Patient-Related Factors Associated With the Initiation of Potentially Inappropriate Medication in Home Care: An...

Area of Science:

• Gerontology
• Pharmacology
• Public Health

Background:

• Potentially inappropriate medications (PIMs) pose significant risks to multimorbid older adults receiving home care.
• Identifying patient-specific factors associated with PIM initiation is crucial for risk mitigation.

Purpose of the Study:

• To identify patient-related factors linked to the initiation of potentially inappropriate medications (PIMs) in home care clients.
• To inform targeted interventions for preventing PIM use in vulnerable older populations.

Main Methods:

• Utilized a register-based study design employing Resident Assessment Instrument-Home Care (RAI-HC) data from 6176 clients (2014-2015).
• Identified PIMs based on the Beers criteria.
• Employed generalized estimating equations to analyze factors associated with PIM initiation.

Main Results:

• 11.3% of clients initiated PIMs over a mean 13-month follow-up.
• Higher education, cognitive impairment, reduced social interaction, and independent outdoor activity were associated with increased PIM initiation.
• Comorbidities like diabetes and Parkinson's disease, along with longer intervals between assessments, also correlated with higher PIM initiation odds.

Conclusions:

• The incidence of PIMs among home care clients is substantial.
• Healthcare professionals should prioritize attention on clients at higher risk for PIM prescribing.
• Preventing PIM use, particularly in older adults with cognitive impairment, is vital to maintain health status and prevent long-term care admissions.