Journal article
A Nationwide Emergency Department Data Analysis to Predict Beers List Medications Use Among Older Adults
The Journal of emergency medicine, Vol.66(6), pp.e704-e713
03/16/2024
DOI: 10.1016/j.jemermed.2024.03.002
PMID: 38734547
Abstract
The use of potentially inappropriate medications (PIMs) is considered an important quality indicator for older adults seen in the ambulatory care setting.
To evaluate the pattern of potentially inappropriate medication (PIMs) use as specified in the Beers Criteria, for older adults during emergency department (ED) visits in the United States.
Using data from the National Hospital Ambulatory Care Survey (NHAMCS) we identified older adults (age 65 or older) discharged home from an ED visit in 2019. We defined PIMs as those with an 'avoid' recommendation under the American Geriatrics Society (AGS) 2019 Beers Criteria in older adults. Logistic regression models were used to assess demographic, clinical, and hospital factors associated with the use of any PIMs upon ED discharge.
Overall, 5.9% of visits by older adults discharged from the ED included administration or prescriptions for PIMs. Among those who received any PIMs, 25.5% received benzodiazepines, 42.5 % received anticholinergics, 1.4% received nonbenzodiazepine hypnotics, and 0.5% received barbiturates. A multivariable model showed statistically significant associations for age 65 to 74 (OR 1.91, 95% CI 1.39-2.62 vs. age >=75), dementia (OR 0.45, 95% CI 0.21-0.95), lower immediacy (OR 2.45, 95% CI 1.56-3.84 vs. higher immediacy), and Northeastern rural region (OR 0.34, 95% CI 0.21-0.55 vs. Midwestern rural).
We found that younger age and lower immediacy were associated with increased prescriptions of PIMs for older adults seen, while dementia and Northeastern rural region was associated with reduced use of PIMs seen and discharged from EDs in United States.
Details
- Title: Subtitle
- A Nationwide Emergency Department Data Analysis to Predict Beers List Medications Use Among Older Adults
- Creators
- Sangil Lee - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Electronic address: sangil-lee@uiowa.eduGabrielle Frediani - Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, IowaBrian C Lund - Iowa City VA Health Care SystemKorey Kennelty - University of IowaMolly Moore Jeffery - Mayo Clinic in ArizonaRyan M Carnahan - University of Iowa
- Resource Type
- Journal article
- Publication Details
- The Journal of emergency medicine, Vol.66(6), pp.e704-e713
- DOI
- 10.1016/j.jemermed.2024.03.002
- PMID
- 38734547
- NLM abbreviation
- J Emerg Med
- ISSN
- 0736-4679
- eISSN
- 2352-5029
- Language
- English
- Electronic publication date
- 03/16/2024
- Academic Unit
- Epidemiology; Emergency Medicine; Family and Community Medicine; Nursing; Pharmacy Practice and Science; Injury Prevention Research Center
- Record Identifier
- 9984627153602771
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