PMID- 30290768 OWN - NLM STAT- MEDLINE DCOM- 20190715 LR - 20221207 IS - 1471-2318 (Electronic) IS - 1471-2318 (Linking) VI - 18 IP - 1 DP - 2018 Oct 5 TI - Potentially inappropriate medication use among hypertensive older African-American adults. PG - 238 LID - 10.1186/s12877-018-0926-9 [doi] LID - 238 AB - BACKGROUND: Inappropriate use of medications, particularly among minority older adults with co-morbidity, remains a major public health concern. The American Geriatrics Society (AGS) reports that Potentially Inappropriate Medication (PIM) continues to be prescribed for older adults, despite evidence of poor outcomes. The main objective of this study was to examine the prevalence of PIM use among underserved non-institutionalized hypertensive older African-American adults. Furthermore, this study examines potential correlations between PIM use and the number and type of chronic conditions. METHODS: This cross-sectional study is comprised of a convenience sample of 193 hypertensive non-institutionalized African-American adults, aged 65 years and older recruited from several senior housing units located in underserved areas of South Los Angeles. The updated 2015 AGS Beers Criteria was used to identify participants using PIMs. RESULTS: Almost one out of two participants had inappropriate medication use. While the average number of PIMs taken was 0.87 drugs, the range was from one to seven medications. Almost 23% of PIMs were due to drugs with potential drug-drug interactions. The most common PIM was the use of proton pump inhibitors (PPI) and Central Nervous System (CNS) active agents. Nearly 56% of PIMs potentially increased the risk of falls and fall-associated bone fractures. The use of PIMs was significantly higher among participants who reported a higher number of chronic conditions. Nearly 70% of participants with PIM use reported suffering from chronic pain. CONCLUSIONS: The major reason for high levels of polypharmacy, PIMs, and drug interactions is that patients suffer from multiple chronic conditions. But it may not be possible or necessary to treat all chronic conditions. Therefore, the goals of care should be explicitly reviewed with the patient in order to determine which of the many chronic conditions has the greatest impact on the life goals and/or functional priorities of the patient. Those drugs that have a limited impact on the patient's functional priorities and that may cause harmful drug-drug interactions can be reduced or eliminated, while the remaining medications can focus on the most important functional priorities of the patient. FAU - Bazargan, Mohsen AU - Bazargan M AD - Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90005, USA. mobazarg@cdrewu.edu. AD - University of California, Los Angeles, USA. mobazarg@cdrewu.edu. FAU - Smith, James L AU - Smith JL AD - Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90005, USA. FAU - King, Ebony O AU - King EO AD - Charles R. Drew University of Medicine and Science, 1731 East 120th Street, Los Angeles, CA, 90005, USA. AD - University of California, Los Angeles, USA. LA - eng GR - R25 MD007610/MD/NIMHD NIH HHS/United States GR - U54 MD007598/MD/NIMHD NIH HHS/United States GR - U54MD007598/MD/NIMHD NIH HHS/United States PT - Case Reports PT - Journal Article PT - Observational Study PT - Research Support, N.I.H., Extramural PT - Research Support, U.S. Gov't, Non-P.H.S. DEP - 20181005 PL - England TA - BMC Geriatr JT - BMC geriatrics JID - 100968548 RN - 0 (Antihypertensive Agents) SB - IM MH - *Black or African American MH - Aged MH - Aged, 80 and over MH - Antihypertensive Agents/*adverse effects/metabolism MH - Chronic Disease MH - Comorbidity MH - Cross-Sectional Studies MH - Drug Interactions/*physiology MH - Female MH - Humans MH - Hypertension/*drug therapy/epidemiology/metabolism MH - Inappropriate Prescribing/prevention & control/*trends MH - Male MH - Polypharmacy MH - Potentially Inappropriate Medication List/*trends MH - Prevalence PMC - PMC6173851 OTO - NOTNLM OT - Falls OT - Minority OT - Older adults OT - Pain OT - Potentially inappropriate medication (PIM) COIS- ETHICS APPROVAL AND CONSENT TO PARTICIPATE: The Charles R. Drew University of Medicine and Science Institutional Review Board approved this study (IRB #14-12-2450). Written informed consent was obtained from all participants. This study did not examine medical files of any individuals who participated in this study. All data collected from 193 participants were self-reports. In addition, participants' medication was documented from medication containers. However, participants signed an individual consent permitting the data collected from their survey to be published without compromising their identity. CONSENT FOR PUBLICATION: The written informed consent for this study was completed according to the established roles and guidelines that were approved by the Institutional Review Board prior to study initiation. Written consent was obtained from all participants. In addition, written and signed consent was obtained from participants described in case studies for publicizing their individual information. COMPETING INTERESTS: The authors declare that they have no competing interests. PUBLISHER'S NOTE: Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. EDAT- 2018/10/07 06:00 MHDA- 2019/07/16 06:00 PMCR- 2018/10/05 CRDT- 2018/10/07 06:00 PHST- 2017/12/20 00:00 [received] PHST- 2018/09/23 00:00 [accepted] PHST- 2018/10/07 06:00 [entrez] PHST- 2018/10/07 06:00 [pubmed] PHST- 2019/07/16 06:00 [medline] PHST- 2018/10/05 00:00 [pmc-release] AID - 10.1186/s12877-018-0926-9 [pii] AID - 926 [pii] AID - 10.1186/s12877-018-0926-9 [doi] PST - epublish SO - BMC Geriatr. 2018 Oct 5;18(1):238. doi: 10.1186/s12877-018-0926-9.