Качественная клиническая практика (Aug 2019)
Prevalence of potentially inappropriate medications among elderly patients in clinical practice
Abstract
Actuality. Rational and safe pharmacotherapy of patients in elderly and senile age is complicated by the polymorbidity of the majority of patients resulting in polypharmacy. The use of tools to identify prescription of potentially inappropriate medications (PIMs) (Beers criteria, STOPP / START criteria) helps to increase the safety of pharmacotherapy in elderly and old age patients. The objective of this work was to determine the prevalence of PIMs in out- and inpatients population ≥65 years old and to identify associated with PIMs factors. Materials and methods. Retrospective pharmacoepidemiology study of medical records of 401 patients ≥65 years old who were hospitalized in the period from 1st of June to 30th of December, 2017. Statistical analysis included methods of parametric and non-parametric statistics and multivariate analysis. Results. The average age was 77.4 + 7.18 years. The median of comorbidities was 3 (IQR 0—5). Th e average number of drugs prescribed per patient was 2 (IQR, 0—4). 37.4 % of patients received ≥5 drugs. The use of STOPP-2 criteria revealed 239 episodes of PIMs in 33.4 % of patients. No correlation was found between age, sex, and PIMs (p = 0.356 and p = 0.718, respectively). Multivariate analysis of PIMs demonstrated a high association with diabetes mellitus ([95 % CI] 28.168 [12.548, 63.230]; p = 0.000) and hypertension (OR [95 % CI] 2.698 [1.637, 4.448]). Conclusions The use of STOPP-2 criteria has shown the practical prevalence of PIMs especially for pharmacotherapy of cardiovascular diseases. The most common drugs identifi ed as PIMs were vasodilators, aspirin, and fi rstgeneration antihistamines. An association was shown for the hospitalizations rates, the presence of comorbidities and PIMs.
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