title: Prescription of potentially inappropriate medication in Korean older adults based on 2012 Beers Criteria: a cross-sectional population based study.
abstract: A high number of elderly people with multiple comorbidities are exposed to the risk of polypharmacy and prescription of potentially inappropriate medication (PIM). The purpose of this study was to determine the prevalence and patterns of PIM prescription in Korean older adults according to the 2012 Beers Criteria.
  
  
  
  A retrospective study was conducted using data from the Korean Health Insurance Review and Assessment (KHIRA) database of outpatient prescription claims collected from January 1, 2009 to December 31, 2011. A total of 523,811 elderly subjects aged 65 years and older were included in the study, and several covariates related to the prescription of PIMs were obtained from the KHIRA database. These covariates were analyzed using Student's t test and the chi-square test; furthermore, multivariate logistic regression analysis was used to evaluate the risk factors associated with the prescription of PIMs.
  
  
  
  A total of 80.96 % subjects were prescribed at least one PIM independent of their diagnosis or condition according to the 2012 Beers Criteria. The most commonly prescribed medication class was first-generation antihistamines with anticholinergic properties (52.33 %). Pain medications (43.04 %) and benzodiazepines (42.53 %) were next in line. When considering subjects' diagnoses or conditions, subjects diagnosed with central nervous system conditions were most often prescribed PIMs. Female sex, severity of comorbidities, and polypharmacy were significant risk factors for PIM prescriptions.
  
  
  
  This study confirmed that PIM prescription is common among elderly Koreans. A clinical decision support system should be developed to decrease the prevalence of PIM prescriptions.
authors.affiliation: Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, South Korea.
authors.forename: You-Seon
authors.initials: YS
authors.lastname: Nam
authors.affiliation: Health Promotion Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Jong Soo
authors.initials: JS
authors.lastname: Han
authors.affiliation: Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea. kkamduri@snubh.org.
authors.forename: Ju Young
authors.initials: JY
authors.lastname: Kim
authors.affiliation: Health Promotion Center, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Bae
authors.affiliation: Department of Family Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea.
authors.forename: Kiheon
authors.initials: K
authors.lastname: Lee
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000009:adverse effects / Q000517:prevention & control; D008297:Male; D054539:Medication Therapy Management; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D015995:Prevalence; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D012307:Risk Factors
keywords: Adverse drug effects (ADEs); Beers Criteria; Polypharmacy; Potentially inappropriate medication (PIM)