A collaborative study between the University of Eastern Finland, Fimea and The Social Insurance Institution of Finland has found that initiation of potentially inappropriate medication (PIM) is associated with increased risk of fracture-specific hospitalisations and mortality.
In the study, which was recently published in The European Journal of Health Economics, PIMs were defined as medications whose potential risks are higher than their clinical benefit, according to the Meds75+ database maintained by the Finnish Medicines Agency (Fimea).
Medications were then divided into four categories: A — ‘suitable for the older persons’, B — ‘there is little evidence, practical evidence or efficacy in older persons’, C — ‘suitable for older persons, with specific cautions’, and D — ‘Avoid use in older persons’.
Using nationwide registers, the study authors followed more than 20,000 community-dwelling people aged ≥65 years between the years 2002 and 2013. Matching persons were identified from the non-users group for those persons who purchased PIMs during the 12-year follow-up.
Based on their results, the authors found that there was an increased risk of hospitalisations due to fractures and death associated with the initiation of PIM. Additionally, patients using a PIM tended to have higher hospital costs than those who were not using a PIM.
Although PIM prescriptions require clinical grounds, the authors stated that healthcare providers should carefully consider the potential health and economic risks of their use when prescribing them for older patients.