Does ongoing general practitioner care in elderly patients help reduce the risk of unplanned hospitalization related to <scp>B</scp>eers potentially inappropriate medications?

<jats:sec><jats:title>Aim</jats:title><jats:p>To compare estimates of unplanned hospitalizations associated with exposure to Beers potentially inappropriate medications (<jats:styled-content style="fixed-case">PIM</jats:styled-content>) in elderly people receiving different levels of ongoing general practitioner (<jats:styled-content style="fixed-case">GP</jats:styled-content>) care.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>Using the pharmaceutical claims and other linked health data of 245 436 Western Australians aged ≥65 years with one or more claims for a medication from a <jats:styled-content style="fixed-case">PIM</jats:styled-content>‐related drug class (1993–2005), we applied an enhanced case–time–control design to obtain odds ratios (<jats:styled-content style="fixed-case">OR</jats:styled-content>) for unplanned hospitalization, from which attributable fractions, numbers, proportions and rates of admissions related to <jats:styled-content style="fixed-case">PIM</jats:styled-content> exposure were derived.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Overall, 383 150 unplanned hospitalizations (“index subjects”) were identified. <jats:styled-content style="fixed-case">PIM</jats:styled-content> exposure was associated with a similar relative risk of unplanned hospitalization in elderly people receiving the lowest and highest levels of ongoing <jats:styled-content style="fixed-case">GP</jats:styled-content> care, but with a decreasing risk in the three highest tiers; adjusted <jats:styled-content style="fixed-case">OR</jats:styled-content> (95% <jats:styled-content style="fixed-case">CI</jats:styled-content>; attributable fractions) were 1.15 (1.09–1.21; 12.9%), 1.36 (1.27–1.46; 26.6%), 1.20 (1.15–1.26; 16.9%) and 1.13 (1.09–1.17; 11.4%) for groups from the lowest to highest levels. However, those with higher <jats:styled-content style="fixed-case">GP</jats:styled-content> coverage had higher rates of <jats:styled-content style="fixed-case">PIM</jats:styled-content>‐related hospitalization. Similar patterns were shown for commonly used high‐risk <jats:styled-content style="fixed-case">PIM</jats:styled-content> (temazepam, diazepam, oxazepam, naproxen and digoxin).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>Increased requirement for ongoing <jats:styled-content style="fixed-case">GP</jats:styled-content> contact in less healthy elderly people appears to help minimize their risk of unplanned hospitalization due to <jats:styled-content style="fixed-case">PIM</jats:styled-content>‐related harm. <jats:styled-content style="fixed-case">GPs</jats:styled-content> should continue to avoid <jats:styled-content style="fixed-case">B</jats:styled-content>eers medications in older patients where possible, given their greater predisposition to medication exposure (including <jats:styled-content style="fixed-case">PIM</jats:styled-content>) and adverse drug events. Nevertheless, close monitoring of elderly patients who need to use <jats:styled-content style="fixed-case">PIM</jats:styled-content> should prove beneficial. <jats:bold>Geriatr Gerontol Int 2015; 15: 1031–1039.</jats:bold></jats:p></jats:sec>