Original Research
Saturday, November 11, 2023
11:30 AM–01:00 PM
Abstract
Introduction:
Potentially inappropriate medications (PIMs) have been associated with geriatric syndromes (GS), although prevalence studies are lacking. Applying geographical Health Information Exchange (HIE) medication data to GS offers an innovative approach to identify problematic PIMs usage and target focused interventions.
Research Question or Hypothesis:
To characterize cumulative polypharmacy, PIMs prevalence and Medications Associated with Geriatric Syndromes (MAGS) in the Western New York (WNY) older population.
Study Design:
Cross-sectional study utilizing WNY HIE data from 1/1/2021 to 12/31/2021.
Methods:
Data were extracted for adults =65 years old under primary care in 2021 from the WNY HIE using electronic health records, therefore representing providers’ intended prescribing. Medication load included prescription and over-the-counter medications. ICD-10 codes identified GS. Using Minitab® v20.2, medication utilization and PIMs prevalence were tabulated, and associations between PIMs and GS were evaluated using Fisher’s Exact Test.
Results:
The dataset (N= 260,093) showed 139,310 between 65-74 years old, 83,337 between 75-84, and 37,446 above 85 with 53.92% female. Disease burden was high based upon Charlson comorbidity index mean 5.39 (SD 2.81). Mean medication load was 12.70 (SD 9.42). Cumulative polypharmacy (=5 meds) was seen in 82.61%; hyperpolypharmacy (=10 meds) was seen in 55.43% of the population.
Mean PIMs prevalence was high at 1.44 (SD 1.67). PIM categories previously described as MAGS were confirmed as noted in Table.
Table - PIMs prevalence in Geriatric Syndromes
|
Total Population
|
Delirium
|
Cognitive Impairment
|
Falls
|
Malnutrition
|
Urinary Incontinence
|
Depression
|
|
Antipsychotics
|
4.74%
|
|
22.15%*
|
10.25%*
|
|
8.31%*
|
14.67%*
|
|
Antidepressants
|
4.11%
|
5.61%*
|
4.92%*
|
5.90%*
|
6.07%*
|
6.64%*
|
|
|
Benzodiazepines
|
12.58%
|
27.12%*
|
19.40%*
|
19.32%*
|
|
|
|
|
Non-benzodiazepine Hypnotics
|
2.50%
|
3.45%‡
|
1.47%*
|
3.18%*
|
|
|
|
|
Anticholinergics
|
14.63%
|
26.66%*
|
19.32%*
|
22.15%*
|
|
39.22%*
|
|
|
Muscle Relaxants
|
5.45%
|
5.99%†
|
2.91%*
|
7.14%*
|
|
8.00%*
|
|
*= p< 0.001
‡= p= 0.002
†= p= 0.20
Conclusion:
High polypharmacy and PIMs rates, especially those associated with geriatric syndromes, provide a target subset of individuals for future interventions to prevent medication associated harm.
Presenting Author
Allison Murchison PharmD StudentUniversity at Buffalo
Authors
Sabrina Casucci PhD, MBA
University at Buffalo
David M. Jacobs PharmD, PhD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Steven Feuerstein MS
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Robert G. Wahler Jr. PharmD
University at Buffalo School of Pharmacy and Pharmaceutical Sciences
Ranjit Singh MB BChir, MBA
University at Buffalo