Potentially inappropriate medication use in elderly patients treated in intensive care units: a cross-sectional study using 2019 Beers, STOPP/v2 Criteria and EU(7)-PIM List.

Demirer Aydemir, Ferhan; Oncu, Seyma; Yakar, Nuri M; Utkugun, Gokalp A; Gokmen, Necati; Comert, Bilgin; Ucku, Reyhan; Gelal, Ayse

OBJECTIVE To determine the prevalence of and the risk factors for Potentialy Inappropriate Medication (PIM), the drug groups most commonly evaluated as PIMs in elderly patients in the ICUs by using 2019 Beers Criteria, STOPP version 2(v2) Criteria and EU(7)-PIM List. The relation between mortality rate and length of ICU stay with PIMs was also examined. METHODS This was a cross sectional study conducted on patients aged ≥65 years, treated in ICUs (n=139) between June 8, 2020 and January 11, 2021. Patients' demographic characteristics, clinical data and laboratory findings about the drugs used were collected prospectively. PIMs were evaluated according to each of the criteria applied. Relationship of dependent and independent variables was evaluated using chi-square analysis, t-test and logistic regression analysis. P<0.05 was considered statistically significant. RESULTS The number of patients with at least 1 PIM according to three criteria was 118(84.9%) (80.6%, 59.7%, 48.2%, Beers, STOPP/v2 and EU(7)-PIM List, respectively). In the univariate analysis, receiving renal replacement therapy and high number of drugs were the covariates that significantly affected the presence of PIM according to all three criteria (p<0.05). Combined use of anxiolytics and opioids in Beers Criteria (58.3%), antipsychotics (26.6%) in STOPP/v2 Criteria, and antiarrhythmics (23.7%) in EU(7)-PIM List were the drugs that caused PIM at most. No relationship was found between the presence of PIM and mortality. Length of ICU stay was determined significantly longer in the presence of PIM according to Beers Criteria (p=0.028). CONCLUSIONS In this study, the prevalence of PIM was determined higher in elderly patients in ICU. Our results supported that 2019 Beers Criteria for ICU patients seems to be more directive in detecting PIMs and determining the prognosis. Reducing the number of drugs administered may be the first step to decrease PIMs in elderly patients in ICU and to maintain the treatment safely.