Just 10 days ago, I wrote about a link between inappropriate medication use and hospitalizations. One of the issues that I wanted to point out was just how do we define inappropriate? After all, what's inappropriate for one person might be appropriate for someone else. More importantly, what's inappropriate for one person at a particular point in time might be appropriate later on (or previously).
Coincidentally, I just stumbled upon yet
another study (published 8d ago) looking at inappropriate medication use among community dwelling elderly. More specifically, the authors analyzed the results of 19 retrospective studies using various iterations of Beers criteria (1991, 1997 & 2002), Zhan's derivation of Beers, HEDIS subset of Zhan, and other measures. Depending upon the measure applied, the prevalence of inappropriate medication use ranged from 11.5% to 62.5%. In other words, at least 1 in 10 community dwelling elderly had an unsafe (combination of) medication(s) in their regimen. And depending upon the criteria used, as many as 2 in 3 community dwelling elderly were at risk.
Of course, just as with other studies, we're more interested in patient oriented evidence that matters (POEMs), those studies that look into clinical outcomes. We're less interested in disease oriented evidence (DOE) that looks into the disease process. In this study, it appears that the authors were more focused on the latter since there was no assessment on the clinical impact of inappropriate medication use, such as emergency room visits, drug-drug interactions, and/or drug-disease interactions.
Nevertheless, the take home point is that clinicians need to be more aware of the medications that they (and their colleagues) prescribe. And you & I need to chat w/our parents and older family members and ask about what medications they're keeping in their medicine cabinet. Great way to strike up a conversation around the holiday dinner table!
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