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.