University of Newcastle, University Drive, Callaghan, NSW, 2308, Australia.
International Medical University, 126 Jalan Jalil Perkasa 19, Bukit Jalil, 57000, Kuala Lumpur, Malaysia.
Aging Clin Exp Res. 2021 Sep;33(9):2499-2509. doi: 10.1007/s40520-020-01772-0. Epub 2021 Jan 15.
Frailty is an essential consideration with potentially inappropriate medications (PIMs), especially among older women.
This study determined the use of potentially inappropriate medications according to frailty status using the Beers Criteria 2019, identified medications that should be flagged as potentially inappropriate and harmful depending on individual health factors, and determined the association between frailty and PIMs, adjusted for characteristics associated with PIMs.
This prospective longitudinal study included 9355 participants aged 77-82 years at baseline (2003). Frailty was measured using the FRAIL (fatigue, resistance, ambulation, illness and loss of weight) scale. Generalised estimating equations using log-binomial regressions determined the association between frailty and risk of using PIMs.
Among participants who were frail and non-frail at baseline, the majority used ≥ 3 PIMs (74.2% and 58.5%, respectively). At 2017, the proportion using ≥ 3 PIMs remained constant in the frail group (72.0%) but increased in the non-frail group (66.0%). Commonly prescribed medications that may be potentially inappropriate in both groups included benzodiazepines, proton-pump inhibitors and non-steroidal anti-inflammatory drugs, and risperidone was an additional contributor in the non-frail group. When adjusted for other characteristics, frail women had a 2% higher risk of using PIMs (RR 1.02; 95% CI 1.01, 1.03).
Given that the majority of frail women were using medications that may have been potentially inappropriate, it is important to consider both frailty and PIMs as indicators of health outcomes, and to review the need for PIMs for women aged 77-96 years who are frail.
衰弱是潜在不适当药物（PIMs）的一个重要考虑因素，尤其是在老年女性中。
本研究使用 2019 年 Beers 标准确定了根据虚弱状态使用潜在不适当药物的情况，确定了应根据个体健康因素将哪些药物标记为潜在不适当和有害的药物，并确定了虚弱与 PIMs 之间的关联，同时调整了与 PIMs 相关的特征。
这项前瞻性纵向研究纳入了 9355 名基线年龄为 77-82 岁的参与者（2003 年）。使用 FRAIL（疲劳、抵抗力、活动能力、疾病和体重减轻）量表测量衰弱程度。使用广义估计方程对数二项式回归确定了虚弱与使用 PIMs 风险之间的关联。
在基线时虚弱和非虚弱的参与者中，大多数人使用了≥3 种 PIMs（分别为 74.2%和 58.5%）。到 2017 年，虚弱组使用≥3 种 PIMs 的比例保持不变（72.0%），但非虚弱组的比例增加（66.0%）。在两组中，常用的可能不适当的药物包括苯二氮䓬类、质子泵抑制剂和非甾体抗炎药，而在非虚弱组中，利培酮是另一种潜在不适当的药物。在调整了其他特征后，虚弱的女性使用 PIMs 的风险增加了 2%（RR 1.02；95%CI 1.01，1.03）。
鉴于大多数虚弱的女性都在使用可能不适当的药物，因此考虑虚弱和 PIMs 作为健康结果的指标非常重要，并考虑为 77-96 岁虚弱的女性审查 PIMs 的需求。
