Yıl: 2023 Cilt: 27 Sayı: 6 Sayfa Aralığı: 328 - 338 Metin Dili: İngilizce DOI: 10.14744/AnatolJCardiol.2023.2618 İndeks Tarihi: 07-06-2023

Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey

Öz:
Background: Elderly comprises a specific group due to possible alterations in the effects of drugs and comorbidities. We aimed to identify for the first time the characteristics and rates regarding the inappropriate prescriptions of cardiovascular system medications in the geriatric age group in Turkey. Methods: Cardiovascular system medications prescribed electronically by family phy- sicians to patients aged 65 and over, in the years 2015 and 2016, were obtained through Prescription Information System administered by the Ministry of Health. Evaluation of potentially inappropriate prescriptions was done according to the “Beers Criteria 2015 update.” Prescription rates for each group were evaluated under sub-breakdowns for the specialty of family physicians, gender, age groups, and “Nomenclature of Territorial Units for Statistics” regions. Results: Approximately 65 million prescriptions were evaluated. The rate of potentially inappropriate cardiovascular medication prescribing was 0.33%. This raised to 11.56% when “drugs to be used with caution” were included. It was observed that potentially inappropriate drugs have been prescribed more by specialist family physicians. The most frequently prescribed potentially inappropriate drugs were doxazosin in the diagnosis of hypertension and methyldopa regardless of indication. Diclofenac-warfarin was the most commonly prescribed concomitant drug use in the potentially clinically important drug–drug interactions group. The rate of potentially inappropriate drug prescribing was higher in males and in aged 80 years and older. Conclusions: This pharmacoepidemiological study draws attention to potentially inap- propriate cardiovascular system drugs prescribed in primary care settings to the elderly. The rate of potentially inappropriate cardiovascular system drug prescribed was found to be very low in Turkey.
Anahtar Kelime:

Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
  • 1. Flint B, Tadi P. Physiology, aging. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2021.
  • 2. Medication Safety in Polypharmacy. Geneva: World Health Organization; 2019. x(WHO/UHC/SDS/2019.11). Available at: https://apps.who.int/iris/rest/bitstreams/1235792/retrieve. Accessed June 25, 2022.
  • 3. İstatistiklerle Yaşlılar (in Turkish) [online]. Turkish Statistical Insti- tute; 2021. Available at: https://data.tuik.gov.tr/Bulten/Index?p= Istatistiklerle-Yaslilar-2021-45636. Accessed June 25, 2022.
  • 4. İstatistiklerle Yaşlılar (in Turkish) [online]. Turkish Statistical Insti- tute; 2016. Available at: https://data.tuik.gov.tr/Bulten/Index?p= Istatistiklerle-Yaslilar-2016-24644. Accessed June 25, 2022.
  • 5. İstatistiklerle Yaşlılar (in Turkish) [online]. Turkish Statistical Insti- tute; 2015. Available at: https://data.tuik.gov.tr/Bulten/Index?p= Istatistiklerle-Yaslilar-2015-21520. Accessed June 25, 2022.
  • 6. İstatistiklerle Yaşlılar (in Turkish) [online]. Turkish Statistical Insti- tute; 2012. Available at: https://data.tuik.gov.tr/Bulten/Index?p= Istatistiklerle-Yaslilar-2012-13466. Accessed June 25, 2022.
  • 7. Gokce Kutsal Y, Barak A, Atalay A, et al. Polypharmacy in the elderly: a multicenter study. J Am Med Dir Assoc. 2009;10(7):486- 490. [CrossRef]
  • 8. Uluoğlu C, Yaklaşım İEA. İlaç etkileşmelerine akilci yaklaşim (in Turkish). Turkiye Klinikleri/Pharmacology Special Topics. 2015;3(1):65-73.
  • 9. Yazdanyar A, Newman AB. The burden of cardiovascular dis- ease in the elderly: morbidity, mortality, and costs. Clin Geriatr Med. 2009;25(4):563-vii. [CrossRef]
  • 10. Zoghi M, Özyüncü N, Özal E, et al. Frequency of cardiovascular diseases and drug use in Turkish elderly population followed up at Cardiology Clinics: the Elderturk study. Turk J Geriatr. 2017;20(2):73-81.
  • 11. Malakouti SK, Javan-Noughabi J, Yousefzadeh N, et al. A sys- tematic review of potentially inappropriate medications use and related costs among the elderly. Value Health Reg Issues. 2021;25:172-179. [CrossRef]
  • 12. By the American Geriatrics Society 2015 Beers Criteria Update Expert Panel. American Geriatrics Society 2015 updated Beers criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227-2246. [CrossRef]
  • 13. By the 2019 American Geriatrics Society Beers Criteria® Update Expert Panel. American Geriatrics Society 2019 updated AGS Beers Criteria® for potentially inappropriate medicationuseinolderadults. J Am Geriatr Soc.2019;67(4):674- 694. [CrossRef]
  • 14. Aksoy M, Alkan A, İşli F. Sağlık Bakanlığı'nın Akılcı İlaç Kullanımını Yaygınlaştırma Faaliyetleri. Turk Klin Pharmacol-Spec Top. 2015;3(1):19-26.
