Objectives

The established Beers Criteria consider side effects and safety concerns when prescribing drugs to the elderly. As the criteria suggest that attention should be paid toward prescriptions rather than prescription prohibition lists, these Beers Criteria medications (BCMs) are used appropriately under unavoidable circumstances.

Methods

Patients aged ≥ 65 years and with an experience of being prescribed inappropriate medications at Konyang University Hospital, South Korea, were selected. We analyzed data from the Korea Adverse Event Reporting System (KAERS) and the Food and Drug Administration Adverse Event Reporting System (FAERS) of the United States to identify medication-induced adverse drug events (ADEs). The actual incidence was predicted by multiplying the incidence and number of BCMs prescribed to the patients. The proportional reporting ratio (PRR) and reporting odds ratio (ROR) were calculated using KAERS and FAERS data.

Results

We predicted that the incidence of ADEs would be higher for metoclopramide, chlorpheniramine, and amitriptyline in patients using medications for more than 1 day and metoclopramide, chlorpheniramine, and ketoprofen in patients using medications only for 1 day. Among the ADEs reported to KAERS and FAERS, significant ROR and PRR values were noted for clonazepam (drowsiness), nortriptyline (sleepiness), and zolpidem (amnesia, somnambulism, agitation, dependence, nightmare, and dysgeusia).

Conclusion

This study highlighted the actual status of BCM prescriptions in clinical institutions and predicted the incidence of ADEs. We concluded that greater care must be taken while prescribing BCMs to the elderly and indicators, such as PRR and ROR should be monitored regularly.

中文翻译：

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使用真实世界数据对有发生不良药物事件风险的啤酒标准药物进行老年病学研究

目标

既定的 Beers 标准在为老年人开药时考虑了副作用和安全问题。由于标准表明应注意处方而不是处方禁止清单，因此在不可避免的情况下可以适当地使用这些 Beers Criteria 药物 (BCM)。

方法

选择年龄≥ 65 岁且在韩国 Konyang University Hospital 有过服用不当药物经历的患者。我们分析了来自韩国不良事件报告系统 (KAERS) 和美国食品和药物管理局不良事件报告系统 (FAERS) 的数据，以确定药物引起的药物不良事件 (ADE)。实际发生率是通过乘以给患者开出的 BCM 的发生率和数量来预测的。使用 KAERS 和 FAERS 数据计算比例报告比 (PRR) 和报告优势比 (ROR)。

结果

我们预测，用药时间超过 1 天的胃复安、氯苯那敏和阿米替林以及仅用药 1 天的胃复安、氯苯那敏和酮洛芬的 ADE 发生率会更高。在向 KAERS 和 FAERS 报告的 ADE 中，氯硝西泮（嗜睡）、去甲替林（嗜睡）和唑吡坦（健忘症、梦游症、激动、依赖、噩梦和味觉障碍）具有显着的 ROR 和 PRR 值。

结论

该研究突出了临床机构中 BCM 处方的实际状况，并预测了 ADE 的发生率。我们得出的结论是，在为老年人开出 BCM 处方时必须更加小心，并且应定期监测 PRR 和 ROR 等指标。