Prevalence and impact of potentially inappropriate medication on community dwelling older adults

Abstract

Introduction: Potentially inappropriate medication (PIM) is associated with adverse health and functional outcomes, and increased health care costs. Objective: To estimate the prevalence and types of PIM according to the Beers criteria in community dwelling older persons and to identify the major clinical and functional consequences of PIM during two years of following. Materials and methods: This was a longitudinal, descriptive and observational study that included 400 dwelling people 65 years and older (48% women) selected by simple random sampling in 2012; in 2014, 372 people were revaluated and classified in two groups based on the presence or absence of PIM through the follow up period. Results: In total, 31% had polypharmacy, (5-9 medications) and 1,8% had excessive polypharmacy (10 or more medications). A higher mean in the number of medications in the PIM group was found (3 vs 5.78 p< 0.001). Additionally, 21,9% held the PIM status at the follow up; of those, 75% had one PIM, and 23% had two PIMs. The presence of PIM was more frequent in frail, bad health selfassessment, depressed, and comorbid (especially Diabetes Mellitus and, Chronic Obstructive Pulmonary Disease, COPD) males. In the group with sustained PIM, deterioration of health self-assessment, increase in frailty, incidence of recurrent falls, and the prevalence of depression, as well as, a higher hospital admission rate, ambulatory medical consultation, and more prescribed medications were found. We did not find an impact on functional capacity. Conclusions: We validate the negative effects of PIM in the long run in the health of older people, so we determined that PIMs must be monitored in primary attention in order to avoid greater risks.