Kaeshaelya Thiruchelvam1,2, Julie Byles3,4, Syed Shahzad Hasan3,5, Nicholas Egan3,4, Therese Kairuz3,6. 1. University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. kaeshaelyathiruchelvam@uon.edu.au. 2. International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia. kaeshaelyathiruchelvam@uon.edu.au. 3. University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia. 4. Priority Research Centre for Generational Health and Ageing, Hunter Medical Research Institute, New Lambton Heights, NSW, 2305, Australia. 5. University of Huddersfield, Queensgate, Huddersfield, HD1 3DH, UK. 6. International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Abstract
BACKGROUND: Frailty is an essential consideration with potentially inappropriate medications (PIMs), especially among older women. AIMS: This study determined the use of potentially inappropriate medications according to frailty status using the Beers Criteria 2019, identified medications that should be flagged as potentially inappropriate and harmful depending on individual health factors, and determined the association between frailty and PIMs, adjusted for characteristics associated with PIMs. METHODS: This prospective longitudinal study included 9355 participants aged 77-82 years at baseline (2003). Frailty was measured using the FRAIL (fatigue, resistance, ambulation, illness and loss of weight) scale. Generalised estimating equations using log-binomial regressions determined the association between frailty and risk of using PIMs. RESULTS: Among participants who were frail and non-frail at baseline, the majority used ≥ 3 PIMs (74.2% and 58.5%, respectively). At 2017, the proportion using ≥ 3 PIMs remained constant in the frail group (72.0%) but increased in the non-frail group (66.0%). Commonly prescribed medications that may be potentially inappropriate in both groups included benzodiazepines, proton-pump inhibitors and non-steroidal anti-inflammatory drugs, and risperidone was an additional contributor in the non-frail group. When adjusted for other characteristics, frail women had a 2% higher risk of using PIMs (RR 1.02; 95% CI 1.01, 1.03). CONCLUSION: Given that the majority of frail women were using medications that may have been potentially inappropriate, it is important to consider both frailty and PIMs as indicators of health outcomes, and to review the need for PIMs for women aged 77-96 years who are frail.
BACKGROUND: Frailty is an essential consideration with potentially inappropriate medications (PIMs), especially among older women. AIMS: This study determined the use of potentially inappropriate medications according to frailty status using the Beers Criteria 2019, identified medications that should be flagged as potentially inappropriate and harmful depending on individual health factors, and determined the association between frailty and PIMs, adjusted for characteristics associated with PIMs. METHODS: This prospective longitudinal study included 9355 participants aged 77-82 years at baseline (2003). Frailty was measured using the FRAIL (fatigue, resistance, ambulation, illness and loss of weight) scale. Generalised estimating equations using log-binomial regressions determined the association between frailty and risk of using PIMs. RESULTS: Among participants who were frail and non-frail at baseline, the majority used ≥ 3 PIMs (74.2% and 58.5%, respectively). At 2017, the proportion using ≥ 3 PIMs remained constant in the frail group (72.0%) but increased in the non-frail group (66.0%). Commonly prescribed medications that may be potentially inappropriate in both groups included benzodiazepines, proton-pump inhibitors and non-steroidal anti-inflammatory drugs, and risperidone was an additional contributor in the non-frail group. When adjusted for other characteristics, frail women had a 2% higher risk of using PIMs (RR 1.02; 95% CI 1.01, 1.03). CONCLUSION: Given that the majority of frail women were using medications that may have been potentially inappropriate, it is important to consider both frailty and PIMs as indicators of health outcomes, and to review the need for PIMs for women aged 77-96 years who are frail.
Authors: Ann T Gregory; Ruth M Armstrong; Tanya D Grassi; Bronwyn Gaut; Martin B Van Der Weyden Journal: Med J Aust Date: 2008 Dec 1-15 Impact factor: 7.738
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Authors: Amy T Page; Michael O Falster; Melisa Litchfield; Sallie-Anne Pearson; Christopher Etherton-Beer Journal: Med J Aust Date: 2019-06-20 Impact factor: 7.738
Authors: Guohua Li; Howard F Andrews; Stanford Chihuri; Barbara H Lang; Cheng Shiun Leu; David P Merle; Abigail Gordon; Thelma J Mielenz; David Strogatz; David W Eby; Marian E Betz; Carolyn DiGuiseppi; Vanya C Jones; Lisa J Molnar; Linda L Hill Journal: BMC Geriatr Date: 2019-10-10 Impact factor: 3.921