Association Between Inappropriate Prescribing According to the 2023 Beers Criteria and Different Health Outcomes: A 1-Year Longitudinal Study in Community-Dwelling Older Adults.

INTRODUCTION

This study aimed to investigate the association between the 2023 Beers criteria for inappropriate prescribing and different health outcomes among community-dwelling older individuals after a 1-year follow-up period and to assess the use and factors associated with inappropriate prescribing.

METHODS

This longitudinal population study spanning from 2017 to 2018 included 490 community-dwelling older adults (≥60 years old) receiving care from family medicine teams in the city of São João del-Rei, Brazil. The 2023 Beers criteria was used to identify potentially inappropriate medications (PIMs). Community health workers carried out interviews assessing different health outcomes, such as cognition, sleep, mental health, quality of life, successful aging, and life satisfaction. Generalized estimating equations were used to evaluate whether the presence of PIMs was longitudinally associated with diverse outcomes following the 1-year follow-up period.

RESULTS

A total of 255 (52%) of the participants used at least one PIM. The most common PIMs were benzodiazepines (36.5-38.3%), followed by proton pump inhibitors (16.2-18.4%) and sulfonylureas (9.8-10.6%). Some sociodemographic factors (e.g., marital status and race) and clinical factors (e.g., difficulties in activities of daily living and the number of diseases) were associated with the presence and/or number of PIMs at baseline. In the longitudinal analysis, the presence of PIMs exhibited associations with a spectrum of outcomes observed after a 1-year follow-up period. These outcomes included diminished physical quality of life (B = -0.21; p = 0.030), disrupted sleep patterns (B = 1.14; p < 0.001), compromised mental health-depression (B = 1.04; p = 0.041), stress (B = 2.00; p = 0.001), and anxiety (B = 1.26; p = 0.004), successful aging (B = -1.92; p = 0.033), and satisfaction with life (B = -0.77; p = 0.013).

CONCLUSION

The use of at least one PIM, according to the 2023 Beers criteria, was high and associated with worse health outcomes. This underscores the imperative for healthcare professionals to exercise caution when prescribing medications to older patients.