Potentially inappropriate medications in Chinese community-dwelling older adults

Background There is a lack of data on the prevalence of potentially inappropriate medications (PIMs) in community-dwelling older adults in China. Objective To assess the prevalence of potentially inappropriate medication in community dwelling older adults in China and to investigate risk factors associated with the use of such medication. Setting Ambulatory Care Clinic of Xiangya Hospital, Central South University. Method A cross-sectional retrospective review of prescriptions for older patients (aged ≥ 65 years) was performed using the 2019 American Geriatrics Society (AGS) Beers Criteria and the 2017 Chinese Criteria. We only assessed potentialli inappropriate medications independently from diagnosis and drug–drug interactions. Each patient was classified as PIM-user or non-PIM-user, according to whether a patient took at least one potentially inappropriate medication. Main outcome measure Prevalence of potentially inappropriate medication based on the two criteria. Results A total of 8477 medications among 1874 elderly patients were examined over the study period from January 1 to December 31, 2018. The Chinese Criteria detected significantly more PIM-users than the AGS Beers Criteria (50.6% vs 35.0%, P < 0.001), and also a higher percentage of inappropriate medication in prescribed medications (14.7% vs 8.5%, P < 0.001). Benzodiazepines, anticholinergics, antipsychotics, and insulin were the most frequently prescribed classes by both criteria. Alprazolam (47.7%) was the most frequently found inappropriate medicine based on the 2019 AGS Beers Criteria compared to clopidogrel (42.2%) based on the Chinese Criteria. The number of medications was a significant risk factor to the use of potentially inappropriate medication in both criteria. Conclusion The prevalence of the use of potentially inappropriate medication in Chinese community-dwelling older adults is high, and explicit criteria are a useful tool to evaluate the prescription of such medication in the elderly.