Abstract
Introduction: There are a lack of potentially inappropriate medications
(PIMs) predictors among the geriatric population with cardiovascular
disease (CVD).
Objective: This study was focussed on finding out the predictors and
prevalence of PIMs use in the older adult patients hospitalized with
cardiovascular disease.
Methods: This prospective cross-sectional study included 250 older adult
patients (mean age 69.03± 5.76 years) with the CVD having age 65 years
or more, admitted in 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
PIMs use in older adult patients.
Results: Results indicate a very high PIM prescription rate of more than
62.4% (n= 156) with Proton pump inhibitor, short acting insulin
according to sliding scale, Enoxaparin <30ml/min as the most
commonly prescribed PIMs. On Binary logistic regression, important
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), ≥ 9 medications per day (OR 0.09, 95% CI
0.01- 0.50, P= 0.006).
Conclusion: The prevalence of PIMs in older adults with cardiovascular
disease is very high, and females with CVD have emerged as a potential
PIM indicator. The study also indicates a lack of awareness towards Beer
criteria in health care workers (physicians/pharmacists/nursing staff)
leading to PIM.
Keywords: Beers Criteria, Cardiovascular disease, older adult patient,
potentially inappropriate medication