Factors Assocaited with Potentially Inappropriate Prescribing in Older Outpatients

• Main Authors: Chao-Hsuan Chang, 張肇烜
• Other Authors: 陳宣志
• Format: Others
• Language: zh-TW
• Published: 2018
• Online Access: http://ndltd.ncl.edu.tw/handle/5v93ee

碩士 === 中山醫學大學 === 醫學研究所 === 106 === Objective: Problems related to inappropriate prescriptions for older patients is considered a major public health issue in recent studies. Potentially inappropriate medications (PIMs) in elderly could lead to an increase in the likelihood of adverse drug events because of aging and multiple chronic comorbidities. The prevalence of PIM use was high in older outpatients in previous studies, but the factors associated with potentially inappropriate medication still had some controversies. The aim of our study is to identify the prevalence and risk factors for PIM use in older outpatients. Methods: This study included 25020 consecutive patients, aged ≥ 60 years receiving long-term (≧28 days) prescriptions at out-patient department visits in central Taiwan between Jan. 1 and December 31, 2015. PIM was assessed according to the 2015 updated Beers Criteria. Data regarding demographic characteristics, coexisting diseases, and prescriptions were collected and analyzed. The clinical factors related to PIM were determined using logistic regression. Results: The mean age of the 25020 patients was 72.6 ± 8.3 years. The mean number of comorbid conditions was 3.7 ± 1.8; the mean number of drugs prescribed was 3.2 ± 1.8. PIM was identified in 11471 patients (45.8%). Most common chronic disease was diseases of cardiovascular system (60.1%), followed by disease of endocrinological system (45.1%) and disease of gastrointestinal system (29.9%). Most common PIMs were Zopidem(23.4%), followed by Clonazepam (18.5%), and Estazolam (16.6%). Multivariate analysis revealed that PIM was significantly associated with the number of drugs prescribed (p< 0.001) and psychiatric illnesses (p< 0.001). Conclusion and and Suggestion: The prevalence of PIM in older outpatients was not rare. Clinicians should be alert to the possibility of PIM in older outpatients, especially in those taking multiple medications and those who have psychiatric illnesses such as cardiovascular system and psychiatric illnesses.