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Retrospective cross-sectional analysis of potentially inappropriate medication use in ambulatory seniors with geriatric syndromes

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Abstract

Background

Potentially inappropriate medications (PIMs) are associated with serious adverse effects, hospitalizations and death. Seniors with geriatric syndromes, such as cognitive impairment, falls and incontinence, are at particularly high risk because of frailty, medical complexity and functional impairment.

Objectives

The aim of this study was to describe the prevalence of seniors with frailty and geriatric syndromes who utilized one or more PIMs, the most commonly prescribed PIMs and risk factors for PIM usage; to determine the rate of PIM usage across geriatric syndromes; and to determine the degree of change in PIM usage from clinic admission to discharge.

Methods

A retrospective cross-sectional study of community-dwelling seniors 65 years of age and older living with frailty and/or geriatric syndromes was performed. PIMs were identified from the 2019 Beers Criteria and frailty was categorized by the Clinical Frailty Scale.

Results

Of the 289 participants included in the study, the mean age was 80.5 years (SD 7.4 years) and 54.7% were female. Overall, 170 participants (58.8%) were receiving one or more medications deemed potentially inappropriate in older adults by the Beers Criteria. The most frequently used PIMs (categorized by medication class) were proton pump inhibitors (31.1%), non-steroidal anti-inflammatories (15.2%) and benzodiazepines (11.1%). The three most common geriatric syndromes were cognitive impairment, falls and depression, in which PIM usage was present in 53.5, 63.9 and 73.2% of participants, respectively.

Conclusion

PIMs are prevalent in ambulatory seniors with geriatric syndromes. Proton pump inhibitors, benzodiazepines/hypnotics and non-steroidal anti-inflammatories were the most commonly used PIMs in this population. Multi-faceted interventions targeting patients, prescribers and pharmacists are needed to lower the usage of these medications in this high-risk population.

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Author information

Authors and Affiliations

  1. Interior Health Authority, Pharmacy Services, Kelowna, BC, Canada

    Jennifer Bolt, Katie Wong, Melissa Lane & Sean K. Gorman

  2. University of British Columbia Faculty of Pharmaceutical Sciences, Kelowna, BC, Canada

    Jennifer Bolt

  3. Vancouver, BC, Canada

    Eunbee Park

Authors
  1. Jennifer Bolt
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  2. Eunbee Park
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  3. Katie Wong
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  4. Melissa Lane
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  5. Sean K. Gorman
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Corresponding author

Correspondence to Jennifer Bolt.

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Funding

The authors did not receive support from any organization for the submitted work.

Conflict of interest

The authors have no relevant financial or non-financial interests to disclose.

Ethics approval

The Interior Health Authority Research Ethics Board approved this study (H20-02223) and waived the requirement for participant consent.

Consent to participate

The Interior Health Research Ethics Board waived the requirement for participant consent.

Consent for publication

The Interior Health Research Ethics Board waived the requirement for participant consent.

Availability of data and material

The data that support the findings of this study are available upon request from the corresponding author. The data are not publicly available due to privacy and ethical restrictions.

Code availability

Not applicable.

Author contributions

All authors contributed to the study conception and design. Data collection and analysis were performed by Eunbee Park and Jennifer Bolt. The first draft of the manuscript was written by Jennifer Bolt and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Bolt, J., Park, E., Wong, K. et al. Retrospective cross-sectional analysis of potentially inappropriate medication use in ambulatory seniors with geriatric syndromes. Drugs Ther Perspect 38, 156–163 (2022). https://doi.org/10.1007/s40267-022-00904-y

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  • DOI: https://doi.org/10.1007/s40267-022-00904-y

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