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Risk factor analysis investigating the use of potentially inappropriate medications
Ryo Nonaka1, Hatsuho Ejima1, Saki Nakayama1
1Division of Geriatric and Community Medicine, Faculty of Medicine, Tohoku Medical and Pharmaceutical University, Sendai, Japan.
Frontiers in Medicine
|July 23, 2026
Summary
Older adults using multiple medications are at higher risk for potentially inappropriate medication (PIM) use. Advanced age and fragmented healthcare, seeing multiple facilities, are key risk factors for PIM prescriptions.
Area of Science:
- Geriatric Medicine
- Clinical Pharmacy
- Health Services Research
Background:
- Polypharmacy is common in older adults, increasing the risk of potentially inappropriate medication (PIM) use.
- The link between healthcare utilization patterns and PIM use is not well understood.
- Identifying risk factors for PIM use is crucial for improving medication safety in the elderly.
Purpose of the Study:
- To investigate the risk factors for PIM use in older adults.
- To examine the association between age, healthcare utilization (number of medical facilities consulted), and PIM use.
Main Methods:
- A multicenter, retrospective, observational study of 351 outpatients.
- Potentially inappropriate medications (PIMs) identified using the Beers Criteria (2023).
- Statistical analyses included Spearman's correlation, Wilcoxon rank-sum test, and multiple logistic regression.
Main Results:
- Age positively correlated with the number of prescribed medications (r=0.476, p<0.0001).
- Patients with PIMs consulted significantly more medical facilities than those without.
- Independent risk factors for PIM use included advanced age, hypertension, gastrointestinal disorders, and neuropsychiatric disorders.
Conclusions:
- Advanced age and fragmented healthcare utilization are significantly associated with PIM prescriptions in older adults.
- Coordinated care and regular medication reviews are recommended to reduce PIMs.
- These findings highlight the need for integrated healthcare approaches to manage polypharmacy in the elderly.
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