Potentially Inappropriate Medications in Hospitalized Older Patients in Tabuk, Saudi Arabia Using 2023 Beers Criteria: A Retrospective Multi-Centric Study

Figures & data

Table 1 Characteristics of the Study Population

Variables	Male n (%)	Female n (%)	Total n (%)
	202 (48.1)	218 (51.9)	420 (100)
Age distribution (years)
Mean age ± SD	75.52 ± 8.70
65–74	102 (50.5)	112 (51.38)	214 (50.95)
75–84	64 (31.68)	68 (31.19)	132 (31.43)
≥ 85	36 (17.82)	38 (17.43)	74 (17.62)
Comorbidities
Hypertension	136 (67.33)	168 (77.06)	304 (72.38)
Diabetes mellitus	104 (51.49)	104 (47.71)	208 (49.52)
Ischemic Heart Disease	58 (28.71)	58 (26.61)	116 (27.62)
Atrial fibrillation	8 (3.96)	24 (11.01)	32 (7.62)
Chronic Obstructive Pulmonary Disease	12 (5.94)	16 (7.34)	28 (6.67)
Congestive Cardiac Failure	6 (2.97)	14 (6.42)	20 (4.76)
Stroke / Transient Ischemic Attack	8 (3.96)	10 (4.59)	18 (4.29)
Osteoporosis	2 (0.99)	4 (1.83)	6 (1.43)
Peptic Ulcer Disease	0 (0%)	4 (1.83)	4 (0.95)

Table 2 Distribution of PIMs as per Patient Characteristics

Variables	Total no. of Participants n = 420	Participants with PIMs n = 342
Age distribution (years)	n (%)	n (%)
65–74	214 (50.95)	166 (77.57)
75–84	132 (31.43)	114 (86.36)
≥ 85	74 (17.62)	62 (83.78)
Gender
Male	202 (48.1)	164 (81.19)
Female	218 (51.9)	178 (81.65)
Number of diseases
1–2	252 (60)	194 (76.98)
3–4	140 (33.33)	122 (87.14)
≥ 5	28 (6.67)	26 (92.86)
Number of medications
5–9	326 (77.62)	248 (76.07)
≥ 10	94 (22.38)	94 (100)

Table 3 Categorization of PIMS

Category of PIMS	Medications	n = 716 Number (%)
Medications considered as potentially inappropriate	Antihistamines	20 (3.98)
	Aspirin	138 (27.49)
	Amiodarone	6 (1.2)
	Digoxin	8 (1.59)
	Barbiturates	4 (0.8)
	Insulin	6 (1.2)
	Sulfonylureas	18 (3.59)
	Proton Pump Inhibitors	266 (52.99)
	Metoclopramide	6 (1.2)
	Nonsteroidal anti-inflammatory drugs	30 (5.98)
	(NSAIDs)	Total: 502 (70.11)
Medications to be used with caution	Diuretics	128 (91.43)
	Tramadol	6 (4.29)
	Carbamazepine	6 (4.29)
		Total: 140 (19.55)
Potentially inappropriate drug–drug interactions	Alpha-1 blockers + Loop diuretics	8 (80)
	Corticosteroids + NSAIDs	2 (20)
		Total: 10 (1.4)
Medications whose dosages should be adjusted based on renal function	Ciprofloxacin	22 (34.38)
	Enoxaparin	18 (28.13)
	Spironolactone	12 (18.75)
	Baclofen	2 (3.13)
	Levetiracetam	2 (3.13)
	NSAIDs	8 (12.5)
		Total: 64 (8.94)

Figure 1 Proportion of older patients receiving PIMS.

Figure 2 Commonly prescribed PIMs.

Table 4 Logistic Regression Analysis Among Explanatory Variables and PIMs

Variables	B	S.E.	Sig.	Exp(B)	95% CI for Exp(B)
					Lower	Upper
Age	0.045	0.017	0.008*	1.046	1.012	1.082
Gender	0.070	0.283	0.804	1.073	0.616	1.869
Comorbidities	0.044	0.133	0.743	1.045	0.805	1.356
Medications	0.991	0.180	<0.001*	2.693	1.891	3.835

Note: *p<0.05, statistically significant.

Abbreviation: CI, Confidence interval.