THE USE OF POTENTIALLY INAPPROPRIATE MEDICATIONS (PIMS) FROM THAILAND CRITERIA AMONG URBAN COMMUNITY-DWELLING ELDERLY: PREVALENCE, PIMS, AND FACTORS ASSOCIATED
DOI:
https://doi.org/10.69598/tbps.14.1.49-63Keywords:
elderly, potentially inappropriate medications, Thailand criteria, prevalence, factors associatedAbstract
The Lists of Risk Drugs for Thai Elderly (LRDTE) was recently developed. No studies reported the prevalence of potentially inappropriate medications (PIMs) use among the urban community-residing elderly using the LRDTE as an assessment tool. The purposes of the study were to determine prevalence, inappropriate medicine items, and factors associated with PIMs use. This research involved a cross-sectional analytic survey by collecting data on medication use of people aged ³ 60 years living in seven urban communities, Phayao province between August 15, 2016 and February 24, 2017. PIMs were identified using the Lists of Risk Drugs for Thai Elderly (LRDTE). Of four hundred elderly persons, they were mostly female (67.3%) with an average age of 72.26 ± 8.73 years. 72.5% (95% CI = 67.8% – 76.8%) of the elderly had been taking at least one PIM with the median number of PIMs being 1 (1, 2) items. In the elderly aged 60 – 74 years, the top three PIMs included amlodipine (18.7%), orphenadrine (9.9%), and diclofenac and nifedipine SR (9.1% each). In the elderly aged ³ 75 years, the top three PIMs were amlodipine (18.8%), nifedipine SR (11.6%), and orphenadrine (9.9%). Factors associated with PIMs use included having income ³ 1,000 baht per month (adjusted OR = 1.83, 95% CI = 1.07 – 3.13, p = 0.028), using dietary supplement/herbal medicine (adjusted OR = 3.12, 95% CI = 1.16 – 8.39, p = 0.025), minor polypharmacy (5 – 9 items) (adjusted OR = 2.45, 95% CI = 1.40 – 4.29, p = 0.002) and major polypharmacy (³ 10 items) (adjusted OR = 6.18, 95% CI = 1.68 – 22.74, p = 0.007). PIMs use was highly prevalent among Thai elderly residing in urban communities. Factors associated with PIMs use found in this study included high income, dietary supplement/herbal medicine use, and polypharmacy.
References
2. National Statistical Office. The 2014 survey of the older persons in Thailand. Bangkok: Text and journal publication; 2014.
3. Prasartkul P. Situation of the Thai elderly 2014. Bangkok: Amarin Printing & Publishing; 2015.
4. Chiewchantanakit D, Kiatying-Angsulee N, Sirisinsuk Y. Medication use situation in Thai elderly: the computerized database from four tertiary care hospitals. TJHP. 2013;23(1):9-20.
5. Caslake R, Soiza RL, Mangoni AA. Practical advice for prescribing in old age. Medicine. 2013;41(1):9-12.
6. Food and Drug Administration. Spontaneous reports of adverse drug reactions 2016. Bangkok: Graphic & Design; 2017.
7. O'Connor MN, Gallagher P, O'Mahony D. Inappropriate prescribing: criteria, detection and prevention. Drugs Aging. 2012;29(6):437-52.
8. Gallagher P, Ryan C, Byrne S, Kennedy J, O'Mahony D. STOPP (Screening Tool of Older Person's Prescriptions) and START (Screening Tool to Alert doctors to Right Treatment). consensus validation. Int J Clin Pharmacol Ther. 2008;46(2):72-83.
9. Azermai M, Vander Stichele RR, Elseviers MM. Quality of pharmacotherapy in old age: focus on lists of potentially inappropriate medications (PIMs) : consensus statements from the European Science Foundation exploratory workshop. Eur J Clin Pharmacol. 2016;72(7):897-904.
10. Hamilton HJ, Gallagher PF, O'Mahony D. Inappropriate prescribing and adverse drug events in older people. BMC geriatrics. 2009;9:5.
11. Lucchetti G, Lucchetti AL. Inappropriate prescribing in older persons: A systematic review of medications available in different criteria. Arch Gerontol Geriatr. 2017;68:55-61.
