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Prevalence of potentially inappropriate medications at admission and discharge among hospitalised elderly patients with acute medical illness at a single centre in Japan: a retrospective cross-sectional study
  1. Junpei Komagamine
  1. Department of Internal Medicine, National Hospital Organisation Tochigi Medical Centre, Utsunomiya, Japan
  1. Correspondence to Dr Junpei Komagamine; junpei0919{at}yahoo.co.jp

Abstract

Objective To determine the prevalence of potentially inappropriate medications (PIMs) at admission and discharge among hospitalised elderly patients with acute medical illness in Japan.

Design A retrospective single-centre cross-sectional study.

Participants Hospitalised patients aged 65 years or older admitted for pneumonia, heart failure, ischaemic stroke, acute coronary syndrome, chronic obstructive pulmonary disease or asthma, gastrointestinal bleeding, urinary tract infection or epilepsy from September 2014 to June 2016 who were still alive at discharge.

Main outcome measures The primary outcome was the proportion of patients taking at least one PIM at admission and discharge. PIMs were defined based on the 2015 American Geriatric Society Beers Criteria. Temporal changes in the proportion of patients taking at least one PIM from admission to discharge were also evaluated.

Results During the study period, 689 eligible patients were identified. The median patient age was 82.0 years (IQR 76.0–88.0), 348 (50.5%) were men and the median number of medications at admission was 5.0 (IQR 3.0–8.0). The proportions of patients taking any PIMs at admission and discharge were 47.9% (95% CI 44.2% to 51.6%) and 25.1% (95% CI 21.9% to 28.4%), respectively. The proportion of patients taking any PIMs was significantly lower at discharge than at admission (reduction rate 0.48, 95%, CI 0.41 to 0.53).

Conclusions A substantial proportion of hospitalised elderly patients with acute medical illness took PIMs at admission and discharge. These findings should be confirmed at other hospitals in Japan.

  • elderly
  • polypharmacy
  • potentially inappropriate medications

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Footnotes

  • Contributors I conceived and designed this study, collected and analysed the data, wrote the main paper and read and approved the final manuscript.

  • Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Not required.

  • Ethics approval This study was approved by the Medical Ethical Committee of the National Hospital Organisation Tochigi Medical Centre (No. 28-21). This study was conducted in accordance with the Ethical Guidelines for Epidemiological Research in Japan.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement Data sharing is not applicable because informed consent for data sharing was not received from the participants.

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