Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases: A report from Iran

被引:3
|
作者
Nader Babaei, Yasaman [1 ]
Niazkhani, Zahra [2 ,3 ]
Makhdoomi, Khadijeh [2 ,4 ]
Esmaeili, Ayda [5 ,6 ]
机构
[1] Urmia Univ Med Sci, Student Res Comm, Orumiyeh, Iran
[2] Urmia Univ Med Sci, Clin Res Inst, Nephrol & Kidney Transplant Res Ctr, Orumiyeh, Iran
[3] Erasmus Univ, Erasmus Sch Hlth Policy & Management, Rotterdam, Netherlands
[4] Urmia Univ Med Sci, Dept Adult Nephrol, Orumiyeh, Iran
[5] Urmia Univ Med Sci, Expt & Appl Pharmaceut Sci Res Ctr, Orumiyeh, Iran
[6] Urmia Univ Med Sci, Sch Pharm, Dept Clin Pharm, Orumiyeh, Iran
关键词
Beers criteria; elderly; kidney disease; patient safety; PIM; potentially inappropriate medication; CLINICAL PHARMACISTS; DRUG-USE; OUTCOMES;
D O I
10.1002/hsr2.1894
中图分类号
R1 [预防医学、卫生学];
学科分类号
1004 ; 120402 ;
摘要
Background and Aims: A potentially inappropriate medication (PIM) is a pharmaceutical agent that poses a greater risk of harm than potential benefit to elderly patients. This study aimed to detect PIMs and their risk factors in hospitalized elderly patients with kidney disease. Methods: This cross-sectional study assessed medication orders of elderly patients (>= 65 years old) with kidney diseases admitted to the hospital. In the first 6 months, we retrospectively evaluated all medications to identify PIMs according to the 2019 Beers criteria. In the second phase, a clinical pharmacist prospectively evaluated all medications and suggested modifications as needed. Data were analyzed to determine risk factors for prescribing PIMs. Results: Based on our evaluation of 258 patients, we observed that the utilization of PIMs was prevalent among the study population. Of the total patients evaluated, 273 instances of PIM use were identified, with only 23.3% of patients not having any PIMs. Notably, proton pump inhibitors and benzodiazepines were the most frequently prescribed PIMs. The risk of experiencing a PIM was significantly amplified by a higher degree of polypharmacy, with odds approximately 2.68 times higher (p < 0.01). Several factors were found to be associated with an increased likelihood of having a PIM, including being male, undergoing hemodialysis, having chronic kidney disease or other comorbidities, and having an extended hospital stay. The second phase of study, in terms of addressing these issues, physicians adhered to 67.5% of the 120 recommendations made by pharmacists regarding the discontinuation of PIM usage. Conclusion: High prevalence of PIMs was detected in our study population. Preventing medication-associated harms in the elderly can reduce the financial burden imposed on healthcare systems. Therefore, routine evaluation of medications with clinical pharmacists and/or implementation of computerized medication decision support systems is recommended to prevent PIMs use.
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页数:9
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