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Observational Study
. 2024 Sep 30;24(1):798.
doi: 10.1186/s12877-024-05308-3.

Prevalence of potentially inappropriate medications and prescription dynamics in elderly hospitalized patients in Spain

T Puig  1   2 , L Leache  3   4 , N M González-Senac  5   6 , E Carreras  7 , M Gutiérrez-Valencia  3   4 , L Losa  8 , J L Revuelta-Herrero  6   9 , P Marrero-Álvarez  10 , M de Miguel  11   12 , A Aguirrezabal Arredondo  13 , A Aranguren  14 , A Vilariño  15 , V E Ruiz  16 , I Fernández  17 , J Bilbao  18 , C González-Guerrero  19 , B Del Pino  20 , N Garin  21   22 ; MAPAC-MPC Network
Collaborators, Affiliations
Observational Study

Prevalence of potentially inappropriate medications and prescription dynamics in elderly hospitalized patients in Spain

T Puig et al. BMC Geriatr. .

Abstract

Purpose: In recent years, the need for a more appropriate prescription of medications in the older population has emerged as a significant public health concern. In this study, we aimed to evaluate the prevalence of potentially inappropriate medications (PIM) in hospitalized adults aged ≥ 75.

Patients and methods: This was a retrospective descriptive observational study of patients at 16 hospitals in Spain. The study population included inpatients aged ≥ 75 admitted during a 7-day period (May 10 to 16, 2021). Data were obtained from the pharmacy databases of the participating hospitals. The list of PIMs was based on the Beers, STOPP-START, EU-PIM and PRISCUS criteria.

Results: A total of 4,183 patients were included. PIMs were detected in 23.5% (N = 1,126) of the cohort. The prevalence rates at the participating hospitals ranged from 10% to 42.5%. The PIM/patient ratio was 1.2. The most common PIMs were midazolam, dexketoprofen, diazepam, and doxazosin, all of which (except for doxazosin) were more common in women. Benzodiazepines accounted for 70% of all PIMs. In 35% of cases, the PIMs were initiated before hospital admission. Of the 818 PIMs initiated during hospitalization, the two most common were benzodiazepines (49%) and anti-inflammatory drugs (25%). At discharge, only 4.9% of the PIMs initiated during the hospital stay were still prescribed.

Conclusion: In this population of older hospitalized patients, the overall prevalence of PIMs was moderate. However, the prevalence rate at the participating hospitals was highly variable. In most cases, PIMs prescribed prior to hospitalization for chronic conditions were not withdrawn during the hospital stay. No significant increase in PIMs was observed from pre-admission to post-discharge. These findings underscore the need for multidisciplinary interventions to optimize the pharmaceutical treatment in older adults in the hospital setting to reduce the consequences of PIMs in patients.

Keywords: Aged; Inappropriate prescribing; Inpatients; Patient discharge.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Patients admitted during the week of the study by sex and hospital
Fig. 2
Fig. 2
Prevalence of potentially inappropriate medications (PIMs) by hospital
Fig. 3
Fig. 3
Top ten most common potentially inappropriate medications (PIMs)
None
Algorithm 1. PIMs detected during hospitalization; PIMs detected prior to admission; and PIMs prescribed at discharge and at one month post-discharge
See this image and copyright information in PMC

References

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