Potentially Inappropriate Prescriptions and Hospital Outcome among Geriatric Patients

Background and aims. High risk medications use is common at hospitals and poses a major risk for frail older adults. The study aims to determine the association between Potentially Inappropriate Prescriptions (PIPs) and hospital outcome among geriatric patients. Methods. A retrospective cohort study including 152 older adults (age >= 60 years). These patients were admitted to the intensive care unit (ICU) at Geriatrics hospital from August 1(st), 2021 to January 1st, 2022. Age, sex, clinical data and medications used throughout admission were extracted for each patient. The target outcome was in-hospital mortality. PIPs were identified in accordance with Screening Tool of Older Persons' potentially inappropriate Prescriptions version 2 (STOPP v. 2). Logistic regression analysis was done to test the association between use of PIPs and in-hospital mortality. Descriptive statistics was performed for PIPs and medications use near the end of life. Results. PIPs occurred in 67.8% (103 patients) of participants. Multivariate regression analysis revealed independent predictors of mortality including older age (OR = 1.075; 95% CI: 1.020-1.134; P.007), delirium/ altered mental status on admission (OR = 2.688; 95% CI: 1.086-6.651; P.032), and utilizing of >= 3 PIPs (OR = 4.049; 95% CI: 1.320-12.421; P.014). Use of anticholinergics in patients with delirium or dementia was the most frequently reported PIPs among participants. Conclusions. PIPs are common and significantly associated with mortality among hospitalized older adults. The study provides an overview for high risk medications and recommends a structured medication reviews and de-prescribing practice for frail older adults.