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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.
Background:
Polypharmacy, defined as the concurrent use of multiple medications, is becoming increasingly prevalent among older adults, and is strongly associated with potentially inappropriate medication (PIM) use. However, the relationship between healthcare utilization patterns and PIM use remains poorly explored. Therefore, in this study, we aimed to identify the risk factors for PIM use, focusing on age and the number of medical facilities consulted.
Methods:
In this multicenter, retrospective, observational study, we enrolled 351 outpatients undergoing treatment at Tohoku Medical and Pharmaceutical University Hospital or Ishinomaki Municipal Hospital. PIMs were identified using the Beers Criteria (2023). Associations were analyzed using Spearman's correlation, Wilcoxon rank-sum test, and multiple logistic regression.
Results:
Age was found to be positively correlated with the number of prescribed medications (r = 0.476; p < 0.0001). Gastrointestinal medications were prescribed most frequently, while proton pump inhibitors were the most common PIMs. Patients prescribed ≥1 PIM consulted significantly more medical facilities than those without PIMs. Multivariate analysis identified age, hypertension, gastrointestinal disorders, and neuropsychiatric disorders (excluding dementia) as independent risk factors of PIM use.
Conclusion:
Overall, our findings showed that advanced age and fragmented healthcare utilization were significantly associated with PIM prescriptions. Strategies promoting coordinated care and medication reviews may reduce the number of inappropriate prescriptions in older adults.
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