Journal ArticleDOI
Potentially inappropriate medication prescribing in outpatient practices: prevalence and patient characteristics based on electronic health records.
Michael Buck,Michael Buck,Ashish Atreja,Cherie P. Brunker,Anil Jain,Theodore T. Suh,Robert M. Palmer,David A. Dorr,C. Martin Harris,Adam B. Wilcox +9 more
TLDR
Female sex, polypharmacy, and number of primary care visits were significantly associated with PIM prescribing, and a small set of 8 medications accounted for the majority of PIMs at both centers, irrespective of geographic and demographic variations.Abstract:
Background : Some older adults receive potentially inappropriate medications (PIMs), increasing their risk for adverse events. A literature search did not find any US multicenter studies that measured the prevalence of PIMs in outpatient practices based on data from electronic health records (EHRs), using both the Beers and Zhan criteria. Objectives : The aims of the present study were to compare the prevalence of PIMs using standard drug terminologies at 2 disparate institutions using EHRs and to identify characteristics of elderly patients who have a PIM on their active-medication lists. Methods : This cross-sectional study of outpatients' active-medication lists from April 1, 2006, was conducted using data from 2 outpatient primary care settings: Intermountain Healthcare, Salt Lake City, Utah (center 1), and the Cleveland Clinic, Cleveland, Ohio (center 2). Data were included from patients who were aged ≥65 years at the time of the last office visit and had ≥2 documented clinic visits within the previous 2 years. The primary end point was prevalence of PIMs, measured according to the 2002 Beers criteria or the 2001 Zhan criteria. Results : Data from 61,251 patients were included (36,663 women, 24,588 men; center 1: 37,247 patients; center 2: 24,004). A total of 8693 (23.3%) and 5528 (23.0%) patients at centers 1 and 2, respectively, were documented as receiving a PIM as per the Beers criteria; this difference was not statistically significant. Per the Zhan criteria ( P Conclusions : In this analysis of data from elderly patients at 2 outpatient centers, a small set of 8 medications accounted for the majority of PIMs at both centers, irrespective of geographic and demographic variations. Female sex, polypharmacy, and number of primary care visits were significantly associated with PIM prescribing. In this analysis of data from elderly patients at 2 outpatient centers, a small set of 8 medications accounted for the majority of PIMs at both centers, irrespective of geographic and demographic variations.read more
Citations
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How safe is primary care? A systematic review
Sukhmeet S Panesar,Debra deSilva,Andrew Carson-Stevens,Kathrin Cresswell,Sarah A Salvilla,Sarah P. Slight,Sundas Javad,Gopalakrishnan Netuveli,Itziar Larizgoitia,Liam Donaldson,David W. Bates,Aziz Sheikh +11 more
TL;DR: Safety incidents are relatively common, but most do not result in serious harm that reaches the patient, and incidents relating to diagnosis and prescribing are the most likely to result in avoidable harm.
Journal ArticleDOI
Polypharmacy in Older Adults with Cancer
TL;DR: The adverse outcomes associated with polypharmacy are outlined, the strengths and weaknesses of these definitions offered are examined, and the relationships among these definitions are explored.
Journal Article
Reducing the risk of adverse drug events in older adults.
TL;DR: Clinicians should involve patients in shared decision making and individualize prescribing decisions based on medical, functional, and social conditions; quality of life; and prognosis.
Journal ArticleDOI
Comparison of published explicit criteria for potentially inappropriate medications in older adults.
Chirn-Bin Chang,Ding-Cheng Chan +1 more
TL;DR: Several sets of explicit criteria for potentially inappropriate medications (PIMs) have been developed by expert consensus and their individual characteristics are presented and incorporation of these criteria into computer-assisted order entry systems would increase their utilization in daily practice.
Journal ArticleDOI
Polypharmacy and potentially inappropriate medication use in older adults with cancer undergoing chemotherapy: effect on chemotherapy-related toxicity and hospitalization during treatment
Ronald J. Maggiore,William Dale,Cary P. Gross,Tao Feng,William P. Tew,Supriya G. Mohile,Cynthia Owusu,Heidi D. Klepin,Stuart M. Lichtman,Ajeet Gajra,Ajeet Gajra,Rupal Ramani,Vani Katheria,Laura Zavala,Arti Hurria +14 more
TL;DR: The prevalence of polypharmacy and potentially inappropriate medication use and the association between these and chemotherapy‐related adverse events in older adults with cancer undergoing chemotherapy are evaluated.
References
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Journal ArticleDOI
Updating the Beers criteria for potentially inappropriate medication use in older adults: results of a US consensus panel of experts.
Donna M. Fick,James W. Cooper,William E. Wade,Jennifer L. Waller,J. Ross Maclean,Mark H. Beers +5 more
TL;DR: The application of the Beers criteria and other tools for identifying potentially inappropriate medication use will continue to enable providers to plan interventions for decreasing both drug-related costs and overall costs and thus minimize drug- related problems.
Journal ArticleDOI
Explicit Criteria for Determining Potentially Inappropriate Medication Use by the Elderly: An Update
TL;DR: In this article, a panel of experts agreed on the validity of 28 criteria describing the potentially inappropriate use of medication by general populations of the elderly as well as 35 criteria defining potentially inappropriate medication use in older persons known to have any of 15 common medical conditions.
Journal ArticleDOI
Explicit criteria for determining inappropriate medication use in nursing home residents. UCLA Division of Geriatric Medicine.
Mark H. Beers,Joseph G. Ouslander,Irving Rollingher,David B. Reuben,Jacqueline Brooks,John C. Beck +5 more
TL;DR: 30 factors agreed on by this method identify inappropriate use of such commonly used categories of medications as sedative-hypnotics, antidepressants, antipsychotics, antihypertensives, nonsteroidal anti-inflammatory agents, oral hypoglycemics, dementia treatments, platelet inhibitors, histamine2 blockers, antibiotics, decongestants, iron supplements, muscle relaxants, gastrointestinal antispasmodics, and antiemetics.
Journal ArticleDOI
The assessment of refill compliance using pharmacy records: Methods, validity, and applications
TL;DR: It is concluded that, though some methodologic problems require further study, RC measures can be a useful source of compliance information in population-based studies when direct measurement of medication consumption is not feasible.
Book
Applied statistics and the SAS programming language
Ronald P. Cody,Jeffrey K. Smith +1 more
TL;DR: A SAS Tutorial Computing With SAS: An Illustrative Example improves the Program for a Variable Number of Questions by Creating a Better Looking Table Using PROC TABULATE and Interpreting Significant Interactions.