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Fu M, Li C, Zhao Z, Ling K, Gong Z, Li H, Li T, Li J, Cao W, Hu X, Shi L, Jin P, Guan X. Potentially inappropriate medications among older patients with Parkinson's disease: a cross-sectional analysis of a national health insurance database in China. BMC Geriatr 2023; 23:827. [PMID: 38066430 PMCID: PMC10709967 DOI: 10.1186/s12877-023-04547-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 11/30/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND With the rapid aging trend of China's population, the issue of drug rational use in older adults has become more and more prominent. Parkinson's disease (PD) is the one of the most common age-related neurodegenerative disorders. Pharmaceutical treatment plays a cardinal role in alleviating motor and non-motor symptoms to improve the quality of life of patients with PD. Patients with PD have complex medical needs yet little is known about the use of potentially inappropriate medications (PIM) among them in China. We quantify the prevalence of PIM use and identify its predictors among older persons with PD in China. METHODS We conducted a cross-sectional analysis using a national representative database of all medical insurance beneficiaries across China, extracting records of ambulatory visits of older adults with PD between 2015 and 2017. Beneficiaries aged 65 and above were eligible for inclusion. The prevalence of patients exposed to overall PIMs and PIMs related to motor and cognitive impairment was calculated based on Beers Criteria 2015 version. Potential predictors of PIM concerning patients' characteristics were estimated using multivariate logistic regression. RESULTS A total of 14,452 older adults with PD were included. In total, 8,356 (57.8%) patients received at least one PIM; 2,464 (17.1%) patients received at least one motor-impairing PIM and 6,201 (42.9%) patients received at least one cognition-impairing PIM. The prevalence of overall PIM use was higher in patients of older age group (54.7% [65-74] vs. 59.5% [75-84; OR, 1.22; 95% CI, 1.14-1.31] vs.65.5% [≥ 85; OR, 1.58; 95% CI, 1.38-1.80) and females (61.4% [female] vs. 55.0% [males; OR, 0.77; 95% CI, 0.72-0.82). CONCLUSIONS Prescribing PIMs for older adults with PD was common in China, especially for females and older age groups, yet younger patients were more inclined to be prescribed with motor or cognition-impaired PIMs. Our findings represent a clear target awaiting multidimensional efforts to promote the rational prescribing of medications for this vulnerable population.
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Affiliation(s)
- Mengyuan Fu
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China
| | - Can Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
| | - Zinan Zhao
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Kexin Ling
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
| | - Zhiwen Gong
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
| | - Huangqianyu Li
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China
| | - Ting Li
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Jianchun Li
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Weihang Cao
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Xin Hu
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China
- National Center of Gerontology, Beijing, People's Republic of China
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China
| | - Luwen Shi
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China
| | - Pengfei Jin
- Department of Pharmacy, Beijing Hospital), Beijing, People's Republic of China.
- National Center of Gerontology, Beijing, People's Republic of China.
- Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.
- Beijing Key Laboratory of Assessment of Clinical Drugs Risk and Individual Application, Beijing Hospital), Beijing, 100730, People's Republic of China.
| | - Xiaodong Guan
- Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, People's Republic of China.
- International Research Center for Medicinal Administration, Peking University, Beijing, People's Republic of China.
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