Abstract Submission for ESCP 2022 Symposium

Public Health

ESCP22SY-1461
COMPARATIVE RESULTS ON POTENTIALLY INAPPROPRIATE MEDICATION (PIM) USE IN CZECH OLDER
PEOPLE IN ACUTE, AMBULATORY CARE AND COMMUNITY PHARMACY PRACTICES: RESULTS FROM THE
INOMED AND THE EUROAGEISM ESR7 PROJECT
Jovana Brkic* 1, Ingrid Kummer1, Olena Antonenko1, Areman Bhagya Sri1, Deepak Kumar Bandari 1, Gabriela Vaculova 1,
Silvia Gresakova1, Akshaya Srikanth Bhagavathula1, Jindra Reissigova2, Daniela Fialova1, 3
1Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Kralove, Charles University, Hradec

Kralove, 2Department of Statistical Modelling, Institute of Computer Science, Czech Academy of Sciences, 3Department
of Geriatrics and Gerontology, 1st Faculty of Medicine, Charles University, Prague, Czech Republic

Is this work original?: Yes

Please specify your abstract type: Research abstract
Background and Objective: Potentially inappropriate medication (PIM) use in older patients has been shown to be highly
prevalent, but the prevalences widely differ between different settings of care. However, the situation with the prescribing
of these medications improves with the implementation of clinical pharmacy services in various settings of care. Thus, the
aim of our study was to compare the prevalence of PIM use in different settings of care in the Czech Republic. This
abstract presents only preliminary findings.
Method: We conducted a national study in 3 settings of care − acute care, ambulatory care, and pharmacy practices. In
each setting of care, 3 bigger facilities from 3 different regions were selected (minimum of 150 patients per facility). All
older patients aged 65+ were assessed in the period 2018-2020 using the EuroAgeism H2020 ESR7 study protocol
based on comprehensive geriatric assessment (CGA). This protocol includes more than 350 patient characteristics −
socio-demographic, clinical assessments, medical history, selected laboratory values and information on medication use.
As a source of data, medical records, interviews with patients and/or their caregivers and interviews with healthcare
professionals were used, along with clinical assessments. We used descriptive statistics for determining the prevalence
of PIM use according to a combination of 3 explicit criteria developed for the European region and applicable to various
settings of care (Laroche's list, EU(7)-PIM list and PRISCUS list). Stepwise logistic regression was applied to determine
the factors related to the PIM prescribing. R-software version 4.1.1 was used for data analyses.
Main outcome measures: The main outcome measure was the prevalence of PIM use.
Results: Our sample consisted of 1602 patients (589 from acute care, 563 from ambulatory care and 450 from
community pharmacy practices). The majority of participants were females (56.5%). The prevalence of PIM use was
68.7% in the total sample, in acute care 86.8%, in ambulatory care 74.1%, and in community pharmacy practices 38.4%.
The odds of being prescribed PIM were higher in patients aged 75 years and older (OR=1.6; 95%CI(1.2-2.1)), using
polypharmacy (5+ medications) 8.3 (6.2-11.2), and having depression 1.7 (1.1-2.6), but lower for pharmacy practice
setting 0.4 (0.3-0.5) and ambulatory care setting 0.6 (0.4-0.8).
Conclusion: PIM prescribing in the Czech Republic was very high (around 70%), particularly in acute care and
ambulatory care and predominant in high-risk older patients. Thus, interventions to reduce the very frequent prescribing
of PIMs to older people are still needed, particularly in these care settings. Implementing PIM assessment and
management tools might considerably reduce the burden of exposure of older people to the simultaneous risk of
polypharmacy and PIM use.
References: The research group was supported by projects: Inomed NO.CZ.02.1.01/0.0/0.0/18_069/0010046,
EuroAgeism Horizon 2020 MSCF-ITN-764632, Cooperatio research program KSKFI.- Faculty of Pharmacy, Charles
University, START/MED/093 CZ.02.2.69/0.0/0.0/19_073/0016935, SVV260 551 and I-CARE4OLD H2020 -
965341 projects.
 

Disclosure of Interest: None Declared