ArticleBMJ open2024
Potentially inappropriate medication as a predictor of poor prognosis of COVID-19 in older adults: a South Korean nationwide cohort study.
Article in BMJ open, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectivesTo 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
settingNationwide 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.
participantsA 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.
resultsAmong 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.
conclusionExposure 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.
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