Subtypes of potentially inappropriate medications in older Chinese-Americans during care transitions: Cross sectional retrospective study

Sophia Huey-Lan Hu, Janice B. Foust, Marie Boltz, Elizabeth Capezuti

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Background: The number of Chinese Americans is growing and nearly 20% of older Chinese-American home care patients have at least one potentially inappropriate medications (PIMs) prescribed at hospital discharge. Further examination of PIMs during care transition is warranted, especially among older Chinese-Americans. Objectives: To describe, during care transitions from hospital to home care: (i) the subtypes of PIMs, (ii) the difference of PIM prevalence prescribed at hospital discharge as compared to home care admission, (iii) the relationship between subtypes of PIMs, and (iv) issues affecting medication reconciliation among older Chinese-Americans. Methods: This cross-sectional, retrospective study was conducted in a large urban home care agency from June 2010 to July 2011. From data collected by in-home survey and chart abstraction, PIMs were identified using 2002 diagnosis-independent Beers criteria. The difference of PIM prevalence at hospital discharge and at home care admission was analyzed by Wilcoxon Signed Ranks test. The relationship between subtypes of PIMs was evaluated using Phi coefficient. Participants: 82 older (age 65 years and above) Chinese-American home care patients following recent hospital discharge. Results: 3.38% (22) and another 3.72% (28) of prescribed medications were identified as PIMs at hospital discharge and home care admission, respectively. There was no statistically significant difference in PIM prevalence identified at hospital discharge and at homecare admission (z=-1.732, p=.083). PIMs included: long-term use of stimulant laxatives and high-dosages of ferrous sulfate, and a significant relationship between these two PIMS (r=.224, p=.04). More than 80% (n=65) of study participants reported low education levels and limited English proficiency. Conclusions: Subtypes of PIMs were ordered during the post-hospital transfers, indicating the necessity to review the appropriateness of medications during this transition. Guidelines such as Beer's criteria regarding appropriateness of medications should be incorporated in medication reconciliation before adding new medications to treat the older adult's health problems. The medication management process needs to be both culturally sensitive and adapted to literacy level; validating the patients' full understanding of their medications is paramount.

Original languageEnglish
Pages (from-to)1221-1229
Number of pages9
JournalInternational Journal of Nursing Studies
Volume51
Issue number9
DOIs
Publication statusPublished - 2014

Fingerprint

Patient Transfer
Asian Americans
Retrospective Studies
Cross-Sectional Studies
Home Care Services
Medication Reconciliation
ferrous sulfate
Potentially Inappropriate Medication List
Regional Health Planning
Home Care Agencies
Laxatives
Nonparametric Statistics

Keywords

  • Care transitions
  • Limited English proficiency
  • Low education levels
  • Medication reconciliation
  • Older Chinese-Americans
  • Potentially inappropriate medication

ASJC Scopus subject areas

  • Nursing(all)
  • Medicine(all)

Cite this

Subtypes of potentially inappropriate medications in older Chinese-Americans during care transitions : Cross sectional retrospective study. / Hu, Sophia Huey-Lan; Foust, Janice B.; Boltz, Marie; Capezuti, Elizabeth.

In: International Journal of Nursing Studies, Vol. 51, No. 9, 2014, p. 1221-1229.

Research output: Contribution to journalArticle

Hu, Sophia Huey-Lan ; Foust, Janice B. ; Boltz, Marie ; Capezuti, Elizabeth. / Subtypes of potentially inappropriate medications in older Chinese-Americans during care transitions : Cross sectional retrospective study. In: International Journal of Nursing Studies. 2014 ; Vol. 51, No. 9. pp. 1221-1229.
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title = "Subtypes of potentially inappropriate medications in older Chinese-Americans during care transitions: Cross sectional retrospective study",
abstract = "Background: The number of Chinese Americans is growing and nearly 20{\%} of older Chinese-American home care patients have at least one potentially inappropriate medications (PIMs) prescribed at hospital discharge. Further examination of PIMs during care transition is warranted, especially among older Chinese-Americans. Objectives: To describe, during care transitions from hospital to home care: (i) the subtypes of PIMs, (ii) the difference of PIM prevalence prescribed at hospital discharge as compared to home care admission, (iii) the relationship between subtypes of PIMs, and (iv) issues affecting medication reconciliation among older Chinese-Americans. Methods: This cross-sectional, retrospective study was conducted in a large urban home care agency from June 2010 to July 2011. From data collected by in-home survey and chart abstraction, PIMs were identified using 2002 diagnosis-independent Beers criteria. The difference of PIM prevalence at hospital discharge and at home care admission was analyzed by Wilcoxon Signed Ranks test. The relationship between subtypes of PIMs was evaluated using Phi coefficient. Participants: 82 older (age 65 years and above) Chinese-American home care patients following recent hospital discharge. Results: 3.38{\%} (22) and another 3.72{\%} (28) of prescribed medications were identified as PIMs at hospital discharge and home care admission, respectively. There was no statistically significant difference in PIM prevalence identified at hospital discharge and at homecare admission (z=-1.732, p=.083). PIMs included: long-term use of stimulant laxatives and high-dosages of ferrous sulfate, and a significant relationship between these two PIMS (r=.224, p=.04). More than 80{\%} (n=65) of study participants reported low education levels and limited English proficiency. Conclusions: Subtypes of PIMs were ordered during the post-hospital transfers, indicating the necessity to review the appropriateness of medications during this transition. Guidelines such as Beer's criteria regarding appropriateness of medications should be incorporated in medication reconciliation before adding new medications to treat the older adult's health problems. The medication management process needs to be both culturally sensitive and adapted to literacy level; validating the patients' full understanding of their medications is paramount.",
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AU - Capezuti, Elizabeth

