The use of potentially inappropriate medications among the Lithuanian elderly according to Beers and EU(7)-PIM list - a nationwide cross-sectional study on reimbursement claims data

Abstract

The prevalence and risk factors for prescribing and using potentially inappropriate medications (PIMs) has been extensively researched in Western Europe and the United States of America; however, research in Central and Eastern Europe remains highly limited. According to a recent systematic review, the overall estimated weighted prevalence of PIM prescribing in community-dwelling elderly in Europe (expressed as a percentage of patients or prescriptions with ≥1 PIM) was 22·6% (95% CI: 19·5%-26·7%). The main objective of this study was to investigate the prevalence of use of PIMs among the elderly in Lithuania according to different sets of published explicit criteria and compare the results with similar research carried out in other European countries. This was a retrospective, observational cross-sectional population-based (n = 431 625) study using the medicines reimbursement claims data covering a 1-year period. The use of PIMs was measured based on 2003 Beers criteria, 2015 AGS Beers criteria and the EU(7)-PIM list. The prevalence was measured as the percentage of patients with at least 1 PIM during 1-year period. Multivariate logistic regression was used to identify risk factors for PIM prescription. The prevalence of PIM use varied from 24·1% according to 2003 Beers criteria and 25·9% according to 2015 AGS Beers criteria, to 57·2% according to the EU(7)-PIM list. Polypharmacy and increasing age had increased the risk of PIM use. Women had an increased risk for prescription of the EU(7)-PIM listed medications compared with men, whereas for Beers drugs the risk in women was lower. Benzodiazepines were the most commonly prescribed PIMs according to all criteria. The use of PIMs is highly prevalent among the Lithuanian elderly and there is a great need of interventions to improve the pharmacotherapy in this age group.