tetano
Editor, Senior Moderator
BMJ Open
. 2024 Jul 17;14(7):e073367.
doi: 10.1136/bmjopen-2023-073367. Potentially inappropriate medication as a predictor of poor prognosis of COVID-19 in older adults: a South Korean nationwide cohort study
Hyungmin Kim[SUP] 1 2 [/SUP], Song Hee Hong[SUP] 3 4 [/SUP]
Affiliations
Objectives: To investigate the association between exposure to potentially inappropriate medication (PIM) and poor prognosis of COVID-19 in older adults, controlling for comorbidity and sociodemographic factors.
Design and setting: Nationwide retrospective cohort study based on the national registry of COVID-19 patients, established through the linkage of South Korea's national insurance claims database with the Korea Disease Control and Prevention Agency registry of patients with COVID-19, up to 31 July 2020.
Participants: A total of 2217 COVID-19 patients over 60 years of age who tested positive between 20 January 2022 and 4 June 2020. Exposure to PIM was defined based on any prescription record of PIM during the 30 days prior to the date of testing positive for COVID-19.
Primary outcome measures: Mortality and utilisation of critical care from the date of testing positive until the end of isolation.
Results: Among the 2217 COVID-19 patients over 60 years of age, 604 were exposed to PIM prior to infection. In the matched cohort of 583 pairs, PIM-exposed individuals exhibited higher rates of mortality (19.7% vs 9.8%, p<0.0001) and critical care utilisation (13.4% vs 8.9%, p=0.0156) compared with non-exposed individuals. The temporal association of PIM exposure with mortality was significant across all age groups (RR=1.68, 95% CI: 1.23~2.24), and a similar trend was observed for critical care utilisation (RR: 1.75, 95% CI: 1.26~2.39). The risk of mortality and critical care utilisation increased with exposure to a higher number of PIMs in terms of active pharmaceutical ingredients and drug categories.
Conclusion: Exposure to PIM exacerbates the poor outcomes of older patients with COVID-19 who are already at high risk. Effective interventions are urgently needed to address PIM exposure and improve health outcomes in this vulnerable population.
Keywords: geriatric medicine; health services for the aged; public health; quality in health care.
. 2024 Jul 17;14(7):e073367.
doi: 10.1136/bmjopen-2023-073367. Potentially inappropriate medication as a predictor of poor prognosis of COVID-19 in older adults: a South Korean nationwide cohort study
Hyungmin Kim[SUP] 1 2 [/SUP], Song Hee Hong[SUP] 3 4 [/SUP]
Affiliations
- PMID: 39019633
- DOI: 10.1136/bmjopen-2023-073367
Objectives: To investigate the association between exposure to potentially inappropriate medication (PIM) and poor prognosis of COVID-19 in older adults, controlling for comorbidity and sociodemographic factors.
Design and setting: Nationwide retrospective cohort study based on the national registry of COVID-19 patients, established through the linkage of South Korea's national insurance claims database with the Korea Disease Control and Prevention Agency registry of patients with COVID-19, up to 31 July 2020.
Participants: A total of 2217 COVID-19 patients over 60 years of age who tested positive between 20 January 2022 and 4 June 2020. Exposure to PIM was defined based on any prescription record of PIM during the 30 days prior to the date of testing positive for COVID-19.
Primary outcome measures: Mortality and utilisation of critical care from the date of testing positive until the end of isolation.
Results: Among the 2217 COVID-19 patients over 60 years of age, 604 were exposed to PIM prior to infection. In the matched cohort of 583 pairs, PIM-exposed individuals exhibited higher rates of mortality (19.7% vs 9.8%, p<0.0001) and critical care utilisation (13.4% vs 8.9%, p=0.0156) compared with non-exposed individuals. The temporal association of PIM exposure with mortality was significant across all age groups (RR=1.68, 95% CI: 1.23~2.24), and a similar trend was observed for critical care utilisation (RR: 1.75, 95% CI: 1.26~2.39). The risk of mortality and critical care utilisation increased with exposure to a higher number of PIMs in terms of active pharmaceutical ingredients and drug categories.
Conclusion: Exposure to PIM exacerbates the poor outcomes of older patients with COVID-19 who are already at high risk. Effective interventions are urgently needed to address PIM exposure and improve health outcomes in this vulnerable population.
Keywords: geriatric medicine; health services for the aged; public health; quality in health care.