Evaluation of potentially inappropriate medication and analysis of risk factors among elderly outpatients based on different criteria
Objective To evaluate potentially inappropriate medication(PIM)and risk factors among elderly outpatients based on different criteria.Methods Prescriptions of elderly outpatients(aged over 65 years)from Qunli Hospital District of the First Affiliated Hospital of Harbin Medical University were retrospectively collected from July to September of 2023.2023 AGS Beers Criteria and 2017 Chinese PIM Criteria were used to determine PIM incidence.Kappa consistency test was used to analyze the consistency between the two criteria.Multivariate logistic regression analysis was performed to identify risk factors related to PIM in elderly patients.Results A total of 14 597 prescriptions were included.The PIM incidence based on 2023 Beers Criteria was 15.39%,significantly higher than the incidence(13.33%)using the Chinese PIM Criteria(χ2=20.186,P<0.01).Combining the two criteria,the drugs with the highest PIM incidence were CNS drugs(including benzodiazepines,antidepressants,antipsychotics,etc.),aspirin,clopidogrel,and insulin.Kappa consistency test revealed the poor consistency between the two criteria in detecting PIM(κ=0.395).Multivariate logistic regression analysis showed that,based on 2023 Beers Criteria,sex,age,number of diagnosed disease and number of types of medication were independent risk factors of PIM(P<0.05).Similarly,based on the Chinese PIM Criteria,age,number of diagnosed diseases,and number of types of medication were independent risk factors of PIM(P<0.05).Conclusion PIM is prevalent among elderly outpatients especially for CNS drugs.Both criteria indicated that age,number of diagnosed disease and number of types of medication are major risk factors for PIM in elderly patients.Given the poor consistency in PIM detection between the two criteria,a combined application of both is recommended in clinical practice.
万方数据
维普
