Potentially inappropriate home medications among older patients with cardiovascular disease in a Moroccan population

Abstract

Abstract Funding Acknowledgements Type of funding sources: None. Background : Patients with cardiovascular diseases use often multi-drugs regimen , which can often be associated with use of potentially inappropriate medications PIMs especially in elderly , which may pose more risks than benefits to patients and is a major factor contributing to the likelihood of serious adverse drug reactions and negative health outcomes among this population . Methods A Prospective study was conducted in a tertiary care hospital in Morocco where home medications of out patients were reviewed during follow-up consults and analyzed over three months, from October till December 2020. Inclusion criteria were age of 65 years and above, history of cardiovascular disease. The aim of our study was to determine the frequency and factors associated with PIMs, by applying the updated Beers 2015 criteria. Results A total of 214 patients were included in the study and were taking a total of 1498 medications at home, an average of 7 ± 3 medications per patient. The proportion of PIMS was 32 % of all medications reported, with an average of 2.2 PIM per patient, and 84% of patients were receiving at least one PIM. Significant association was found between use of PIMs and number of home medications, female gender, self medication , and number and types of comorbidities. Comorbidities associated with more PIMs were heart failure, atrial fibrillation/flutter, rheumatological diseases, cerebrovascular accident, and insomnia/depression . The most commonly prescribed PIMs were: drugs that may exacerbate or cause syndrome of inappropriate antidiuretic hormone secretion or hyponatremia (27.3%), NSAIDs use in patients under anticoagulants (21.2%) , use of proton pump inhibitors (PPIs) > 8 weeks in non-high-risk patients (10.5%), and benzodiazepines (5.7%). Conclusions A high prevalence of PIMs in older patients with cardiovascular disease was observed. Health care giver’s education and detailed assessment of medication lists upon follow-up consults or hospital admission by multidisciplinary teams can help in preventing the use of PIMs.