PMID- 20059286
OWN - NLM
STAT- MEDLINE
DCOM- 20100511
LR  - 20220420
IS  - 1936-2692 (Electronic)
IS  - 1088-0224 (Linking)
VI  - 16
IP  - 1
DP  - 2010 Jan 1
TI  - Clinical and economic outcomes associated with potentially inappropriate 
      prescribing in the elderly.
PG  - e1-10
AB  - OBJECTIVE: To evaluate the risk of adverse events (AEs) and the healthcare costs 
      for elderly patients receiving specific potentially inappropriate medications 
      (PIMs). STUDY DESIGN: Retrospective cohort study. METHODS: Patients 65 years and 
      older who started 1 of 23 PIMs were matched with control subjects who were not 
      receiving PIMs. The following 4 AEs and PIMs were evaluated: delirium or 
      hallucinations with Beers high-severity (BHS) anticholinergics, delirium or 
      hallucinations with BHS narcotics (meperidine hydrochloride or pentazocine 
      lactate or pentazocine hydrochloride), extrapyramidal effects with 
      trimethobenzamide hydrochloride, and falls or fractures with BHS sedative 
      hypnotics. The risk of having the AE of interest within 360 days and the annual 
      healthcare costs were examined. RESULTS: Patients receiving BHS sedative 
      hypnotics were significantly more likely to have a fall or fracture than controls 
      (hazard ratio, 1.22; 95% confidence interval [CI], 1.10-1.35). Patients receiving 
      BHS anticholinergics did not have higher risk of delirium or hallucinations than 
      controls (hazard ratio, 1.03; 95% CI, 0.91-1.16). Delirium or hallucinations 
      occurred at a higher rate among patients receiving BHS narcotics, and 
      extrapyramidal effects occurred at a higher rate among patients receiving 
      trimethobenzamide; however, too few events occurred to assess statistical 
      significance. For all PIMs evaluated, annual adjusted medical and total 
      healthcare costs were significantly higher for patients exposed to PIMs than for 
      controls. CONCLUSION: The use of certain BHS PIMs in the elderly may increase AEs 
      or healthcare costs.
FAU - Stockl, Karen M
AU  - Stockl KM
AD  - Prescription Solutions, 2300 Main St, MS CA 134-0404, Irvine, CA 92614, USA. 
      karen.stockl@prescriptionsolutions.com
FAU - Le, Lisa
AU  - Le L
FAU - Zhang, Shaoang
AU  - Zhang S
FAU - Harada, Ann S
AU  - Harada AS
LA  - eng
PT  - Journal Article
DEP - 20100101
PL  - United States
TA  - Am J Manag Care
JT  - The American journal of managed care
JID - 9613960
MH  - Age Factors
MH  - Aged
MH  - Delirium/*chemically induced
MH  - Female
MH  - Hallucinations/*chemically induced
MH  - Humans
MH  - Insurance Claim Review
MH  - Male
MH  - Medication Errors/adverse effects/economics/*statistics & numerical data
MH  - Prescriptions/economics/*statistics & numerical data
MH  - Retrospective Studies
MH  - United States
EDAT- 2010/01/12 06:00
MHDA- 2010/05/12 06:00
CRDT- 2010/01/12 06:00
PHST- 2010/01/12 06:00 [entrez]
PHST- 2010/01/12 06:00 [pubmed]
PHST- 2010/05/12 06:00 [medline]
AID - 12554 [pii]
PST - epublish
SO  - Am J Manag Care. 2010 Jan 1;16(1):e1-10.