Comparison of Beers criteria and EU(7) potentially inappropriate medications list for the potentially inappropriate medications in Indian elderly inpatients
Keywords:Beers criteria, EU(7) PIM list, Elderly, Internal medicine wards, Intensive care units, Potentially inappropriate medications
Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.
Methods: This cross-sectional study was carried out on medical records of elderly patients (≥65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.
Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).
Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria.
Davies EA, O’Mahony MS. Adverse drug reactions in special populations – the elderly. Br J Clin Pharmacol. 2015;80(4):796-807.
Patel TK, Patel PB. Incidence of Adverse Drug Reactions in Indian Hospitals: A Systematic Review of Prospective Studies. Curr Drug Saf. 2016;11(2):128-36.
Oscanoa TJ, Lizaraso F, Carvajal A. Hospital admissions due to adverse drug reactions in the elderly. A meta-analysis. Eur J Clin Pharmacol. 2017;73(6):759-70.
Laroche ML, Charmes JP, Bouthier F, Merle L. Inappropriate medications in the elderly. Clin Pharmacol Ther. 2009;85(1):94-7.
Laroche ML, Charmes JP, Merle L. Potentially inappropriate medications in the elderly: A French consensus panel list. Eur J Clin Pharmacol. 2007;63(8):725-31.
Onda M, Imai H, Takada Y, Fujii S, Shono T, Nanaumi Y. Identification and prevalence of adverse drug events caused by potentially inappropriate medication in homebound elderly patients: a retrospective study using a nationwide survey in Japan. BMJ Open. 2015;5(8):e007581.
Hyttinen V, Jyrkkä J, Valtonen H. A Systematic Review of the Impact of Potentially Inappropriate Medication on Health Care Utilization and Costs Among Older Adults. Med Care. 2016;54(10):950-64.
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.
Holt S, Schmiedl S, Thürmann PA. Potentially Inappropriate Medications in the Elderly: The PRISCUS List. Dtsch Arztebl Int. 2010;107(31-32):543-51.
Renom-Guiteras A1, Meyer G, Thürmann PA. The EU(7)-PIM list: a list of potentially inappropriate medications for older people consented by experts from seven European countries. Eur J Clin Pharmacol. 2015;71(7):861-75.
Lee PCL, Jawad MS, Eccles R. Antitussive Efficacy of Dextromethorphan in Cough Associated with Acute Upper Respiratory Tract Infection. J Pharm Pharmacol. 2000;52(9):1137-42.
Storms H, Marquet K, Aertgeerts B, Claes N. Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review. Eur J Gen Pract. 2017;23(1):69-77.
Egger SS, Bachmann A, Hubmann N, Schlienger RG, Krähenbühl S. Prevalence of potentially inappropriate medication use in elderly patients: comparison between general medical and geriatric wards. Drugs Aging. 2006;23(10):823-37.
Kersten H, Hvidsten LT, Gløersen G, Wyller TB, Wang-Hansen MS. Clinical impact of potentially inappropriate medications during hospitalization of acutely ill older patients with multimorbidity. Scand J Prim Health Care. 2015;33(4):243-51.
Morandi A, Vasilevskis E, Pandharipande PP, et al. Inappropriate medication prescriptions in elderly adults surviving an intensive care unit hospitalization. J Am Geriatr Soc. 2013;61(7):1128-34.
Morandi A, Vasilevskis EE, Pandharipande PP, et al. Inappropriate medications in elderly ICU survivors: where to intervene? Arch Intern Med. 2011;171(11):1032-4.
Vishwas HN, Harugeri A, Parthasarathi G, Ramesh M. Potentially inappropriate medication use in Indian elderly: comparison of Beers' criteria and Screening Tool of Older Persons' potentially inappropriate Prescriptions. Geriatr Gerontol Int. 2012;12(3):506-14.
Jhaveri BN, Patel TK, Barvaliya MJ, Tripathi C. Utilization of potentially inappropriate medications in elderly patients in a tertiary care teaching hospital in India. Perspect Clin Res. 2014;5(4):184-9.
Rawat RS. Evaluation of Potentially Inappropriate Medication Use and Risk of Adverse Drug Reactions in Hospitalized Older Adults: An Observational Study in a Tertiary Care Hospital. Indian J Pharm Pr. 2018;11(2):75-85.
American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 Updated Beers Criteria for Potentially Inappropriate Medication Use in Older Adults. J Am Geriatr Soc. 2015;63(11):2227-46.
Slugg PH, Haug MT 3rd, Pippenger CE. Pippenger. Ranitidine Pharmacokinetics and Adverse Central Nervous System Reactions. Arch Intern Med. 1992;152(11):2325-9.
