Alhubaishi Alaa A, Alkhaldi Shahad O, Abanumay Al-Jawhara K, Alzaidy Sadeem M, Alqahtani Abdulhadi M, Badawoud Amal M, Ali Abdulrahman S, Almoharb Haya F, Alsharekh Lolwa M, Alshehri Ghadah H
Department of Pharmacy Practice, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
PharmD Candidate, College of Pharmacy, Princess Nourah Bint Abdulrahman University, Riyadh, Saudi Arabia.
Int J Gen Med. 2024 Jun 17;17:2801-2808. doi: 10.2147/IJGM.S456091. eCollection 2024.
Dementia is a common neurogenerative disease among older adults. Therefore, they are more prone to potentially inappropriate medication (PIM), which is medication that causes more harm rather than protecting the health of an individual. Hence, the American Geriatrics Society (AGS) has recognized the risk of certain medication classes on this population and released PIM according to Beers criteria, which is a helpful guide for clinicians to ensure the safety of medication before it is prescribed. The aim of this study is to assess the prevalence of PIM use among older adults with dementia as a risk factor in comparison to other older adults without dementia.
A retrospective study was conducted in an outpatient setting in a tertiary hospital targeting elderly patients aged 65 years old or over from January 2020 to September 2022. A total of 598 patients were screened, and 270 patients met the inclusion criteria. The eligible patients were then divided into two groups: 168 were in a non-dementia group and 102 were in a dementia group.
PIM use was reported in patients with and without dementia. The most inappropriate medication that was prescribed comprised atypical antipsychotics PIM for both patients with and without dementia. However, the prevalence was higher in the dementia group for quetiapine (75% vs 24% respectively), olanzapine (82% vs 17% respectively) or risperidone (92% vs 7%, respectively). Anticholinergics were highly prescribed in older adult without dementia as compared to dementia patient and was statistically significant for solifenacin (96% vs.3.6% respectively) and amitriptyline (88% vs 11% respectively).
Among elderly patients in outpatient care settings, the prevalence of PIM use is considered high in dementia patients for antipsychotics, while a higher use of benzodiazepine and anticholinergics was found in non-dementia patients.
痴呆是老年人中常见的神经退行性疾病。因此，他们更容易出现潜在不适当用药（PIM），即对个体健康造成更多伤害而非保护作用的药物。因此，美国老年医学会（AGS）已认识到某些药物类别对该人群的风险，并根据Beers标准发布了PIM，这对临床医生在开药前确保用药安全是一个有用的指南。本研究的目的是评估与其他无痴呆的老年人相比，患有痴呆的老年人中PIM使用的患病率作为一个风险因素。
在一家三级医院的门诊环境中进行了一项回顾性研究，目标是2020年1月至2022年9月期间65岁及以上的老年患者。共筛查了598名患者，270名患者符合纳入标准。然后将符合条件的患者分为两组：168名在非痴呆组，102名在痴呆组。
痴呆患者和非痴呆患者均报告有PIM使用情况。所开的最不适当药物包括痴呆患者和非痴呆患者的非典型抗精神病药物PIM。然而，喹硫平（分别为75%和24%）、奥氮平（分别为82%和17%）或利培酮（分别为92%和7%）在痴呆组中的患病率更高。与痴呆患者相比，非痴呆老年人中抗胆碱能药物的处方率较高，索利那新（分别为96%和3.6%）和阿米替林（分别为88%和11%）具有统计学意义。
在门诊护理环境中的老年患者中，痴呆患者使用抗精神病药物的PIM患病率较高，而非痴呆患者中苯二氮䓬类药物和抗胆碱能药物的使用较多。
