Marie-Eve Gagnon1, Caroline Sirois2, Marc Simard3, Barbara Roux4, Céline Plante3. 1. Department of Social and Preventive Medicine, 1050 ave de la Médecine, Université Laval, Québec G1V 0A6, Canada; Institut national de santé publique du Québec, 945 ave Wolfe, Québec G1V 5B3, Canada. 2. Department of Social and Preventive Medicine, 1050 ave de la Médecine, Université Laval, Québec G1V 0A6, Canada; Institut national de santé publique du Québec, 945 ave Wolfe, Québec G1V 5B3, Canada; Centre d'Excellence sur le Vieillissement de Québec, 1050 Chemin Ste-Foy, Local L2-28, Québec G1S 4L8, Canada. Electronic address: caroline.sirois@fmed.ulaval.ca. 3. Institut national de santé publique du Québec, 945 ave Wolfe, Québec G1V 5B3, Canada. 4. Pharmacology-Toxicology and Pharmacovigilance Department, University Hospital of Limoges, 2 ave Martin-Luther-King, 87042 Limoges, France; INSERM UMR 1248, University of Limoges, Limoges, France.
Abstract
AIM: To study the population-based prevalence of potentially inappropriate medication (PIM) among older individuals with diabetes, and to identify factors associated with their use. METHODS: We used the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database to conduct a population-based cohort study of individuals with diabetes ≥66 years between April 1st, 2014 and March 31st, 2015. PIMs were defined according to the 2015 Beers Criteria. Factors associated with PIM use were identified using robust Poisson regression models. Risk ratios (RR) and 99% confidence intervals (99%CI) were calculated. RESULTS: More than half (56%) of the 286,962 older individuals with diabetes used at least one PIM over a year. Benzodiazepines (41%), proton pump inhibitors (27%) and endocrine medication (mainly glibenclamide) (25%) were the most common PIMs used. Factors associated with PIM use included female sex (RR: 1.17; 99%CI: 1.16-1.18), and comorbidities such as schizophrenia (1.48; 1.45-1.51), anxiety disorders (1.34; 1.33-1.35) and Alzheimer's disease (1.14; 1.13-1.25). Risks of using PIMs increased both with increasing comorbidities and number of medications. CONCLUSION: PIM use is highly prevalent among older individuals with diabetes. Interventions to promote optimal medication use should particularly target individuals with comorbidities and polypharmacy who are most vulnerable to adverse drug events.
AIM: To study the population-based prevalence of potentially inappropriate medication (PIM) among older individuals with diabetes, and to identify factors associated with their use. METHODS: We used the Quebec Integrated Chronic Disease Surveillance System (QICDSS) database to conduct a population-based cohort study of individuals with diabetes ≥66 years between April 1st, 2014 and March 31st, 2015. PIMs were defined according to the 2015 Beers Criteria. Factors associated with PIM use were identified using robust Poisson regression models. Risk ratios (RR) and 99% confidence intervals (99%CI) were calculated. RESULTS: More than half (56%) of the 286,962 older individuals with diabetes used at least one PIM over a year. Benzodiazepines (41%), proton pump inhibitors (27%) and endocrine medication (mainly glibenclamide) (25%) were the most common PIMs used. Factors associated with PIM use included female sex (RR: 1.17; 99%CI: 1.16-1.18), and comorbidities such as schizophrenia (1.48; 1.45-1.51), anxiety disorders (1.34; 1.33-1.35) and Alzheimer's disease (1.14; 1.13-1.25). Risks of using PIMs increased both with increasing comorbidities and number of medications. CONCLUSION: PIM use is highly prevalent among older individuals with diabetes. Interventions to promote optimal medication use should particularly target individuals with comorbidities and polypharmacy who are most vulnerable to adverse drug events.
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