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Prevalence of potentially inappropriate medications use and associated risk factors among elderly cardiac patients using the 2015 American Geriatrics Society beers criteria

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Abstract

Purpose

Age-associated pharmacological and physiological changes increase the susceptibly of elderly populations to the occurrence of adverse events attributed to the use of potentially inappropriate medications (PIMs). The purpose of this study was to evaluate the prevalence of PIMs and associated risk factors among elderly cardiac outpatients.

Methods

A descriptive, non-experimental, cross-sectional study was conducted at the outpatient department of a tertiary-care hospital in Islamabad, Pakistan from June to September 2018. Eligible patients were those aged ≥ 65 years with one or more cardiovascular condition taking one or more prescribed drugs. Patients were interviewed to collect patient-related information using a structured questionnaire. Beers criteria 2015 and the Barthel index were used to assess PIMs and performance in activities of daily living (ADL), respectively.

Results

Of the 386 elderly cardiac patients who were interviewed, 260 (67.4%) were exposed to at least one PIM based on Beers criteria 2015. The most commonly prescribed PIMs were hydrochlorothiazide (21.5%), furosemide (17.1%), omeprazole (13.7%), and orphenadrine (6.7%). Based on logistic regression analysis, the strongest predictors of PIM use were excessive polypharmacy (i.e. use of ≥ 10 medications) (odds ratio [OR] 18.83; p = 0.005), comorbidity (OR 1.80; p = 0.046), and dependence in performing ADL (OR 2.52; p = 0.012).

Conclusion

The use of PIMs is common in elderly cardiac patients and significantly associated with dependence in performing ADL. Strict compliance to guideline recommendations is necessary to improve the quality of medication use.

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Acknowledgements

The authors acknowledge the participation and help of patients and prescribers in conducting this study.

Author information

Authors and Affiliations

  1. Department of Pharmacy, Quaid-I-Azam University, Islamabad, 45320, Pakistan

    Muhammad Saqlain, Ali Ahmed & Hussain Ali

  2. Department of Pharmacy, University of Sargodha, Sargodha, Pakistan

    Zaheer Ahmed, Sanan Amjad Butt & Ajmal Khan

Authors
  1. Muhammad Saqlain
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  2. Zaheer Ahmed
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  3. Sanan Amjad Butt
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  4. Ajmal Khan
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  5. Ali Ahmed
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  6. Hussain Ali
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Contributions

MS, ZK, and HA were responsible for the concept, writing, and layout of the study. SAB and ZK provided critical help in writing, statistical analysis, and layout design. AK and SAB provided critical input regarding statistical analysis at every step of the manuscript. MS and HA proof read the manuscript and provided input in formatting. All authors have given consent for publication of this version of the manuscript.

Corresponding author

Correspondence to Hussain Ali.

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Funding

No funding was received.

Availability of data and material

The data and materials are available from the corresponding author and can be obtained upon a request.

Conflicts of interest

None.

Ethics approval

The study protocol was approved by an ethical review board of the Pakistan Institute of Medical Sciences hospital (1–1/2015/ERB/SZABMU/229).

Informed consent

Informed consent was obtained from participants after they were given written and verbal explanations of the study. Participants were informed that participation in the study was voluntary and could be cancelled at any time.

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Saqlain, M., Ahmed, Z., Butt, S.A. et al. Prevalence of potentially inappropriate medications use and associated risk factors among elderly cardiac patients using the 2015 American Geriatrics Society beers criteria. Drugs Ther Perspect 36, 368–376 (2020). https://doi.org/10.1007/s40267-020-00747-5

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