Potentially inappropriate medication use among geriatric patients in primary health care centers by applying the list of risk drugs for Thai elderly criteria

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Pasitpon Vatcharavongvan
Vanida Prasert
Chanuttha Ploylearmsang
Viwat Puttawanchai

Abstract

Potentially inappropriate medications (PIM) are medications having a risk greater than benefit, leading to a high risk of adverse drug reactions and mortality in elderly patients. The List of Risk Drugs for Thai Elderly (LRDTE) was the criteria used for identifying PIM in Thai elderly. This study aimed to examine the prevalence of PIM use in primary care centers (PHCs) using the LRDTE and identify factors associated with PIM use. A retrospective, cross-sectional descriptive study was conducted in 2017 at eight PHCs in Thailand. Secondary data of eligible elderly patients aged 60 years and older were retrieved from the Health Data Center database. Descriptive statistics and multivariate logistic regression were used to identify patient characteristics and health service utilization variables of PIM use. A total of 20,671 prescriptions were included for analysis. The prevalence of PIM prescription was 45.7%. The top three PIMs were Anticholinergic drugs (40.5%), Non-steroidal anti-inflammatory drugs (7.5%) and Proton Pump Inhibitors (3.4%). Three severity levels of PIM (mild, moderate and severe) were identified by age group. We found 35.8% of elderly participants aged 60–74 years received mild PIM, while 16.1% of elderly participants aged 75 years and over were prescribed moderate PIM. The percentages of elderly participants aged 60-74 years and 75 years and older that were prescribed severe PIM were 0.03% and 0.02%, respectively. The likelihood of using PIM increased significantly in elderly patients aged 75 years and older [adjusted OR 1.3 95% CI 1.2-1.4] along with polypharmacy [adjusted OR 1.7; 95% CI 1.6-1.9]. The statistically significant factors associated with having PIM prescriptions were diabetes mellitus, hypertension, dyslipidemia, upper respiratory tract infection, dizziness, and muscle strain. Therefore, these factors should be addressed, and the PIM knowledge of health professionals in PHCs is important to avoid PIM prescription in elderly patients.

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Author Biographies

Pasitpon Vatcharavongvan, Department of Community Medicine and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

Department of Community Medicine and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

Vanida Prasert, Faculty of Public Health and Allied Health Sciences, Royal Institute Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand

Faculty of Public Health and Allied Health Sciences, Royal Institute Office of the Permanent Secretary, Ministry of Public Health, Nonthaburi, Thailand

Chanuttha Ploylearmsang, Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand

Social Pharmacy Research Unit, Faculty of Pharmacy, Mahasarakham University, Mahasarakham, Thailand

Viwat Puttawanchai, Department of Community Medicine and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

Department of Community Medicine and Family Medicine, Faculty of Medicine, Thammasat University, Pathumthani, Thailand

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