12. Kaufmann CP, Tremp R, Hersberger KE, Lampert ML. Inappropriate prescribing: a systematic overview of published assessment tools. Eur J Clin Pharmacol. 2014;70(1):1-11.
13. Kashyap M, Iqbal MZ. A review of screening tools used for the assessment of appropriateness of prescription’s among elderly patients. J Pharm Bio Sci. 2014;3:72-9.
14. Fick DM, Mion LC, Beers MH, J LW. Health outcomes associated with potentially inappropriate medication use in older adults. Res Nurs Health. 2008;31(1):42-51.
15. Cahir C, Bennett K, Teljeur C, Fahey T. Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients. Br J Clin Pharmacol. 2014;77(1):201-10.
16. Ploylearmsang C, Kerdchantuk P, SoonKang K, Worasin P, Kedhareon P. Drug-related problems and factors affecting on drug use problems in elderly of Banmakok, Kantharawichai, Maha Sarakham Province. J Sci Technol MSU. 2013:803-12.
17. Bua-Khwan W, Pichayapaiboon S. Potentially Inappropriate Medication Usage by Nursing Home Residents. TJPP. 2016;8(1):3-14.
18. Baldoni Ade O, Ayres LR, Martinez EZ, Dewulf Nde L, Dos Santos V, Pereira LR. Factors associated with potentially inappropriate medications use by the elderly according to Beers criteria 2003 and 2012. Int J Clin Pharm. 2014;36(2):316-24.
19. Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol. 2015;71(12):1415-27.
20. Hudhra K, Garcia-Caballos M, Casado-Fernandez E, Jucja B, Shabani D, Bueno-Cavanillas A. Polypharmacy and potentially inappropriate prescriptions identified by Beers and STOPP criteria in co-morbid older patients at hospital discharge. J Eval Clin Pract. 2016;22(2):189-93.
21. Nauta KJ, Groenhof F, Schuling J, Hugtenburg JG, van Hout HPJ, Haaijer-Ruskamp FM, et al. Application of the STOPP/START criteria to a medical record database. Pharmacoepidemiol Drug Saf. 2017;26(10):1242-7.
22. Ploylearmsang C, Tieankanitikul K, ChobPradit J, Suntorn S, Suwankasawong W. Development of medicine list for screening and reducing medication-related problems in Thai elderly. Bangkok: Health systems research institute (HSRI); 2013. Contract No.: IHPF/QUM 058-04/2554, Sponsored by International health policy program foundation (IHPP).
23. Prasert V, Akazawa M, Shono A, Chanjaruporn F, Ploylearmsang C, Muangyim K, et al. Applying the Lists of Risk Drugs for Thai Elderly (LRDTE) as a mechanism to account for patient age and medicine severity in assessing potentially inappropriate medication use. Res Social Adm Pharm. 2017.
24. Chaimay B. Sample size determination in descriptive study in public health. Thaksin J. 2013;16(2):9-18.
25. Kaiyawan Y. Principle and using logistic regression analysis for research. RMUTSV Res J. 2013;4(1):1-12.
26. Tosato M, Landi F, Martone AM, Cherubini A, Corsonello A, Volpato S, et al. Potentially inappropriate drug use among hospitalised older adults: results from the CRIME study. Age Ageing. 2014;43(6):767-73.
27. Thavornwattanayong W, Anothayanon J, Reungsakul N, Sriphiromrak P, R C. High-risk medication use in Thai elderly patients: case study in Wangtaku subdistrict, Nakhonpathom. J Health Syst Res. 2011;5(2):187-94.
28. de Lima TJV, Garbin CAS, Garbin AJÍ, Sumida DH, Saliba O. Potentially inappropriate medications used by the elderly: prevalence and risk factors in Brazilian care homes. BMC geriatrics. 2013;13(1):52.
29. Limpawattana P, Kamolchai N, Theeranut A, Pimporn J. Potentially inappropriate prescribing of Thai older adults in an internal medicine outpatient clinic of a tertiary care hospital. Afr J Pharm Pharmacol 2013;7(34):2417-22.
30. Elmståhl S, Linder H. polypharmacy and inappropriate drug use among older people—a systematic Review. Healthy Aging Clin Care Elder. 2013;2013(5):1-8.
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