Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions
ABSTRACT Objective To examine associations between potentially inappropriate medication, use and the risk of falls, unplanned hospitalization and death in older patients receiving initial care in a geriatric day hospital due to acute conditions. Methods Cohort study with older adults referred to a geriatric day hospital from 2014 to 2017 due to acute conditions. Patients were submitted to comprehensive geriatric assessment. Use of medications was analyzed according to Beers Criteria 2019. Outcome assessment was based on monthly follow-up telephone calls made over the course of one year. Results In this sample, 40.6% of patients had been prescribed at least one potentially inappropriate medication, particularly proton pump inhibitors (66.5%). Over the course of follow-up, 44.7% of patients receiving potentially inappropriate medications sustained at least one fall (p=0.0043) and 70% visited the emergency department (p=0.0452). These outcomes were more common among patients using two or more of drugs. Use of potentially inappropriate medication was associated with a 64% increase in the odds of unplanned hospitalization and a two-fold increase in risk of death. Conclusion Associations between potentially inappropriate medication use and unfavorable outcomes such as falls and unplanned hospitalizations within one year of admission to a geriatric day hospital support the application of Beers Criteria and emphasize the importance of periodic prescription review, deprescription and rational use of these drugs whenever possible.
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Instituto Israelita de Ensino e Pesquisa Albert Einstein
2022
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oai:scielo:S1679-450820220001002712022-06-29Use of potentially inappropriate medications and adverse events in older outpatients with acute conditionsViana,Stéphanie de Souza CostaSouza,Natália Pereira dos SantosAliberti,Márlon Juliano RomeroJacob-Filho,Wilson Drug-related side effects and adverse reactions Frail elderly Aged Potentially inappropriate medication list ABSTRACT Objective To examine associations between potentially inappropriate medication, use and the risk of falls, unplanned hospitalization and death in older patients receiving initial care in a geriatric day hospital due to acute conditions. Methods Cohort study with older adults referred to a geriatric day hospital from 2014 to 2017 due to acute conditions. Patients were submitted to comprehensive geriatric assessment. Use of medications was analyzed according to Beers Criteria 2019. Outcome assessment was based on monthly follow-up telephone calls made over the course of one year. Results In this sample, 40.6% of patients had been prescribed at least one potentially inappropriate medication, particularly proton pump inhibitors (66.5%). Over the course of follow-up, 44.7% of patients receiving potentially inappropriate medications sustained at least one fall (p=0.0043) and 70% visited the emergency department (p=0.0452). These outcomes were more common among patients using two or more of drugs. Use of potentially inappropriate medication was associated with a 64% increase in the odds of unplanned hospitalization and a two-fold increase in risk of death. Conclusion Associations between potentially inappropriate medication use and unfavorable outcomes such as falls and unplanned hospitalizations within one year of admission to a geriatric day hospital support the application of Beers Criteria and emphasize the importance of periodic prescription review, deprescription and rational use of these drugs whenever possible.info:eu-repo/semantics/openAccessInstituto Israelita de Ensino e Pesquisa Albert Einsteineinstein (São Paulo) v.20 20222022-01-01info:eu-repo/semantics/articletext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082022000100271en10.31744/einstein_journal/2022ao8024 |
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Viana,Stéphanie de Souza Costa Souza,Natália Pereira dos Santos Aliberti,Márlon Juliano Romero Jacob-Filho,Wilson |
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Viana,Stéphanie de Souza Costa Souza,Natália Pereira dos Santos Aliberti,Márlon Juliano Romero Jacob-Filho,Wilson Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
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Viana,Stéphanie de Souza Costa Souza,Natália Pereira dos Santos Aliberti,Márlon Juliano Romero Jacob-Filho,Wilson |
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Viana,Stéphanie de Souza Costa |
title |
Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
title_short |
Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
title_full |
Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
title_fullStr |
Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
title_full_unstemmed |
Use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
title_sort |
use of potentially inappropriate medications and adverse events in older outpatients with acute conditions |
description |
ABSTRACT Objective To examine associations between potentially inappropriate medication, use and the risk of falls, unplanned hospitalization and death in older patients receiving initial care in a geriatric day hospital due to acute conditions. Methods Cohort study with older adults referred to a geriatric day hospital from 2014 to 2017 due to acute conditions. Patients were submitted to comprehensive geriatric assessment. Use of medications was analyzed according to Beers Criteria 2019. Outcome assessment was based on monthly follow-up telephone calls made over the course of one year. Results In this sample, 40.6% of patients had been prescribed at least one potentially inappropriate medication, particularly proton pump inhibitors (66.5%). Over the course of follow-up, 44.7% of patients receiving potentially inappropriate medications sustained at least one fall (p=0.0043) and 70% visited the emergency department (p=0.0452). These outcomes were more common among patients using two or more of drugs. Use of potentially inappropriate medication was associated with a 64% increase in the odds of unplanned hospitalization and a two-fold increase in risk of death. Conclusion Associations between potentially inappropriate medication use and unfavorable outcomes such as falls and unplanned hospitalizations within one year of admission to a geriatric day hospital support the application of Beers Criteria and emphasize the importance of periodic prescription review, deprescription and rational use of these drugs whenever possible. |
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Instituto Israelita de Ensino e Pesquisa Albert Einstein |
publishDate |
2022 |
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http://old.scielo.br/scielo.php?script=sci_arttext&pid=S1679-45082022000100271 |
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