Introduction
PIM is defined as those medications whose adverse risk outweighs its health benefits, mainly when safer or alternative treatment is available.[1] PIMs use in the older adults is increasing day by day due to several underlying reasons, including lack of knowledge about the application of Beer criteria among the physicians and health care workers.[2] PIMs use is also increasing due to a lack of classified PIM predictors for various diseases. Various studies have reported a high prevalence of PIMs in the USA, China, and the Indian older adults and are estimated to be within the range of 25% - 90% as identified by different validated criteria.[3- 5] The prevalence of CVDs along with other comorbidities is widespread in the older adults. CVDs such as hypertension, coronary heart disease, congestive heart failure, stroke, etc are the most common cause of death among the older adults.[6] PIM use is very harmful to the geriatric population, specifically to patients suffering from CVD and other comorbidities and can lead to severe outcomes.[7] Older adults is considered frail and more vulnerable to adverse drug events or any medication-related problems due to polypharmacy/high level polypharmacy to treat comorbidities.[8] Moreover, age-related changes in the physiology of the older adults might also alter the pharmacokinetics and pharmacodynamics of drugs.[9] Despite this, PIMs continue to be prescribed as a first-line treatment in the older adults, and the increased prevalence of PIMs in the older adults is an issue of grave concern.[10] Identify inappropriate use of medication in the older adults having to age 65 years or more is of supreme importance.
Various tools like Beer criteria have been developed to determine the use of PIMs in the older adults and minimize the drug-related problems associated with PIMs use. Numerous studies have been conducted to find out the prevalence and predictors of PIMs in the older adults. Still, very few studies have been conducted to find out the PIMs use in the older adult patients hospitalized with CVD. Studies have documented the prevalence of PIMs in CVD older adult patients in a different health care setting. In a recent study, 87.4% of patients received at least one PIM in cardiology service.[11] However, there is a complete lack of data on PIMs predictors in older adult patients hospitalized with CVD. Hence, the present study’s main objective was to determine the prevalence and predictors of Potentially Inappropriate Medication in older adult patients hospitalized with cardiovascular disease using Beers criteria 2019.