Association Between Potentially Inappropriate Medications and Hospital Encounters Among Older Adults: A Meta-Analysis

Background Potentially inappropriate medications (PIMs) are defined by the American Geriatric Society as medications that should be avoided in the elderly in general, or in specific situations. However, PIM use remains high among aging populations and may result in increased utilization of healthcare resources. Objective The aim of this meta-analysis was to evaluate the impact of PIM use on hospital encounters among older adults. Methods We searched Medline and Scopus from January 1991 to April 2019 using keywords and MeSH terms related to PIMs. Studies were included if they compared the odds of hospital encounters between PIM and non-PIM groups. Hospital encounters could be either hospital admissions or emergency department (ED) visits. Using random-effects meta-analytic methods, we calculated the pooled odds of any hospital encounter in PIM versus non-PIM users. Results A total of 21 studies evaluating 3,137,188 patients were included. The proportion of patients on PIMs was > 20% in most (n = 18) studies, median follow up was 12 months, and the mean age of patients ranged from 72 to 86 years. Upon meta-analysis, PIM use was associated with increased odds of both hospital admissions (OR 1.52; 95% CI 1.40-1.65) and ED visits (OR 1.72, 95% CI 1.33-2.24). Conclusion PIM use among older patients was associated with more hospital encounters. These unnecessary encounters likely cause a substantial burden to the healthcare system and patients.