Potentially Inappropriate Medication Prescribing in Elderly Hypertensive Patients in the Primary Care Unit
Siriwan Prangphanta¹, Thareerat Ananchaisarp¹
Affiliation : ¹ Family Medicine Unit, Department of Family and Preventive Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
Background: Pharmacotherapy is necessary in the treatment of chronic diseases. However, potential inappropriate medication (PIM) prescriptions are associated with adverse events, especially in the elderly.
Objective: To quantify the prevalence and classify the type of PIM prescribing in elderly patients with hypertension, in a primary care unit (PCU) of a tertiary hospital, as well as to study factors associated with PIM prescription.
Materials and Methods: A retrospective medical record review was conducted in elderly patients followed up for treatment of hypertension at the PCU, between January 1 and December 31, 2018. Beers criteria were used to identify PIM. Factors associated with PIM prescription were analyzed using generalized estimating equation (GEE) modeling analysis.
Results: Nine hundred sixty-six subjects were included in the present study with 61.4% female and a median age (Q1, Q3) of 72.5 (68.5, 78.0) years. The prevalence of PIM was 66.9%. Most common PIM were diuretics (28.9%), aspirin (10.2%), and benzodiazepines (9.1%). The associated factors of PIM prescription were being female, visiting the PCU with an acute illness only, and the number of drugs prescribed [adjusted OR (95% CI): 1.60 (1.24 to 2.06), 2.32 (1.45 to 3.70), and 1.73 (1.61 to 1.86), respectively].
Conclusion: The prevalence of PIM prescription among elderly hypertensive patients was high, especially female patients, patients with a high number of medications prescribed, and patients visiting the OPD with acute illnesses. Appropriate medication prescribing can reduce preventable adverse drug events from PIM prescription. Using explicit criteria for prescription is one such useful method.
Received 21 September 2021 | Revised 25 November 2021 | Accepted 5 January 2022
DOI: 10.35755/jmedassocthai.2022.01.13233
Keywords : Inappropriate medications prescription; Hypertension; Elderly; Primary care unit
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