• J Emerg Med · Jun 2024

    A Nationwide Emergency Department Data Analysis to Predict Beers List Medications Use Among Older Adults.

    • Sangil Lee, Gabrielle Frediani, Brian C Lund, Korey Kennelty, Molly Moore Jeffery, and Ryan M Carnahan.
    • Department of Emergency Medicine, University of Iowa Carver College of Medicine, Iowa City, Iowa. Electronic address: sangil-lee@uiowa.edu.
    • J Emerg Med. 2024 Jun 1; 66 (6): e704e713e704-e713.

    BackgroundThe use of potentially inappropriate medications (PIMs) is considered an important quality indicator for older adults seen in the ambulatory care setting.Study ObjectivesTo 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.MethodsUsing 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.ResultsOverall, 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).ConclusionWe 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.Copyright © 2024 Elsevier Inc. All rights reserved.

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