Patterns and Outcomes of Polypharmacy and Effect of Potentially Inappropriate Medications in Elderly Patients undergoing Orthopaedic Surgeries: A Retrospective Observational Study
Introduction: Prescription of Potentially Inappropriate Medication (PIM) among elderly patients is becoming a global concern. There has been an increase in the number of elderly patients coming for operative procedures, especially in orthopaedic surgery, due to the association of advanced age w...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2024-01-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://www.jcdr.net/articles/PDF/18962/66774_CE[Ra1]_F(IS)_QC(KK_RDW_SHU)_PF1(RI_KM)_PFA(RI_KM)_PN(KM).pdf |
| Summary: | Introduction: Prescription of Potentially Inappropriate
Medication (PIM) among elderly patients is becoming a
global concern. There has been an increase in the number of
elderly patients coming for operative procedures, especially in
orthopaedic surgery, due to the association of advanced age
with chronic musculoskeletal conditions, such as osteoarthritis,
and an increased incidence of fragility fractures.
Aim: To determine the prevalence of polypharmacy and PIMs
among elderly patients undergoing orthopaedic surgery.
Materials and Methods: A retrospective observational study
was conducted from February 2022 to April 2022 in the
Orthopaedic Department of Anaesthesiology, MOSC Medical
College, Kolenchery, Ernakulam, Kerala, India. Hospital records
of 130 patients aged 65 years and above, who underwent
orthopaedic surgeries from January 2016 to December 2021,
were included. The prescriptions during the perioperative period
were analysed for polypharmacy, defined as the use of five or
more drugs. The American Geriatric Society (AGS) 2019 Beers
criteria were used to identify PIMs, drug interactions, and drugsyndrome interactions. Chi-square tests were performed on
clinically significant variables to assess their effect on hospital
stay, with a p-value of <0.05 considered significant.
Results: Polypharmacy was highest on postoperative day 1,
with 119 patients (91.5%) experiencing it. The study observed
a high prevalence of PIMs, with 106 patients (81.53%) affected.
The most commonly used PIMs were Pantoprazole, followed by
Piroxicam, Regular human Insulin, and Glimepride. A significant
association was observed between hospital stay ≥10 days,
postoperative Intensive Care Unit (ICU) stay, and preoperative
polypharmacy (p-value=0.002).
Conclusion: Polypharmacy and PIMs in patients above 65
years of age admitted for surgeries remain major concerns.
Further exploration of current pharmacologic practices in the
perioperative period and interventions, such as physician
education programs regarding PIMs, are needed. |
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| ISSN: | 2249-782X 0973-709X |