Factors associated with inappropriate prescribing among older adults with complex care needs who have undergone the interRAI assessment

TitleFactors associated with inappropriate prescribing among older adults with complex care needs who have undergone the interRAI assessment
Publication TypeJournal Article
Year of Publication2019
AuthorsBala SS, Jamieson HA, Nishtala PS
JournalCurr Med Res Opin
Volume35
Issue5
Pagination917-923
Date PublishedMay
ISBN Number1473-4877 (Electronic)<br/>0300-7995 (Linking)
Accession Number30380343
Keywords*Geriatric Assessment, *Inappropriate Prescribing, Activities of Daily Living, Aged, Aged, 80 and over, Cross-Sectional Studies, Female, Geriatric Assessment, Home Care Services, Humans, Logistic Models, Male, New Zealand, Potentially inappropriate medication list, Prevalence, Retrospective Studies, Risk Assessment
Abstract

AIM: To identify factors associated with prescribing potentially inappropriate medications (PIMs) in older adults (>/=65 years) with complex care needs, who have undertaken a comprehensive geriatric risk assessment. METHODS: A nationwide cross-sectional (retrospective, observational) study was performed. The national interRAI Home Care assessments conducted in New Zealand in 2015 for older adults were linked to the national pharmaceutical prescribing data (PHARMS). The 2015 Beers criteria were applied to the cross-matched data to identify the prevalence of PIMs. The factors influencing PIMs were analyzed using a multinomial logistic regression model. RESULTS: In total, 16,568 older adults were included in this study. Individuals diagnosed with cancer, dementia, insomnia, depression, anxiety, and who were hospitalized in the last 90 days were more likely to be prescribed PIMs than those who were not diagnosed with the above disorders, and who were not hospitalized in the last 90 days. Individuals over 75 years of age, the Maori ethnic group among other ethnicities, individuals who were diagnosed with certain clinical conditions (diabetes, chronic obstructive pulmonary disease, stroke, or congestive cardiac failure), individuals requiring assistance with activities of daily living, and better self-reported health, were associated with a lesser likelihood of being prescribed PIMs. CONCLUSION: The study emphasizes the identification of factors associated with the prescription of PIMs during the first completed comprehensive geriatric assessment. Targeted strategies to reduce modifiable factors associated with the prescription of PIMs in subsequent assessments has the potential to improve medication management in older adults.

DOI10.1080/03007995.2018.1543185
Link

https://www.ncbi.nlm.nih.gov/pubmed/30380343