The release of the 2018 Chinese criteria significantly decreased the slope of overall potentially inappropriate medication prevalence among older outpatients (β = -0.607; 95% CI -0.881 to -0.482; P<0.001).
Observational (n=982,605)
Yes
Does the release of the 2018 Chinese criteria reduce the prevalence of potentially inappropriate medication use in older outpatients in China?
The release of the 2018 Chinese criteria for potentially inappropriate medication use significantly reduced the prevalence of PIM use among older outpatients in China.
Effect estimate: β = -0.607 (95% CI -0.881, -0.482)
p-value: p=< 0.001
Background: In 2018, China issued a set of criteria for effectively identifying and managing potentially inappropriate medication (PIM) use in older adults. However, there is currently a lack of evidence regarding the impact of these criteria on PIM use among older Chinese adults. Methods: We used interrupted time series analysis on the prescription data of older outpatients from 59 hospitals in six major geographic regions of China to compare changes in the overall prevalence of PIM use, the prevalence of PIM use stratified by different numbers of PIMs, and the prevalence of top five PIMs (i.e. clopidogrel, estazolam, zolpidem, sliding-scale insulin, and alprazolam) from 2015 (before) to 2021 (after) the release of criteria in 2018. Results: We included 982 605 older outpatients. Compared with trends prior to the publication of the criteria, there were significant decreases in the coefficient for change in the slope of the overall prevalence of PIM use (β = -0.607; 95% confidence interval (CI) = -0.881, -0.482; P < 0.001), the prevalence of single PIM use (β = -0.368; 95% CI = -0.465, -0.272; P < 0.001), the prevalence of multiple PIM use (β = -0.104; 95% CI = -0.173, -0.080; P = 0.019), the prevalence of clopidogrel (β = -0.342; 95% CI = -0.463, -0.227; P = 0.006), and the prevalence of estazolam (β = -0.077; 95% CI = -0.124, -0.037; P = 0.009) post-publication. Conversely, there was a significant increase in the prevalence of zolpidem, after the criteria were released (β = 0.030; 95% CI = 0.002, 0.057; P = 0.036). Conclusions: We found that the release of criteria for effectively identifying and managing PIM use has had a positive effect on its prevalence among older outpatients in China.
Tian et al. (Thu,) conducted a observational in Potentially inappropriate medication (PIM) use (n=982,605). Release of 2018 Chinese criteria for PIM use vs. Trends prior to the publication of the criteria was evaluated on Change in the slope of the overall prevalence of PIM use (β = -0.607, 95% CI -0.881, -0.482, p=< 0.001). The release of the 2018 Chinese criteria significantly decreased the slope of overall potentially inappropriate medication prevalence among older outpatients (β = -0.607; 95% CI -0.881 to -0.482; P<0.001).