Factors Associated with Potentially Inappropriate Medication Use in
Older Adults in China applying 2019 Updated Beers Criteria
Abstract
Objectives This study aimed to measure the prevalence of potentially
inappropriate medications (PIMs) in Chinese elderly population according
to the 2019 Beers Criteria and to evaluate the associative factors of
PIMs. Methods Prescriptions of patients aged over 65 years who were
hospitalized during January 2017 to December 2017 were retrieved from
Hospital Prescription Analysis Cooperation Project, covering seventy-six
facilities in six cities in China. PIMs were identified by 2019 Beers
Criteria. Results In total, 40.1% elderly patients were treated with at
least one PIM independent of their diagnoses or conditions according to
the 2019 Beers Criteria. The most frequently prescribed inappropriate
medications independent of diagnoses or conditions were proton-pump
inhibitors (12.9%). Diuretics (8.2%) and central nervous system
medications (6.9%) also showed a relatively high prevalence among the
investigated patients. Based on the Beers Criteria’s lists of
drug-disease interactions, elderly patients with central nervous system
conditions (including delirium, dementia or cognitive impairment) or
with a history of falls or fractures were most commonly exposed to PIMs.
Logistic regression revealed that inappropriate medication use was
associated with age (≥80 years old), number of conditions (≥5), number
of medications prescribed (≥10) and class of healthcare facilities.
Conclusion This study was able to confirm that the phenomenon of
prescribing potentially inappropriate medications was common in China.
Our findings support the importance of developing explicit criteria to
detect PIMs in China and implementing effective interventions to promote
better quality of prescribing for elderly patients.