Impact of potentially inappropriate medication use on healthcare utilization and mortality in older adults with multimorbidity

Impact of potentially inappropriate medication use on healthcare utilization and mortality in older adults with multimorbidity | Authorea try { document.documentElement.classList.add('js'); } catch (e) { } var _gaq = _gaq || []; _gaq.push(['_setAccount', 'G-8VDV14Y67G']); _gaq.push(['_trackPageview']); (function() { var ga = document.createElement('script'); ga.type = 'text/javascript'; ga.async = true; ga.src = ('https:' == document.location.protocol ? 'https://ssl' : 'http://www') + '.google-analytics.com/ga.js'; var s = document.getElementsByTagName('script')[0]; s.parentNode.insertBefore(ga, s); })(); Skip to main content Preprints Collections Wiley Open Research IET Open Research Ecological Society of Japan All Collections About About Authorea FAQs Contact Us Quick Search anywhere Search for preprint articles, keywords, etc. Search Search ADVANCED SEARCH SCROLL This is a preprint and has not been peer reviewed. Data may be preliminary. 30 June 2025 V1 Latest version Share on Impact of potentially inappropriate medication use on healthcare utilization and mortality in older adults with multimorbidity Authors : Betty Chia-Chen Chang , I-Hua Lai , Yee-Yung Ng , and Shiao-Chi Wu 0000-0002-8051-0769 [email protected] Authors Info & Affiliations https://doi.org/10.22541/au.175130673.32246368/v1 144 views 126 downloads Contents Abstract Supplementary Material Information & Authors Metrics & Citations View Options References Figures Tables Media Share Abstract Aim Ensuring medication safety continues to be a challenging problem in older adults with multiple chronic diseases. This study aims to investigate the association of potentially inappropriate medication use with healthcare utilization and mortality and also explore the influence of pay-for-performance programs in multimorbid older adults in Taiwan. Method The study population was comprised of older adults aged 65 years or older with multimorbidity and at least one outpatient drug prescription in 2018. Healthcare utilization (outpatient clinic visit, emergency room visit, hospitalization) and medical cost at six months were analyzed using general linear model (continuous) and multiple logistic regression (categorical). Mortality at one year was determined using Cox-proportional hazard regression model. Separate analyses were performed for disease subgroups with pay-for-performance programs. Results The prevalence of PIM use was 85.6% in the multimorbid older adult population. PIM use was associated with increased outpatient clinic visit (β=0.0591, SE 0.0008, p<0.0001), emergency department visit (aOR 1.103, 95% CI 1.094-1.112, p<0.0001), hospitalization (aOR 1.131, 95%CI 1.120-1.143, p<0.0001), and total medical cost (β=0.0507, SE 0.0024, p<0.0001). After adjusting for covariates, PIM use had higher risk of mortality at one year (aHR 3.509, 95%CI 3.285-3.748, p<0.0001). The positive association of PIM use with healthcare utilization attenuated with enrollment in pay-for-performance program. Conclusion: PIM use was significantly associated with increased risk of healthcare utilization and mortality in older adults with multimorbidity, which indicated the need for selection of safer drug therapy or alternatives in this vulnerable population. Supplementary Material File (pds-25-0486-file001.docx) Download 58.61 KB Information & Authors Information Version history V1 Version 1 30 June 2025 Copyright This work is licensed under a Non Exclusive No Reuse License. Keywords healthcare utilization mortality multimorbidity potentially inappropriate medications Authors Affiliations Betty Chia-Chen Chang National Yang Ming Chiao Tung University Institute of Health and Welfare Policy View all articles by this author I-Hua Lai National Yang Ming Chiao Tung University Institute of Health and Welfare Policy View all articles by this author Yee-Yung Ng Fu Jen Catholic University College of Medicine View all articles by this author Shiao-Chi Wu 0000-0002-8051-0769 [email protected] National Yang Ming Chiao Tung University Institute of Health and Welfare Policy View all articles by this author Metrics & Citations Metrics Article Usage 144 views 126 downloads .FvxKWukQNSOunydq8rnd { width: 100px; } Citations Download citation Betty Chia-Chen Chang, I-Hua Lai, Yee-Yung Ng, et al. Impact of potentially inappropriate medication use on healthcare utilization and mortality in older adults with multimorbidity. Authorea . 30 June 2025. DOI: https://doi.org/10.22541/au.175130673.32246368/v1 If you have the appropriate software installed, you can download article citation data to the citation manager of your choice. Simply select your manager software from the list below and click Download. For more information or tips please see 'Downloading to a citation manager' in the Help menu . Format Please select one from the list RIS (ProCite, Reference Manager) EndNote BibTex Medlars RefWorks Direct import Tips for downloading citations document.getElementById('citMgrHelpLink').addEventListener('click', function() { popupHelp(this.href); return false; }); $(".js__slcInclude").on("change", function(e){ if ($(this).val() == 'refworks') $('#direct').prop("checked", false); $('#direct').prop("disabled", ($(this).val() == 'refworks')); }); View Options View options PDF View PDF Figures Tables Media Share Share Share article link Copy Link Copied! Copying failed. 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