Key result
Among 508 hospitalized older adults, 69.3% had at least one potentially inappropriate medication (Beers criteria), which was significantly associated with an increased risk of hospital readmission.
Why the study?
This study aimed to compare the prevalence of potentially inappropriate medications among hospitalized elderly patients using Beers and Chinese criteria and identify their correlation with hospital readmission and death.
Does the use of potentially inappropriate medications increase the risk of hospital readmission and death in hospitalized older patients?
Cohort (n=508)
No
Does the use of potentially inappropriate medications increase the risk of hospital readmission and death in hospitalized older patients?
Potentially inappropriate medications, particularly as defined by the Beers criteria, are highly prevalent and independently associated with an increased risk of hospital readmission in older Chinese patients.
May support PIM screening in older inpatients; leaves open whether deprescribing reduces readmissions.
OBJECTIVE: This study aimed to compare the prevalence of potentially inappropriate medications (PIMs) among hospitalized elderly patients using Beers and Chinese criteria and identify the correlation between PIMs and the risk of hospital readmission and death. METHODS: This study was conducted on geriatric patients aged ≥65 years at Beijing Fuxing Hospital between June 2015 and December 2017. The Beers criteria of 2015 and the Chinese criteria of 2017 were used to detect PIMs. Follow-ups were conducted for 12-36 months (or until patients' death, if it came sooner). Cox proportional-hazards models were used to explore the correlations between PIM use and the risk of hospital readmission and death. RESULTS: Of 508 patients, 352 (69.3%) and 339 (66.7%) had at least one PIM identified using the Beers criteria and the Chinese criteria, respectively. Proton-pump inhibitors in the Beers criteria and clopidogrel in the Chinese criteria were the most leading PIMs. PIMs identified using the Beers criteria were a risk factor for the all-cause hospital readmission. After adjusting for age, gender, comorbidity, and so forth, PIM use was still an indicator of rehospitalization. PIM grouping defined using the Chinese criteria was not associated with hospital readmission. PIM grouping defined using either criteria was not associated with all-cause death. CONCLUSION: The study showed a high prevalence of PIM use in China. PIMs defined using the Beers criteria increased the risk of hospital readmission. Clinicians should pay more attention to PIMs, carry out routine PIM assessment, and reduce adverse health outcomes in elderly patients.
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Wang et al. (2019) conducted a cohort in Hospitalized elderly patients (n=508). Potentially inappropriate medications (PIMs) vs. No potentially inappropriate medications was evaluated on All-cause hospital readmission and all-cause death. Among 508 hospitalized older adults, 69.3% had at least one potentially inappropriate medication (Beers criteria), which was significantly associated with an increased risk of hospital readmission.
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