Frailty, polypharmacy and potentially inappropriate medications in older patients in hospital: A cross-sectional study
Frailty, polypharmacy and potentially inappropriate medications in older patients in hospital: A cross-sectional study
Introduction: Many older patients experience polypharmacy and risk taking potentially inappropriate medications (PIMs) leading to adverse events. Recent studies have demonstrated the association between frailty and an increase in PIMs among community-dwelling older people and those with cancer. We evaluated whether frailty in hospitalised older patients is associated with polypharmacy and PIMs.
Methods: A cross-sectional study of inpatients aged ≥70 years admitted to one UK hospital. Frailty was assessed using the Fried Frailty Phenotype and FRAIL Scale. Polypharmacy and hyper-polypharmacy were defined as the concomitant use of five + and 10 + medications, respectively. PIMs were identified using the Beers and STOPP criteria.
Results: 201 participants (median age 80.7 years; 120 (60%) men) were recruited. 1738 medications were prescribed in this cohort, median 9 medications/ patient. Frailty was identified in 56% and 36% using the Fried Frailty Phenotype and FRAIL scale, respectively. Polypharmacy (46%) and hyper-polypharmacy (41%) were also common. Frailty using both scales was significantly associated with polypharmacy (P< 0.001). The Beers’ criteria identified 90 PIMs in 57 (28%) patients. 33 (58%) received one and 24 (42%) received 2+ PIMs. 108 PIMs in 76 (38%) patients were identified using the STOPP criteria. 53 patients (70%) received one and 23 (30%) received 2+ PIMs. Both frailty tools were significantly associated with PIMs using the STOPP criteria but not using the Beers’ criteria.
Conclusion: Frailty in older inpatients was significantly associated with polypharmacy and PIMs using the STOPP criteria. Structured medication review is essential for older people in hospital.
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Howson, Fiona, Frances Anne
7058d707-80f8-4cf7-b270-497b18275ca0
2018
Ibrahim, Kinda
54f027ad-0599-4dd4-bdbf-b9307841a294
Roberts, Helen
5ea688b1-ef7a-4173-9da0-26290e18f253
Aihie Sayer, Avan
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Howson, Fiona, Frances Anne
7058d707-80f8-4cf7-b270-497b18275ca0
Ibrahim, Kinda, Roberts, Helen, Aihie Sayer, Avan and Howson, Fiona, Frances Anne
(2018)
Frailty, polypharmacy and potentially inappropriate medications in older patients in hospital: A cross-sectional study.
14th International Congress of the EuGMS: Advancing Geriatric Medicine in a Modern World, , Berlin, Germany.
10 - 12 Oct 2018.
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Conference or Workshop Item
(Paper)
Abstract
Introduction: Many older patients experience polypharmacy and risk taking potentially inappropriate medications (PIMs) leading to adverse events. Recent studies have demonstrated the association between frailty and an increase in PIMs among community-dwelling older people and those with cancer. We evaluated whether frailty in hospitalised older patients is associated with polypharmacy and PIMs.
Methods: A cross-sectional study of inpatients aged ≥70 years admitted to one UK hospital. Frailty was assessed using the Fried Frailty Phenotype and FRAIL Scale. Polypharmacy and hyper-polypharmacy were defined as the concomitant use of five + and 10 + medications, respectively. PIMs were identified using the Beers and STOPP criteria.
Results: 201 participants (median age 80.7 years; 120 (60%) men) were recruited. 1738 medications were prescribed in this cohort, median 9 medications/ patient. Frailty was identified in 56% and 36% using the Fried Frailty Phenotype and FRAIL scale, respectively. Polypharmacy (46%) and hyper-polypharmacy (41%) were also common. Frailty using both scales was significantly associated with polypharmacy (P< 0.001). The Beers’ criteria identified 90 PIMs in 57 (28%) patients. 33 (58%) received one and 24 (42%) received 2+ PIMs. 108 PIMs in 76 (38%) patients were identified using the STOPP criteria. 53 patients (70%) received one and 23 (30%) received 2+ PIMs. Both frailty tools were significantly associated with PIMs using the STOPP criteria but not using the Beers’ criteria.
Conclusion: Frailty in older inpatients was significantly associated with polypharmacy and PIMs using the STOPP criteria. Structured medication review is essential for older people in hospital.
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Published date: 2018
Venue - Dates:
14th International Congress of the EuGMS: Advancing Geriatric Medicine in a Modern World, , Berlin, Germany, 2018-10-10 - 2018-10-12
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Local EPrints ID: 425725
URI: http://eprints.soton.ac.uk/id/eprint/425725
PURE UUID: e2b27121-dd61-4fc8-b651-ccac9451d201
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Date deposited: 02 Nov 2018 17:30
Last modified: 23 Jul 2022 02:08
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Author:
Avan Aihie Sayer
Author:
Fiona, Frances Anne Howson
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