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N2 - Background: The number of Chinese Americans is growing and nearly 20% of older Chinese-American home care patients have at least one potentially inappropriate medications (PIMs) prescribed at hospital discharge. Further examination of PIMs during care transition is warranted, especially among older Chinese-Americans. Objectives: To describe, during care transitions from hospital to home care: (i) the subtypes of PIMs, (ii) the difference of PIM prevalence prescribed at hospital discharge as compared to home care admission, (iii) the relationship between subtypes of PIMs, and (iv) issues affecting medication reconciliation among older Chinese-Americans. Methods: This cross-sectional, retrospective study was conducted in a large urban home care agency from June 2010 to July 2011. From data collected by in-home survey and chart abstraction, PIMs were identified using 2002 diagnosis-independent Beers criteria. The difference of PIM prevalence at hospital discharge and at home care admission was analyzed by Wilcoxon Signed Ranks test. The relationship between subtypes of PIMs was evaluated using Phi coefficient. Participants: 82 older (age 65 years and above) Chinese-American home care patients following recent hospital discharge. Results: 3.38% (22) and another 3.72% (28) of prescribed medications were identified as PIMs at hospital discharge and home care admission, respectively. There was no statistically significant difference in PIM prevalence identified at hospital discharge and at homecare admission (z=-1.732, p=.083). PIMs included: long-term use of stimulant laxatives and high-dosages of ferrous sulfate, and a significant relationship between these two PIMS (r=.224, p=.04). More than 80% (n=65) of study participants reported low education levels and limited English proficiency. Conclusions: Subtypes of PIMs were ordered during the post-hospital transfers, indicating the necessity to review the appropriateness of medications during this transition. Guidelines such as Beer's criteria regarding appropriateness of medications should be incorporated in medication reconciliation before adding new medications to treat the older adult's health problems. The medication management process needs to be both culturally sensitive and adapted to literacy level; validating the patients' full understanding of their medications is paramount.

AB - Background: The number of Chinese Americans is growing and nearly 20% of older Chinese-American home care patients have at least one potentially inappropriate medications (PIMs) prescribed at hospital discharge. Further examination of PIMs during care transition is warranted, especially among older Chinese-Americans. Objectives: To describe, during care transitions from hospital to home care: (i) the subtypes of PIMs, (ii) the difference of PIM prevalence prescribed at hospital discharge as compared to home care admission, (iii) the relationship between subtypes of PIMs, and (iv) issues affecting medication reconciliation among older Chinese-Americans. Methods: This cross-sectional, retrospective study was conducted in a large urban home care agency from June 2010 to July 2011. From data collected by in-home survey and chart abstraction, PIMs were identified using 2002 diagnosis-independent Beers criteria. The difference of PIM prevalence at hospital discharge and at home care admission was analyzed by Wilcoxon Signed Ranks test. The relationship between subtypes of PIMs was evaluated using Phi coefficient. Participants: 82 older (age 65 years and above) Chinese-American home care patients following recent hospital discharge. Results: 3.38% (22) and another 3.72% (28) of prescribed medications were identified as PIMs at hospital discharge and home care admission, respectively. There was no statistically significant difference in PIM prevalence identified at hospital discharge and at homecare admission (z=-1.732, p=.083). PIMs included: long-term use of stimulant laxatives and high-dosages of ferrous sulfate, and a significant relationship between these two PIMS (r=.224, p=.04). More than 80% (n=65) of study participants reported low education levels and limited English proficiency. Conclusions: Subtypes of PIMs were ordered during the post-hospital transfers, indicating the necessity to review the appropriateness of medications during this transition. Guidelines such as Beer's criteria regarding appropriateness of medications should be incorporated in medication reconciliation before adding new medications to treat the older adult's health problems. The medication management process needs to be both culturally sensitive and adapted to literacy level; validating the patients' full understanding of their medications is paramount.

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