Potentially Inappropriate Medication among Older Patients Who Are Frequent Users of Outpatient Services

Kung-Chuan Hsu, Hai-Lin Lu, Chi-Ming Kuan, Jin-Song Wu, Chyn-Liang Huang, Pu-Hua Lin, Damien Trezise and Tzu-Chueh Wang
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Kung-Chuan Hsu: Giraffe Pharmacy, Tainan City 710, Taiwan
Hai-Lin Lu: Department of Information Management, Chia-Nan University of Pharmacy and Science, Tainan City 717, Taiwan
Chi-Ming Kuan: Department of Information Management, Chia-Nan University of Pharmacy and Science, Tainan City 717, Taiwan
Jin-Song Wu: National Health Insurance Administration-Kaoping Division, Ministry of Health And Welfare, Kaohsiung City 801, Taiwan
Chyn-Liang Huang: Division of Medicinal Products, Taiwan Food and Drug Administration, Ministry of Health and Welfare, Taipei City 115, Taiwan
Pu-Hua Lin: Division of Medicinal Products, Taiwan Food and Drug Administration, Ministry of Health and Welfare, Taipei City 115, Taiwan
Damien Trezise: Department of Applied Foreign Languages, Chia-Nan University of Pharmacy and Science, Tainan City 717, Taiwan
Tzu-Chueh Wang: Department of Pharmacy, Chia-Nan University of Pharmacy and Science, Tainan City 717, Taiwan

IJERPH, 2021, vol. 18, issue 3, 1-11

Abstract: Aging is accompanied by changes in organ degeneration, and susceptibility to multiple diseases, leading to the frequent occurrence of adverse drug reactions resulting from polypharmacy (PP) and potentially inappropriate medications (PIM) in older patients. This study employs a retrospective cohort design and investigates the association of PP with PIM among older patients with high rates of medical utilization. Using records from a national pharmaceutical care database, an experimental group is formed from patients meeting these criteria, who are then offered home pharmaceutical care. Correspondingly, a control group is formed by identifying older patients with regular levels of use of medical services who had been dispensed medications at community pharmacies. Multivariate logistic regression is performed to assess the association between the rate of PIM and variables, including age, gender, and PP. The study finds that experimental PP participants had a higher rate of PIM prescription (odds ratio (OR) = 5.4) than non-PP control participants (all p < 0.001). In clinical practice, additional caution is required to avoid PIMs. Patients engaged in continuously using long-term medication should take precautions in daily life to alleviate related discomforts. Pharmacists should serve as a bridge between patients and physicians to enhance their health and improve their quality of life.

Keywords: older adults care; polypharmacy; potentially inappropriate medication (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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