  • 15. BÖLGE (İBBS-Düzey 1) Yerleşim Yerleri Yaşlı Nüfusunun Adrese Dayalı Nüfus Kayıt Sistemi (Adnks) 2018 Verilerine Göre Dağılımları Ve Oranları (in Turkish) [online]. Republic of Turkey Ministry of Family and Social Services; 2018. Available at: https ://www.aile.gov.tr/media/5199/2018-bolge-yerlesim-yerleri.pdf. Accessed June 25, 2022.
  • 16. Republic of Turkey Official Gazette. Decree of the Council of Ministers Decree Number: 2002/4720, Gazette Number:24884; 2002. Available at: https://www.resmigazete.gov.tr/eskiler/ 2002/09/20020922.htm#3
  • 17. İstatistiklerle Yaşlılar (in Turkish) [online]. Turkish Statistical Insti- tute; 2014. Available at: https://data.tuik.gov.tr/Bulten/Index?p= Istatistiklerle-Yaslilar-2014-18620. Accessed June 25, 2022.
  • 18. Hwang HJ, Kim SH, Lee KS. Potentially inappropriate medica- tions in the elderly in Korean long-term care facilities. Drugs Real World Outcomes. 2015;2(4):355-361. [CrossRef]
  • 19. Nam YS, Han JS, Kim JY, Bae WK, Lee K. Prescription of poten- tially inappropriate medication in Korean older adults based on 2012 Beers Criteria: a cross-sectional population based study. BMC Geriatr. 2016;16:118. [CrossRef]
  • 20. Ungan M. Aile hekimliğinde sayı, sistem, nitelik ve eğitim (in Turkish). Sağlık Düşüncesi Tıp Kültürü Derg. 2019;49:26-29. Available at: https://www.sdplatform.com/Dergi/1155/Aile-he kimliginde-sayi-sistem-nitelik-ve-egitim.aspx.
  • 21. Carmel S. Health and well-being in late life: gender differences worldwide. Front Med (Lausanne). 2019;6:218. [CrossRef]
  • 22. Balbay Y, Gagnon-Arpin I, Malhan S, et al. Modeling the burden of cardiovascular disease in Turkey. Anatol J Cardiol. 2018;20(4):235-240. [CrossRef]
  • 23. Lloyd-Jones DM, Evans JC, Levy D. Hypertension in adults across the age spectrum: current outcomes and control in the commu- nity. JAMA. 2005;294(4):466-472. [CrossRef]
  • 24. Divo MJ, Martinez CH, Mannino DM. Ageing and the epidemiol- ogy of multimorbidity. Eur Respir J. 2014;44(4):1055-1068. [CrossRef]
  • 25. Writing Committee Members, Yancy CW, Jessup M, et al. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/ American Heart Association Task Force on Practice Guidelines. Circulation. 2013;128(16):e240-e327. [CrossRef]
  • 26. McDonagh TA, Metra M, Adamo M, et al. 2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure [published correction appears in Eur Heart J. 2021. Eur Heart J. 2021;42(36):3599-3726. [CrossRef]
  • 27. Heidenreich PA, Bozkurt B, Aguilar D, et al. 2022 AHA/ACC/ HFSA guideline for the management of heart failure: A report of the American College of Cardiology/American Heart Asso- ciation joint committee on clinical practice guidelines [pub- lished correction appears in Circulation. 2022;145(18):e1033; published correction appears in Circulation. 2022;146(13):e185]. Circulation. 2022;145(18):e895-e1032. [CrossRef]
  • 28. Varlı M, Aras SD, Atlı T. Yaşlılarda Üriner inkontinans ve Tedavisi (in Turkish). Akad Geriatr. 2009;1:45-58.
  • 29. Johnson TM 2nd, Vaughan CP. Urological function and dysfunc- tion in aging: diagnosis and treatment. Handb Clin Neurol. 2019;167:495-509. [CrossRef]
  • 30. White WB, Moon T. Treatment of benign prostatic hyperplasia in hypertensive men. J Clin Hypertens (Greenwich). 2005;7(4):212- 217. [CrossRef]
  • 31. Unger T, Borghi C, Charchar F, et al. 2020 International Society of Hypertension Global Hypertension Practice Guidelines. Hypertension. 2020 [international Society of Hypertension Global Hypertension Practice guidelines];75(6):1334-1357. [CrossRef]
  • 32. Rehberi KK. Türk hematoloji Derneği (in Turkish) [online]. 2022. Available at: http://www.thd.org.tr/thd_halk/?sayfa=kkr. Accessed June 25, 2022.
  • 33. Di Minno A, Frigerio B, Spadarella G, et al. Old and new oral anti- coagulants: food, herbal medicines and drug interactions. Blood Rev. 2017;31(4):193-203. [CrossRef]
  • 34. Republic of Turkey official. Sosyal güvenlik kurumu sağlık uygu- lama tebliği. Gazette Number:28597. 2013. Available at: https:// www.mevzuat.gov.tr/mevzuat?MevzuatNo=17229&MevzuatTu r=9&MevzuatTertip=5.
