Late Breaking Original Research
Tuesday, November 14, 2023
08:30 AM–10:00 AM
Abstract
Introduction: Elderly patients are more likely to experience the adverse effects of potentially inappropriate medication (PIM), including anticholinergics.
Research Question or Hypothesis: To investigate the prevalence of PIM use among geriatric clinic outpatients after implementing the clinical decision support system (CDSS).
Study Design: Cross-sectional study
Methods: We conducted a repeated cross-sectional study of elderly outpatients aged 65 and above who visited geriatric clinics in a medical center between 2018 and 2022. The CDSS for PIM was implemented in 2018. We reviewed electronic medical records retrospectively to identify the use of PIMs based on the 2019 Beers Criteria and Anticholinergic Cognitive Burden scale. We excluded as-needed prescriptions and calculated the annual prevalence of prescribing at least one PIM to evaluate the change in PIM use. We also examined the characteristic of the study population annually, including sex and comorbidity. We performed logistic regression to estimate the prevalence Odds Ratio (OR) and 95% confidence interval (CI), comparing the annual prevalence of at least one PIM use from 2018 to 2022, with 2018 as the baseline year.
Results: We observed a decreasing trend in using at least one PIM from 2018 to 2022. Specifically, the annual prevalence of at least one PIM use decreased from 67.11% in 2018 to 63.94% in 2022 (adjusted OR= 0.83; 95%CI: 0.75, 0.93). Furthermore, there was a significant reduction in the annual prevalence of anticholinergics use in 2022 compared to 2018 (adjusted OR= 0.79; 95%CI: 0.72, 0.88). In subgroup analysis, we found a significant decrease in ergoloid mesylates use, the most frequently prescribed PIMs in 2018, compared to 2022 (OR = 0.80; 95% CI: 0.70, 0.90). However, the use of proton-pump inhibitors raised noticeably throughout the study period.
Conclusion: Our study showed that incorporating CDSS can improve medication prescribing practices and reduce PIM use for older geriatric clinic outpatients, demonstrating the potential benefit of utilizing CDSS.
Presenting Author
Yuying Yuan B.S. Pharm, MPHKaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
Authors
Chih-Kuang Liang MD, PhD
Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
Pei Yu Hsiao B.S. Pharm, MS
Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
Ying Hsin Hsu MD
Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan
Miao Ting Chen B.S. Pharm, MSCP
Kaohsiung Veterans General Hospital, Kaohsiung City, Taiwan