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
Abstract 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...
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| Format: | Article |
| Language: | English |
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Wiley
2024-03-01
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| Series: | Health Science Reports |
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| Online Access: | https://doi.org/10.1002/hsr2.1894 |
| _version_ | 1797237003288313856 |
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| author | Yasaman Nader Babaei Zahra Niazkhani Khadijeh Makhdoomi Ayda Esmaeili |
| author_facet | Yasaman Nader Babaei Zahra Niazkhani Khadijeh Makhdoomi Ayda Esmaeili |
| author_sort | Yasaman Nader Babaei |
| collection | DOAJ |
| description | Abstract 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. |
| first_indexed | 2024-04-24T17:12:50Z |
| format | Article |
| id | doaj.art-78d06b1a72a24216bb275d4194fa02ee |
| institution | Directory Open Access Journal |
| issn | 2398-8835 |
| language | English |
| last_indexed | 2024-04-24T17:12:50Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Health Science Reports |
| spelling | doaj.art-78d06b1a72a24216bb275d4194fa02ee2024-03-28T08:36:41ZengWileyHealth Science Reports2398-88352024-03-0173n/an/a10.1002/hsr2.1894Potentially inappropriate medication prescribing based on 2019 Beers criteria and the impact of pharmacist intervention in elderly patients with kidney diseases: A report from IranYasaman Nader Babaei0Zahra Niazkhani1Khadijeh Makhdoomi2Ayda Esmaeili3Student Research Committee Urmia University of Medical Sciences Urmia IranNephrology and Kidney Transplant Research Center, Clinical Research Institute Urmia University of Medical Sciences Urmia IranNephrology and Kidney Transplant Research Center, Clinical Research Institute Urmia University of Medical Sciences Urmia IranExperimental and Applied Pharmaceutical Sciences Research Center Urmia University of Medical Sciences Urmia IranAbstract 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.https://doi.org/10.1002/hsr2.1894Beers criteriaelderlykidney diseasepatient safetyPIMpotentially inappropriate medication |
| spellingShingle | Yasaman Nader Babaei Zahra Niazkhani Khadijeh Makhdoomi Ayda Esmaeili 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 Health Science Reports Beers criteria elderly kidney disease patient safety PIM potentially inappropriate medication |
| title | 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 |
| title_full | 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 |
| title_fullStr | 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 |
| title_full_unstemmed | 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 |
| title_short | 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 |
| title_sort | 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 |
| topic | Beers criteria elderly kidney disease patient safety PIM potentially inappropriate medication |
| url | https://doi.org/10.1002/hsr2.1894 |
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