Analysis on prevalence and risk factors of potentially inappropriate medication in elderly inpatients

Abstract

Objective To analyze the prevalence and risk factors of potentially inappropriate medication (PIM) use among elderly inpatients. Methods The data of patients ≥65 years of age and hospitalized in Department of Internal Medicine in the Third People′s Hospital of Hefei from January to December in 2015 were collected and the gender, age, department, diseases that patient suffered from, hospitalization days, drug varieties used in one patient, methods of payment were recorded. The patients were divided into 2 groups: the 65-79 years old group and the 80 years old group. The utilization rate of PIM drugs, the drug varieties, the proportion of PIM use between the patients in the 2 groups were calculated. The risk factors of PIM use was analyzed by Logistic regression method. Results A total of 388 patients (their ages were from 65 to 79 years and their average age was (76±7) years were enrolled in this study, including 206 males and 182 females. Of the 388 patients, 278 (71.6%) patients were in the 65-79 years old group and 110 (28.4%) were in the ≥80 years old group. The utilization rate of PIM drugs was 54.9% (213/388) and the utilization rate of high-risk PIM drugs was 28.6% (111/388). The utilization rate of PIM drugs in the 65-79 years old group was 57.9% (161/278) and 47.3% (52/110) in the ≥80 years old group (χ2=3.604, P=0.058). Among 213 patients receiving PIM drugs, 132 (62.0%) patients were prescribed with one PIM drug, and 56 (26.3%), 17 (8.0%), 6 (2.8%), 2(0.9%) patients were prescribed with 2 to 5 PIM drugs, respectively. Twenty-four PIM drugs were used in the 213 patients and 17 high-risk PIM drugs were used in 111 patients, accounting for 33.3% (24/72) of the total number of PIM drugs and 48.6% (17/35) of the high-risk PIM drugs, respectively. According to the ratio of application, the top 3 drugs were insulin, anticoagulants, sedatives and hypnotics in the 65-79 years old group and anticoagulants, sedatives and hypnotics, and theophylline in the ≥80 years old group. The results of Logistic regression showed that the main risk factors of PIM use were ages (OR=0.531, 95%CI: 0.326-0.865, P=0.011) and prescribed drugs varieties (OR=3.927, 95%CI: 2.678-5.757, P<0.001). Conclusions The utilization rate of PIM drugs in elderly inpatients in our hospital was higher. The risk factors of PIM use were patients′ages and drugs varieties. Key words: Potentially inappropriate medication list; Aged