Potentially Inappropriate Medications In Geriatric Hemodialysis Patients

Yıl 2023, Cilt: 6 Sayı: 3, 463 - 468, 01.07.2023

Kenan Evren Öztop , Mahmud İslam , Enes Zafer , Perihan Varım , Hamad Dheir

https://doi.org/10.19127/bshealthscience.1271905

Öz

Concerns about inappropriate drug use are increasing in geriatric patients. Potentially inappropriate medication (PIM) lists are being updated accordingly. The aim of this study is to determine the prevalence of PIM in elderly Turkish hemodialysis patients and to assess the association of patient’s characteristic as risk factors for PIMs in this population. Patients aged 65 years and over who were treated at two different hemodialysis centers were included in the study. Medical and sociodemographic information of the patients was obtained from patient’s files and medical records. Patients’ files and SGK-Online Medulla System were used to identify medications used by patients. PIMs were defined by using the modified Beers’ criteria independent of diagnosis and Beers’ Kidney-List. A total of 110 patients (mean age 73.31±6.4 years) were included in the study. 69 of the patients were male (62.7%) and 41 female (37.3%). Only 47.3% of the patients were independent in daily functioning. The average number of medications received by the patients was 7.3. When the charts in the patient files were examined, it was determined that 54.5% of all patients used PIM. However, when all prescribed drugs were scanned online from the Medulla-SGK system, it was found that inappropriate drugs were prescribed in 70.9% of the patients. A statistically significant relationship was found between the use of PIM and the total number of drugs used and the number of hospital admissions. The prevalence rate of PIM in elderly Turkish hemodialysis patients was higher. It is necessary to raise awareness of this in terms of reducing unwanted drug interactions and contributing economically.

Anahtar Kelimeler

Aging, Hemodialysis, Polypharmacy, Inappropriate prescriptions, Potentially Inappropriate medications

Kaynakça

• Battistella M, Jandoc R, Ng JY, McArthur E, Garg AX. 2018. A province-wide, cross-sectional study of demographics and medication use of patients in hemodialysis units across ontario. Canadian J Kidney Health Disease, 5: 1-10.
• Beers Criteria® Update Expert Panel. 2019. Potentially inappropriate medication use in older adults. J American Geriat Soc, 67(4): 674-694.
• Chahine B. 2020. Potentially inappropriate medications prescribing to elderly patients with advanced chronic kidney by using 2019 American Geriatrics Society Beers Criteria. Health Sci Rep, 3(4): e214.
• Charlson ME, Pompei P, Ales KL, MacKenzie CR. 1987. A new method of classifying prognostic comorbidity in longitudinal studies: development and validation. J Chronic Dis, 40(5): 373-383.
• Eyigör S, Kutsal Gökçe Y. 2012. Polypharmacy in the elderly: To prescribe or not prescribe “That is the Question”. Turkish J Geriat, 15(4): 445-454.
• Hajjar ER, Hanlon JT, Sloane RJ, Lindblad CI, Pieper CF, Ruby CM, Branch LC, Schmader KE. 2005. Unnecessary drug use in frail older people at hospital discharge. J Am Geriatr Soc, 53(9): 1518-1523.
• Helldén A, Bergman U, von Euler M, Hentschke M, Odar-Cederlöf I, Ohlén G. 2009. Adverse drug reactions and impaired renal function in elderly patients admitted to the emergency department: a retrospective study. Drugs Aging, 26(7): 595-606.
• Ilotto A, Franceschi M, Leandro G, Di Mario F. 2003. Geriatric gastroenterology study group (societè italiana gerontologie geriatria). NSAID and aspirin use by the elderly in general practice: effect on gastrointestinal symptoms and therapies. Drugs Aging, 20(9): 701-710.
• Jones SA, Bhandari S. 2013. The prevalence of potentially inappropriate medication prescribing in elderly patients with chronic kidney disease. Postgrad Med J, 89(1051): 247-250.
• Kaiser MJ, Bauer JM, Ramsch C, Uter W, Guigoz Y, Cederholm T, Thomas DR, Anthony P, Charlton KE, Maggio M, Tsai AC, Grathwohl D, Vellas B, Sieber CC, MNA-International Group. 2009. Validation of the mini nutritional assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutrit Health Aging, 13(9): 782-788.
• Kondo N, Nakamura F, Yamazaki S, Yamamoto Y, Akizawa T, Akiba T, Saito A, Kurokawa K, Fukuhara S. 2015. Prescription of potentially inappropriate medications to elderly hemodialysis patients: prevalence and predictors. Nephrol Dial Transplant, 30(3): 498-505.
• Maes ML, Fixen DR, Linnebur SA. 2017 Adverse effects of proton-pump inhibitor use in older adults: a review of the evidence. Ther Adv Drug Saf, 8(9): 273-297.
• Mahoney FI, Barthel DW. 1965. Functional evaluation: The Barthel Index. Md State Med J, 14: 61-65.
• Manley HJ, McClaran ML, Overbay DK, Wright MA, Reid GM, Bender WL, Neufeld TK, Hebbar S, Muther RS. 2003. Factors associated with medication-related problems in ambulatory hemodialysis patients. American journal of kidney diseases. Offic J National Kidney Found, 41(2): 386-393.
• Novaes PH, da Cruz DT, Lucchetti ALG, Leite ICG, Lucchetti G. 2017. Comparison of four criteria for potentially inappropriate medications in Brazilian community-dwelling older adults. Geriatr Gerontol Int, 17(10): 1628-1635.
• Parker K, Aasebø W, Stavem K. 2016. Potentially inappropriate medications in elderly haemodialysis patients using the STOPP criteria. Drugs Real World Outcomes, 3(3): 359-363.
• Pehlivanlı A, Selçuk A, Eyüpoğlu Ş, Ertürk Ş, Özçelikay AT. 2022. Potentially inappropriate medication use in older adults with chronic kidney disease. Turk J Pharm Sci, 19(3): 305-313.
• SGK. 2022. Duyurular: Bedeli ödenecek ilaçlar listesinde yapılan düzenlemeler hakkında duyuru. URL: https://www.sgk.gov.tr/Duyuru/Detay/Bedeli-Odenecek-Ilaclar-Listesinde-Yapilan-uzenlemeler-hakkinda-Duyuru-202223- (accessed date: September 06, 2022).
• St Peter WL. 2015. Management of polypharmacy in dialysis patients. Semin Dial, 28(4): 427-432.
• Vandraas KF, Spigset O, Mahic M, Slørdal L. 2010. Non-steroidal anti-inflammatory drugs: use and co-treatment with potentially interacting medications in the elderly. Eur J Clin Pharmacol, 66(8): 823-829.
• Weir MR, Fink JC. 2014. Safety of medical therapy in patients with chronic kidney disease and end-stage renal disease. Curr Opin Nephrol Hypertens, 23(3): 306-313.
• Wongrakpanich S, Wongrakpanich A, Melhado K, Rangaswami J. 2018. A comprehensive review of non-steroidal anti-inflammatory drug use in the elderly. Aging Dis, 9(1): 143-150.