Potentially Inappropriate Medications Use Among Older Residents At Penang Nursing Homes
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Date
2013-03
Authors
Chen, Li Li
Journal Title
Journal ISSN
Volume Title
Publisher
Universiti Sains Malaysia
Abstract
Inappropriate prescribing is highly prevalent among the older population leading to increased risk of drug related hospitalizations. Detecting the potentially inappropriate medications (PIMs) requires a multiple factorial approaches, namely comprehensive medication review, expertise availability and screening tool as a guide. This research was aimed to evaluate the prevalence of PIMs in nursing home care in Malaysia as using Screening Tool of Older Peoples Prescriptions (STOPP) and Beers criteria with their associated predictors. In addition, the association between PIMs and health related quality of life was also studied. A multicenter and cross-sectional study was conducted over 6-month period at four large non-governmental organizations nursing homes in Penang. The study population included older residents (≥ 65 years old) taking at least one medication. This study recruited a total of 211 residents at baseline with a median age of 77 [inter quartile range (IQR) 72–82] years old. The prevalence of PIMs identified by STOPP criteria was 23.7% compared to 32.7% by Beers criteria. The most common PIMs identified by both criteria was the use of first generation antihistamines. Higher number of medications (OR=1.60 [0.08-0.51]; OR=1.72 [1.31-2.26]) and longer stay at nursing home (OR=1.11 [1.03-1.20]; OR=1.13 [1.03-1.23]) were identified as predictors for both Beers and STOPP PIMs. The associations of PIMs with adverse drug event, possibility of depression, hospitalization, death and health related quality of life were not found to achieve statistical significant but were clinically meaningful. In conclusion, PIMs is relatively common among older residents at Penang Nursing Homes with higher number of medications and number of years residing in the nursing home as the risk factors. This study has also compared the adaptability of two widely used explicit criteria in our Malaysian nursing home setting. Both criteria have strengths and weaknesses in our local context due to different in prescribing practices and the availability of drugs. Further research is warranted to develop a tool tailored to our population.
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Keywords
Inappropriate medications use , among older residents