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@ARTICLE{Muhlack:142094,
      author       = {D. C. Muhlack$^*$ and L. Hoppe$^*$ and C. Stock$^*$ and W.
                      E. Haefeli and H. Brenner$^*$ and B. Schöttker$^*$},
      title        = {{T}he associations of geriatric syndromes and other patient
                      characteristics with the current and future use of
                      potentially inappropriate medications in a large cohort
                      study.},
      journal      = {European journal of clinical pharmacology},
      volume       = {74},
      number       = {12},
      issn         = {1432-1041},
      address      = {New York},
      publisher    = {Springer},
      reportid     = {DKFZ-2018-02324},
      pages        = {1633 - 1644},
      year         = {2018},
      abstract     = {To assess the changes in use of potentially inappropriate
                      medication (PIM) as defined by the 2015 Beers criteria, the
                      EU(7)-PIM, and the PRISCUS list over a 6-year period and to
                      identify determinants for current and future PIM use with a
                      particular focus on geriatric syndromes.In a German cohort
                      of 2878 community-dwelling adults aged ≥ 60 years,
                      determinants of the use of ≥ 1 PIM were identified in
                      multivariable logistic regression (cross-sectional analysis)
                      and weighted generalized estimating equation models
                      (longitudinal analysis).Prevalences for Beers, EU(7), and
                      PRISCUS PIM were 26.4, 37.4, and $13.7\%$ at baseline and
                      decreased to 23.1, 36.5, and $12.3\%,$ respectively,
                      6 years later. Unadjusted prevalences in participants with
                      any geriatric syndrome (frailty, co-morbidity, functional,
                      or cognitive impairment) were approximately twice as high as
                      in robust older adults. In multivariable analyses, cognitive
                      impairment was statistically significantly associated with
                      the use of PIM of all three criteria in the cross-sectional
                      (odds ratio (OR) point estimates 1.90-2.21) but not in the
                      longitudinal models. In contrast, frailty, co-morbidity, and
                      functional impairment were statistically significantly
                      associated with the use of PIM of at least one of the three
                      criteria in both models. However, the associations varied
                      for the PIM criteria, and in the longitudinal analysis,
                      associations were only statistically significant for Beers
                      PIM (ORs $[95\%$ confidence intervals]: frailty (2.23 [1.15,
                      4.31]), co-morbidity by five total co-morbidity score points
                      (1.21 [1.05, 1.38]), and functional impairment (1.51 [1.00,
                      2.27]). Other statistically significant determinants of the
                      incidence of PIM (any definition) were female sex, age,
                      coronary heart disease, heart failure, biomarkers of the
                      metabolic syndrome, and history of ulcer, depressive
                      episodes, hip fracture, or any cancer.Older adults with
                      frailty, co-morbidity, cognitive, and functional impairment
                      had higher odds of taking PIM or getting a PIM prescription
                      in the future (exception: cognitive impairment). Physicians
                      should be especially cautious when prescribing drugs for
                      these patients who are particularly susceptible to adverse
                      reactions.},
      cin          = {C070 / G110},
      ddc          = {610},
      cid          = {I:(DE-He78)C070-20160331 / I:(DE-He78)G110-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30159676},
      doi          = {10.1007/s00228-018-2534-1},
      url          = {https://inrepo02.dkfz.de/record/142094},
}