Korean J Clin Pharm.  2015 Dec;25(4):254-263. 10.0000/kjcp.2015.25.4.254.

Assessment of Potentially Inappropriate Medication Use in Korean Elderly Patients with Parkinson's Disease

• Seo MK
• Bae MK
• Lee IH
• Jeon S
• Yoon JH

• KMID: 2226419
• DOI: http://doi.org/10.0000/kjcp.2015.25.4.254

Abstract

OBJECTIVES
The present study assessed the prevalence of the potentially inappropriate medication (PIM) use in Korean elderly patients with Parkinson's disease. In addition, this study examined risk factors that affect PIM use. METHOD: A retrospective, observational study was conducted using Korean National Health Insurance claims database of 2009. PIM use in Parkinson's disease patients aged 65 years or older was examined based on 2012 Beers Criteria. Multivariable logistic regression was conducted to identify risk factors for PIM use.
RESULTS
Among 5,277 elderly patients with Parkinson's disease, 88.9% of patients used PIM(s) at least once. The average number of PIM items used per patient was 4.2. PIM use ratio, the proportion of total amount of PIMs to all medications per patient, was 12.6%. Frequently used PIM therapeutic classes were benzodiazepines (32.7%), first-generation antihistamines (19.2%), and prokinetics (17.5%). Individual PIMs most commonly used included chlorpheniramine (11.4%), levosulpiride (10.9%), diazepam (9.0%), and alprazolam (7.6%). Women (odds ratio [OR] 1.14, 95% confidence interval [CI] 1.11-1.16), medical aid (OR 1.18, 95% CI 1.15-1.21), and long-term facilities (OR 2.43, 95% CI 2.22-2.65) were shown to be risk factors associated with PIM use. Of particular, wide variation in PIM use was associated with the types of healthcare facility.
CONCLUSION
The PIM prevalence was very high in elderly Parkinson's disease patients. Nationally effective and systematic efforts to identify and prevent PIM use should be made to ensure patient safety and to improve quality of care in the elderly.

Keyword

Beers criteria; elderly; PIM; potentially inappropriate medication; Parkinson's disease

MeSH Terms

Aged*
Alprazolam
Beer
Benzodiazepines
Chlorpheniramine
Delivery of Health Care
Diazepam
Female
Histamine Antagonists
Humans
Logistic Models
National Health Programs
Observational Study
Parkinson Disease*
Patient Safety
Prevalence
Retrospective Studies
Risk Factors
Alprazolam
Benzodiazepines
Chlorpheniramine
Diazepam
Histamine Antagonists