Prevalence and predictors of potentially inappropriate medication in older adults hospitalized with cardiovascular disease.

Abstract

Introduction: The use of potentially inappropriate medications (PIMs) is a significant concern among older adults with cardiovascular disease (CVD) as it can lead to adverse drug events, increased hospitalizations, and poorer health outcomes. Despite the known risks, limited evidence exists on predictors of PIM use in this population.

Objective: To determine the prevalence and predictors of PIM use in the older adult patients hospitalized with CVD.

Methods: This prospective cross-sectional study included 250 older adult patients (mean age 69.03 ± 5.76 years) with the CVD, admitted to the cardiology/medicine department of a tertiary care hospital. PIMs were identified as per Beers criteria^® 2019. Binary logistic regression analysis was used to determine the predictors of PIM use.

Results: The PIM prescription rate was 62.4% (n = 156) with a proton pump inhibitor, short acting insulin according to sliding scale, and Enoxaparin <30 mL/min as the most prescribed PIM. Predictors for PIMs use were found to be females (odds ratio [OR] 2.36, 95% confidence interval (CI) 1.36-4.09, P = 0.002), three diagnosis (OR 4.29, 95% CI 1.31-14.0, P = 0.016), ≥4 diagnosis (OR 4.8, 95% CI 1.49-15.44, P = 0.009), 7-9 days of hospital stay (OR 4.74, 95% CI 1.07-20.96, P = 0.04), and ≥9 medications per day (OR 0.09, 95% CI 0.01-0.50, P = 0.006).

Conclusion: PIM prevalence in older adults with CVD is very high, and females with CVD have emerged as a potential PIM indicator. The study also indicates a lack of awareness toward Beers criteria^® in health care workers (physicians/pharmacists/nursing staff) leading to PIM.