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The effect of hospitalization on potentially inappropriate medication use in older adults with chronic kidney disease

Citation

Tesfaye, WH and Wimmer, BC and Peterson, GM and Castelino, RL and Jose, MD and McKercher, C and Zaidi, STR, The effect of hospitalization on potentially inappropriate medication use in older adults with chronic kidney disease, Current Medical Research and Opinion, 35, (6) pp. 1119-1126. ISSN 0300-7995 (2018) [Refereed Article]


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Copyright Statement

Copyright 2019 Informa UK Limited, trading as Taylor & Francis Group This is an Accepted Manuscript of an article published by Taylor & Francis in Current Medical Research and Opinion on 11 January 2019, available online: http://www.tandfonline.com/10.1080/03007995.2018.1560193

DOI: doi:10.1080/03007995.2018.1560193

Abstract

Objectives: Potentially inappropriate medication (PIM) use is associated with increased morbidity and mortality in chronic kidney disease (CKD). However, there is a paucity of data on how hospitalization affects PIM use in older adults with CKD. Therefore, we aimed to measure the impact of hospitalization on PIM use in older CKD patients, and identify factors predicting PIM use.

Methods: A retrospective cohort study was conducted in older adults (≥65 years) with CKD admitted to an Australian tertiary care hospital over a 6 month period. PIM use was measured, upon admission and at discharge, using the Medication Appropriateness Index (MAI) and Beers criteria (2015 version) for medications recommended to be avoided in older adults and under certain conditions.

Results: The median age of the 204 patients was 83 years (interquartile range (IQR): 76-87 years) and most were men (61%). Overall, the level of PIM use (MAI) decreased from admission to discharge (median [IQR]: 6 [3-12] to 5 [2-9]; p < .01]). More than half of the participants (55%) had at least one PIM per Beers criterion on admission, which was reduced by discharge (48%; p < .01). People admitted with a higher number of medications (β 0.72, 95% CI 0.56-0.88) and lower eGFR values (β -0.11, 95% CI -0.18 to -0.04) had higher MAI scores after adjusting for age, sex and Charlson’s comorbidity index.

Conclusions: PIMs were commonly used in older CKD patients. Hospitalization was associated with a reduction in PIM use, but there was considerable scope for improvement in these susceptible individuals.

Item Details

Item Type:Refereed Article
Keywords:Beers criteria, medication appropriateness index, chronic kidney disease, elderly, potentially inappropriate medications
Research Division:Biomedical and Clinical Sciences
Research Group:Pharmacology and pharmaceutical sciences
Research Field:Clinical pharmacy and pharmacy practice
Objective Division:Manufacturing
Objective Group:Human pharmaceutical products
Objective Field:Human pharmaceutical treatments
UTAS Author:Tesfaye, WH (Mr Wubshet Tesfaye)
UTAS Author:Wimmer, BC (Dr Barbara Wimmer)
UTAS Author:Peterson, GM (Professor Gregory Peterson)
UTAS Author:Castelino, RL (Dr Ronald Castelino)
UTAS Author:Jose, MD (Professor Matthew Jose)
UTAS Author:McKercher, C (Dr Charlotte McKercher)
UTAS Author:Zaidi, STR (Dr Tabish Razi Zaidi)
ID Code:131588
Year Published:2018
Web of Science® Times Cited:10
Deposited By:Pharmacy
Deposited On:2019-03-25
Last Modified:2019-08-26
Downloads:25 View Download Statistics

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