Potentially inappropriate medicine use is common among older adults
Background
In the context of this article, potentially inappropriate medicines (PIMs) are defined as medicines whose potential harms outweigh their benefits in older adults. The purpose of the research was to investigate the prevalence of PIM use and changes over a fourteen-year period (years 2000−2013) among Finnish community-dwelling elderly. In addition, our aim was to investigate which factors are associated with PIM use.
Methods
A 10% random sample of people aged ≥ 65 years (n = 64,250) was gathered from the nationwide Prescription Register of the Social Insurance Institution (SII) in Finland from 2000 to 2013. The data was linked to the registers of Statistics Finland (causes of death and socioeconomic information). PIMs were defined according to the criteria of the Meds75+ database maintained by the Finnish Medicines Agency. Crosstabulation and a chi-square test were used as statistical methods.
Results
In the year 2000 there were 43% PIM users in the study population. In the year 2013, there were 18% PIM users in the same population group. PIM use was associated with female gender, lower socioeconomic position and higher morbidity, as PIM users were more likely to engage in polypharmacy and used more cardiovascular medicines, diabetes medicines and psychopharmaceuticals. However, use of PIMs decreased during the follow-up, especially among persons with excessive polypharmacy.
Conclusions
There were a remarkable number of PIM users (over 40%) among the elderly in 2000, but the number of PIM users decreased from the year 2000 onwards within the research population. Nevertheless, use of potentially inappropriate medicines remains very common. There is a need to raise awareness of PIMs and to develop new tools in clinical practice, in order to promote safe pharmacotherapy.