  • 35. US Preventive Services Task Force, Davidson KW, Barry MJ, et al. Aspirin use to prevent cardiovascular disease: US Preventive Services Task Force recommendation statement. JAMA. 2022;327(16):1577-1584. [CrossRef]
  • 36. Bibbins-Domingo K, U.S. Preventive Services Task Force. Aspirin use for the primary prevention of cardiovascular disease and colorectal cancer: U.S. Preventive Services Task Force recom- mendation statement. Ann Intern Med. 2016;164(12):836-845. [CrossRef]
  • 37. Gelbenegger G, Postula M, Pecen L, et al. Aspirin for primary prevention of cardiovascular disease: a meta-analysis with a particular focus on subgroups. BMC Med. 2019;17(1):198. [CrossRef]
  • 38. Flory JH, Ky B, Haynes K, et al. Observational cohort study of the safety of digoxin use in women with heart failure [published correction appears in BMJ Open. 2012;2(4)]. BMJ Open. 2012;2(2):e000888. [CrossRef]
  • 39. Juurlink DN, Mamdani MM, Kopp A, Herrmann N, Laupacis A. A population-based assessment of the potential interaction between serotonin-specific reuptake inhibitors and digoxin. Br J Clin Pharmacol. 2005;59(1):102-107. [CrossRef]
APA KİTAPÇI M, Karakuş O, İşli F, Aksoy M, GÜVEL M, ULUOGLU C (2023). Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. , 328 - 338. 10.14744/AnatolJCardiol.2023.2618
Chicago KİTAPÇI MEHMET TEVFİK,Karakuş Osman,İşli Fatma,Aksoy Mesil,GÜVEL MUHAMMED CİHAN,ULUOGLU CANAN Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. (2023): 328 - 338. 10.14744/AnatolJCardiol.2023.2618
MLA KİTAPÇI MEHMET TEVFİK,Karakuş Osman,İşli Fatma,Aksoy Mesil,GÜVEL MUHAMMED CİHAN,ULUOGLU CANAN Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. , 2023, ss.328 - 338. 10.14744/AnatolJCardiol.2023.2618
AMA KİTAPÇI M,Karakuş O,İşli F,Aksoy M,GÜVEL M,ULUOGLU C Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. . 2023; 328 - 338. 10.14744/AnatolJCardiol.2023.2618
Vancouver KİTAPÇI M,Karakuş O,İşli F,Aksoy M,GÜVEL M,ULUOGLU C Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. . 2023; 328 - 338. 10.14744/AnatolJCardiol.2023.2618
IEEE KİTAPÇI M,Karakuş O,İşli F,Aksoy M,GÜVEL M,ULUOGLU C "Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey." , ss.328 - 338, 2023. 10.14744/AnatolJCardiol.2023.2618
ISNAD KİTAPÇI, MEHMET TEVFİK vd. "Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey". (2023), 328-338. https://doi.org/10.14744/AnatolJCardiol.2023.2618
APA KİTAPÇI M, Karakuş O, İşli F, Aksoy M, GÜVEL M, ULUOGLU C (2023). Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. The Anatolian Journal of Cardiology, 27(6), 328 - 338. 10.14744/AnatolJCardiol.2023.2618
Chicago KİTAPÇI MEHMET TEVFİK,Karakuş Osman,İşli Fatma,Aksoy Mesil,GÜVEL MUHAMMED CİHAN,ULUOGLU CANAN Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. The Anatolian Journal of Cardiology 27, no.6 (2023): 328 - 338. 10.14744/AnatolJCardiol.2023.2618
MLA KİTAPÇI MEHMET TEVFİK,Karakuş Osman,İşli Fatma,Aksoy Mesil,GÜVEL MUHAMMED CİHAN,ULUOGLU CANAN Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. The Anatolian Journal of Cardiology, vol.27, no.6, 2023, ss.328 - 338. 10.14744/AnatolJCardiol.2023.2618
AMA KİTAPÇI M,Karakuş O,İşli F,Aksoy M,GÜVEL M,ULUOGLU C Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. The Anatolian Journal of Cardiology. 2023; 27(6): 328 - 338. 10.14744/AnatolJCardiol.2023.2618
Vancouver KİTAPÇI M,Karakuş O,İşli F,Aksoy M,GÜVEL M,ULUOGLU C Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey. The Anatolian Journal of Cardiology. 2023; 27(6): 328 - 338. 10.14744/AnatolJCardiol.2023.2618
IEEE KİTAPÇI M,Karakuş O,İşli F,Aksoy M,GÜVEL M,ULUOGLU C "Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey." The Anatolian Journal of Cardiology, 27, ss.328 - 338, 2023. 10.14744/AnatolJCardiol.2023.2618
ISNAD KİTAPÇI, MEHMET TEVFİK vd. "Evaluation of the Potentially Inappropriate Cardiovascular Medication Prescription in Elderly: A Nationwide Study in Turkey". The Anatolian Journal of Cardiology 27/6 (2023), 328-338. https://doi.org/10.14744/AnatolJCardiol.2023.2618