期刊
BRITISH JOURNAL OF CLINICAL PHARMACOLOGY
卷 88, 期 7, 页码 3378-3391出版社
WILEY
DOI: 10.1111/bcp.15286
关键词
emergency department visits; expenditures; healthcare insurance; hospitalization; potentially inappropriate medications
资金
- Beijing Municipal Science and Technology Commission [D181100000218002]
This study investigated the prevalence of potentially inappropriate medication (PIM) prescribing in community-dwelling older adults in Beijing and found that using two or more PIMs was associated with increased risks of hospitalizations, emergency department visits, and higher medication expenditures for inpatient visits.
Aims The aim of this study was to investigate the prevalence of potentially inappropriate medication (PIM) prescribing and its number-dependent association (PIM = 1, 2, >= 3) with all-cause hospitalizations, emergency department (ED) visits, and medication expenditures in Beijing, China. Methods A retrospective cohort analysis was conducted to analyse PIM prescribing in community-dwelling older adults aged >= 65 years within the Beijing Municipal Medical Insurance Database (data from July to September 2016). The prevalence of PIMs was estimated based on the 2015 Beers Criteria. Logistic models were utilized to investigate the associations between PIM use and all-cause hospitalizations and ED visits. Generalized linear models with the logic link and gamma distribution were used to analyse associations between PIM use and medication expenditures. Results Among the 506 214 older adults, the prevalence of PIM was 38.07%. After adjusting for covariables, prescribing two and three or more PIMs was associated with increased risks of hospitalizations (PIM = 2: odds ratio [OR] 1.34, 95% confidence interval [CI]: 1.22-1.47; PIM >= 3: OR = 1.47, 95% CI: 1.32-1.63) and ED visits (PIM = 2: OR = 1.29, 95% CI 1.12-1.48; PIM >= 3: OR = 1.23, 95% CI: 1.04-1.44). Exposures to two and three or more PIMs were associated with higher medication expenditures for inpatient visits (PIM = 2: incidence rate ratio [IRR] = 1.08, 95% CI 1.01-1.16; PIM >= 3: IRR = 1.18, 95% CI: 1.08-1.28). Vasodilators were the most frequent PIM prescribing group among patients who were hospitalized or had to visit the ED. Conclusions PIMs were prescribed at a high rate among community-dwelling older adults in Beijing. Two or more PIMs were associated with increased risks of hospitalizations, ED visits, and increased inpatient medication expenditures. Effective interventions are needed to target unnecessary and inappropriate medications in older adults.
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