Potentially inappropriate prescribing of cardiovascular system and antiplatelet/anticoagulant drugs among elderly patients:a Korean population-based national study

OBJECTIVES To investigate the prevalence of potentially inappropriate prescribing(PIP)for cardiovascular system(CVS)and antiplatelet/anticoagulant(AP/AC)drugs among Korean elderly patients,using the Screening Tool of Older Persons’Prescriptions(STOPP)criteria version 2 and to identify the risk factors related to PIP.METHODS The 2016 National Aged Patient Sample data,comprising National Health Insurance claim records for a random sample of 20%of patients aged≥65 years,were used to calculate PIP prevalence of outpatient prescriptions.For criteria including drugdisease interactions,PIP prevalence per indication was estimated.RESULTS Among 1,274,148 elderly patients and 27,062,307 outpatient prescription claims,100,085 patients(7.85%)and 341,664 claims(1.27%)had one or more PIP.The most frequent PIP was“nonsteroidal antiinflammatory drug with concurrent antiplatelet agent(s)without protonpump inhibitor prophylaxis”in the claimlevel(0.97%)and patientlevel(6.33%)analyses.“Betablocker with bradycardia”(16.47%of claims)and“angiotensin receptor blockers in patients with hyperkalaemia”(23.89%of claims)showed the highest PIP prevalence per indication.Logistic regression analysis revealed that,among the patient and health care provider characteristics,female,older age,more severe comorbidities,polypharmacy,higher level of healthcare organization,and specialty of prescriber were significantly associated with a higher risk of PIP.CONCLUSIONS Our findings of a high prevalence of PIP for CVS and AP/AC drugs among the elderly suggest that an effective strategy is urgently needed to improve the prescription practices of these drugs.

Gender differences in adult traumatic brain injury according to the Glasgow coma scale:A multicenter descriptive study

Purpose:Patients’gender,which can be one of the most important determinants of traumatic brain injury(TBI)outcomes,is also likely to interact with many other outcome variables of TBI.This multicenter descriptive study investigated gender differences in epidemiological,clinical,treatment,mortality,and variable characteristics in adult TBI patients.Methods:The selection criteria were defined as patients who had been diagnosed with TBI and were admitted to the hospital between January 1,2016 and December 31,2018.A total of 4468 adult TBI patients were enrolled at eight University Hospitals.Based on the list of enrolled patients,the medical records of the patients were reviewed and they were registered online at each hospital.The registered patients were classified into three groups according to the Glasgow coma scale(GCS)score:mild(13-15),moderate(9-12),and severe(3-8),and the differences between men and women in each group were investigated.The risk factors of moderated and severe TBI compared to mild TBI were also investigated.Results:The study included 3075 men and 1393 women and the proportion of total males was 68.8%.Among all the TBI patients,there were significant differences between men and women in age,past history,and GCS score.While the mild and severe TBI groups showed significant differences in age,past history,and clinical symptoms,the moderate TBI group showed significant differences in age,past history,cause of justice,and diagnosis.Conclusion:To the best of our knowledge,this multicenter study is the first to focus on gender differences of adult patients with TBI in Korea.This study shows significant differences between men and women in many aspects of adult TBI.Therefore,gender differences should be strongly considered in TBI studies.