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Association between Potentially Inappropriate Medication (PIM) Use and Risk of Hospitalization in Older Adults: An Observational Study Based on Routine Data Comparing PIM Use with Use of PIM Alternatives

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  • Heinz G Endres
  • Petra Kaufmann-Kolle
  • Valerie Steeb
  • Erik Bauer
  • Caroline Böttner
  • Petra Thürmann

Abstract

Objective: The safety of potentially inappropriate medications (PIMs) in elderly patients is still debated. Using the PRISCUS list, we examined the incident all-cause hospitalization risk associated with PIMs compared to PIM alternatives during the 180 days post individual first pharmacy dispensing (index date). Methods: Routine claims data from a German health insurer on 392,337 ambulatory patients aged ≥65 years, were used to estimate adjusted hazard ratios (HRs) for hospitalization associated with incident PIM use. Observation period was January 2009 –December 2010. Users of PIM alternatives, as defined by the PRISCUS list, were the reference group. Patients with PIM dispensing or hospital stay in a six month “washout” period (second half of 2008) were excluded. All potential confounders were determined in the half year before the individual index date. Results: In the total cohort 60.7% were female. Median age was 73 years. Of 79,041 incident PIM users, 58.4% had PIMs dispensed in one quarter of 2009 or 2010, 19.3% in two quarters, and 22.3% in three or more quarters. There were 126,535 hospitalizations during the observation period, and 47,470 of them occurred within 180 days post first dispensing. Multivariable Cox regression analysis revealed PIM use as a significant risk factor for hospitalization (HR 1.378; 95% CI 1.349–1.407) compared to use of PIM alternatives. Conclusions: PIM use compared to use of PIM alternatives is associated with an increased risk of all-cause hospitalization in the 180 days following individual index date. Future analyses comparing a single PIM with its corresponding alternative may help identify those PIMs responsible for this.

Suggested Citation

  • Heinz G Endres & Petra Kaufmann-Kolle & Valerie Steeb & Erik Bauer & Caroline Böttner & Petra Thürmann, 2016. "Association between Potentially Inappropriate Medication (PIM) Use and Risk of Hospitalization in Older Adults: An Observational Study Based on Routine Data Comparing PIM Use with Use of PIM Alternati," PLOS ONE, Public Library of Science, vol. 11(2), pages 1-15, February.
  • Handle: RePEc:plo:pone00:0146811
    DOI: 10.1371/journal.pone.0146811
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    1. Chirn-Bin Chang & Hsiu-Yun Lai & Shu-Yu Yang & Ru-Shu Wu & Hsing-Cheng Liu & Hsiu-Ying Hsu & Shinn-Jang Hwang & Ding-Cheng Chan, 2014. "Patient- and Clinic Visit-Related Factors Associated with Potentially Inappropriate Medication Use among Older Home Healthcare Service Recipients," PLOS ONE, Public Library of Science, vol. 9(4), pages 1-7, April.
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    Cited by:

    1. Dirk Heider & Herbert Matschinger & Andreas D Meid & Renate Quinzler & Jürgen-Bernhard Adler & Christian Günster & Walter E Haefeli & Hans-Helmut König, 2018. "The impact of potentially inappropriate medication on the development of health care costs and its moderation by the number of prescribed substances. Results of a retrospective matched cohort study," PLOS ONE, Public Library of Science, vol. 13(7), pages 1-12, July.
    2. Tobias Dreischulte & Linda Sanftenberg & Philipp Hennigs & Isabel Zöllinger & Rita Schwaiger & Caroline Floto & Maria Sebastiao & Thomas Kühlein & Dagmar Hindenburg & Ildikó Gagyor & Domenika Wildgrub, 2023. "Detecting Medication Risks among People in Need of Care: Performance of Six Instruments," IJERPH, MDPI, vol. 20(3), pages 1-15, January.

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