

This study was funded by the Beijing Science and Technology Planning Project (No. D181100000218002).

Author information

Author notes

  1. Yan Zeng and Yongpei Yu contributed equally to this work.

Authors and Affiliations

  1. Department of Pharmacy, Xuanwu Hospital, Capital Medical University, Suying Yan, No.45 Changchun Street, Xicheng District, Beijing, China

    Yan Zeng, Su Su & Suying Yan

  2. Department of Biostatistics, Peking University Clinical Research Institution, Beijing, China

    Yongpei Yu

  3. Department of Clinical Pharmacy, Capital Medical University, Beijing, China

    Qingyang Liu

  4. Department of Pharmacy, Beijing Anzhen Hospital, Capital Medical University, Beijing, China

    Yang Lin

  5. Department of Pharmacy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

    Hongyan Gu

  6. Department of Pharmacy, Beijing Luhe Hospital, Capital Medical University, Beijing, China

    Shicai Chen

  7. Department of Pharmacy, China-Japan Friendship Hospital, Beijing, China

    Pengmei Li

  8. Department of Pharmacy, Taiyanggong Community Health Center, Beijing, China

    Tong Xu

  9. Department of Pharmacy, Datun Community Health Center, Beijing, China

    Naizhao Sun

  10. Department of Pharmacy, Ganjiakou Community Health Center, Beijing, China

    Tao Lin

  11. Department of Pharmacy, Konggang Community Health Center, Beijing, China

    Qian Huang

  12. Department of Pharmacy, Guangnei Community Health Center, Beijing, China

    Yujie Fan

  13. Department of Data Management, Peking University Clinical Research Institute, Beijing, China

    Fengzhi Wang

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  1. Yan Zeng
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Zeng, Y., Yu, Y., Liu, Q. et al. Comparison of the prevalence and nature of potentially inappropriate medication use in geriatric outpatients between tertiary and community healthcare settings: a multicenter cross-sectional study. Int J Clin Pharm 44, 619–629 (2022). https://doi.org/10.1007/s11096-022-01380-0

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