OBJECTIVE:

The data on the prevalence of potentially inappropriate medications (PIMs) use and their predictors among elderly systemic autoimmune disorders is still unknown. Hence, we aimed to determine the prevalence and predictors of potentially inappropriate medication (PIM) use among elderly patients with systemic autoimmune disorders.

METHODS: Patients who were admitted or visited the department of rheumatology in a tertiary care teaching hospital between July 2019 and April 2021 were included in this study. Patients of any gender, aged above 60 years, diagnosed with a systemic autoimmune disorder (rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis and psoriasis) were included in this study upon their consent. A clinical pharmacist reviewed medications details to evaluate PIM used according to the American Geriatric Society 2019 Beers criteria (BC). The descriptive data were presented in frequency and percentage. Multivariate logistic regression analysis was used to identify predictors associated with PIM use. The statistical data were analysed using SPSS version 25.

RESULTS:

A total of 123 elderly patients’ medication details were reviewed during the study period. Of them, 78 (63.4%) patients were found with at least one PIM use. A total of 192 PIMs use were identified with an average of 2.46 PIM use per patient. Most of the identified PIMs use were related to older adults (n=90/192, 46%), followed by drug-disease or drug-syndrome interactions (n=39/192, 20.3%) and with caution use in older adults (n=11/192, 11.4%). Overall, the majority of PIMs had moderate 153/192 (79.5%), followed by high 35/192 (18.2%) and low 4/192 (2.0%) quality of evidence. The increased number of medication use ≥10 drugs (OR 5.36, 95% Confidence Interval: 2.40-8.72, P<000.1) was identified as a major predictor to develop PIM.

CONCLUSION: This study revealed that PIM use was common (63.4%) among elderly patients with systemic autoimmune disorders and required close monitoring to avoid further complications.