Assessment of Potentially Inappropriate Medications Using the EU (7)-PIM List, in a Sample of Portuguese Older Adults’ Residents in Nursing Homes

Ana Isabel Plácido,1 Ana Aguiar,1 María Piñeiro-Lamas,2,3 Fabiana Varallo,4 Adolfo Figueiras,2,3,5 Maria Teresa Herdeiro,6 Fátima Roque1,7 1Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Guarda, Portugal; 2Consortium for Biomedical Research in Epidemiology and Public Health (CIBER en Epidemiología y Salud Pública-CIBERESP), Madrid, Spain; 3Institute of Health Research of Santiago de Compostela (IDIS), Santiago de Compostela, Spain; 4Department of Pharmaceutical Sciences, School of Pharmaceutical Sciences of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil; 5Department of Preventive Medicine and Public Health, Faculty of Medicine, University of Santiago de Compostela, Santiago de Compostela, Spain; 6Institute of Biomedicine (iBiMED-UA), Department of Medical Sciences, University of Aveiro, Aveiro, 3810-193, Portugal; 7Health Sciences Research Centre, University of Beira Interior (CICS-UBI) Covilhã, Covilhã, PortugalCorrespondence: Fátima Roque, Research Unit for Inland Development, Polytechnic of Guarda (UDI-IPG), Avenida Dr. Francisco Sá Carneiro, no. 50, Guarda, 6300-559, Portugal, Tel +35 1-271205220, Email froque@ipg.ptAbstract: Prescription of potentially inappropriate medication (PIM) in older adults is associated with poor clinical outcomes. The EU (7)-PIM list was created for the European market to improve pharmacotherapy in older adults.Purpose: This work aims to characterize the medication profile and assess the presence of PIM, using the EU (7)-PIM list in older adults’ residents at nursing homes.Methods: Retrospective data were collected from the anonymized nursing home records. After PIM identification, a descriptive analysis was performed, and a generalized linear model for dependent negative binomial-type variables was constructed to assess the risk of PIM.Results: Of the 210 participants (mean age 85.10), 82.40% were polymedicated. PIM was observed in 86.4% participants (mean per patient = 2.30± 0.10). The most common PIM were proton pump inhibitors (n = 121, 57.62%), followed by anxiolytics (n = 96, 45.71%). 64.30% of all patients take 2– 4 PIM and 5.80% take five or more PIM. The occurrence of PIM is influenced by the number of prescribed medicines (RR 1.14; 95% CI 1.1.-1.17) and the presence of digestive system diseases (RR 1.05; 95% CI 1.0– 1.09).Conclusion: The high prevalence of PIM observations highlights the necessity of the implementation of guidelines to prevent PIM.Keywords: elderly, institutionalized older adults, medication profile, prescription