Simonson DC, Kourides IA, Feinglos M, Shamoon H, Fischette CT. Efficacy, safety, and dose-response characteristics of glipizide gastrointestinal therapeutic system on glycemic control and insulin secretion in NIDDM. Results of two multicenter, randomized, placebo-controlled clinical trials. The Glipizide Gastrointestinal Therapeutic System Study Group. Diabetes Care. 1997;20(4):597-606.
Garber AJ, Duncan TG, Goodman AM, Mills DJ, Rohlf JL. Efficacy of metformin in type II diabetes: results of a double-blind, placebo-controlled, dose-response trial. Am J Med. 1997;103(6):491-7.
Butler J, Anstrom KJ, Felker GM, et al. Efficacy and Safety of Spironolactone in Acute Heart Failure: The ATHENA-HF randomized clinical trial. JAMA Cardiol. 2017;2(9):950-8.
Schmidt M, Sørensen HT, Pedersen L. Diclofenac use and cardiovascular risks: series of nationwide cohort studies. BMJ. 2018;362:k3426.
Yohannes AM, Willgoss TG, Vestbo J. Tiotropium for treatment of stable COPD: a meta-analysis of clinically relevant outcomes. Respir Care. 2011;56(4):477-87.
Ismaila AS, Huisman EL, Punekar YS, Karabis A. Comparative efficacy of long-acting muscarinic antagonist monotherapies in COPD: a systematic review and network meta-analysis. Int J Chron Obstruct Pulmon Dis. 2015;10:2495-517.
Singh S, Loke YK, Enright P, Furberg CD. Republished: pro-arrhythmic and pro-ischaemic effects of inhaled anticholinergic medications. Postgrad Med J. 2014;90(1062):205-7.
Ogale SS, Lee TA, Au DH, Boudreau DM, Sullivan SD. Cardiovascular events associated with ipratropium bromide in COPD. Chest. 2010;137(1):13-9.
Mion D Jr, Ortega KC, Gomes MA, Kohlmann O Jr, Oigman W, Nobre F. Amlodipine 2.5 mg once daily in older hypertensives: A Brazilian multi-centre study. Blood Press Monit. 2004;9(2):83-9.
Pascual J. Hypertension control in the elderly with amlodipine. Curr Med Res Opin. 2000;16(1):33-6.
Owen AJ, Reid CM. Cardio classics revisited: focus on the role of amlodipine. Integr Blood Press Control. 2012;5:1-7.
McNeil JJ, Wolfe R, Woods RL, et al. Effect of Aspirin on Cardiovascular Events and Bleeding in the Healthy Elderly. N Engl J Med. 2018;379(16):1509-18.
Brett AS. Adverse Effects of Thiazide Diuretics in Older Patients. J Am Geriatr Soc. 2014;62:1039.
Gandhi S, McArthur E, Reiss JP, Mamdani MM, Hackam DG, Weir MA, et al. Atypical antipsychotic medications and hyponatremia in older adults: a population-based cohort study. Can J Kidney Health Dis. 2016;3:21.
Meulendijks D, Mannesse CK, Jansen PA, van Marum RJ, Egberts TC. Antipsychotic-induced hyponatraemia: a systematic review of the published evidence. Drug Saf. 2010;33(2):101-14.
Lien YHH. Antidepressants and Hyponatremia. Am J Med. 2018;131(1):7-8.
Girouard C, Grégoire JP, Poirier P, Moisan J. Effect of contraindicated drugs for heart failure on hospitalization among seniors with heart failure: A nested case-control study. Medicine. 2017;96(9):e6239.
Inouye SK, Marcantonio ER, Metzger ED. Doing damage in delirium: The Hazards of Antipsychotic Treatment in Elderly persons. Lancet Psychiatry. 2014;1(4):312-5.
Kalish VB, Gillham JE, Unwin BK. Delirium in Older Persons: Evaluation and Management. Am Fam Physician. 2014;90(3):150-8.
Alagiakrishnan K, Wiens CA. An approach to drug induced delirium in the elderly. Postgrad Med J. 2004;80(945):388-93.
Chan R, Caplan G. Management of delirium in the elderly. Aust Prescr. 2011;34:63-6.
Carrière I, Annie Fourrier-Reglat, Dartigues JF, et al. Drugs with anticholinergic properties, cognitive decline, and dementia in an elderly general population: the 3-city study. Arch Intern Med. 2009;169(14):1317-24.
Masud T, Frost M, Ryg J, Matzen L, Ibsen M, Abrahamsen B, et al. Central nervous system medications and falls risk in men aged 60-75 years: the Study on Male Osteoporosis and Aging (SOMA). Age Ageing. 2013;42(1):121-4.