Potentially inappropriate medications and anticholinergic and sedative burden in older patients with haemophilia or von Willebrand disease: The M'HEMORRH-AGE study

J Clin Pharm Ther. 2022 Jun;47(6):783-791. doi: 10.1111/jcpt.13607. Epub 2022 Jan 12.

Abstract

What is known and objective: In older patients, multiple chronic conditions lead to the intake of multiple medications and a higher risk of adverse drug events. The exposure to inappropriate medications in older patients with bleeding disorders is poorly explored. The aim of this study was to describe the exposure to potentially inappropriate medications (PIMs) and medications with anticholinergic and sedative properties in older community-dwelling patients with haemophilia or von Willebrand Disease (VWD).

Methods: The M'HEMORRH-AGE study (Medication in AGEd patients with HAEMORRHagic disease) is a multicentre prospective observational study. Community-dwelling patients over 65 years with haemophilia or VWD were included in the study. PIMs were identified using the EU(7)-PIM list, and the anticholinergic and sedative drug exposure was measured using the Drug Burden Index.

Results and discussion: 142 older community-dwelling patients with haemophilia (n = 89) or VWD (n = 53) were included (mean age: 72.8 ± 5.8 years). PIMs were used by 45.8% of older patients and were mainly represented by cardiovascular (34.9%), nervous systems (26.7%) and alimentary tract and metabolism PIMs (25.6%). Regarding anticholinergic and/or sedative medications, 37.3% of older patients were exposed mainly due to nervous system medications (68.3%), for example analgesics.

What is new and conclusion: The M'HEMORRH-AGE study showed the exposure to PIMs and anticholinergic/sedative medications was high in older community-dwelling patients with haemophilia or VWD. Interventions focusing on deprescription of these inappropriate medications should be conducted in this specific population.

Keywords: Drug burden index; France; haemophilia; older patient; potentially inappropriate medication; von Willebrand disease.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Cholinergic Antagonists / adverse effects
  • Hemophilia A* / drug therapy
  • Humans
  • Hypnotics and Sedatives / therapeutic use
  • Inappropriate Prescribing
  • Potentially Inappropriate Medication List
  • von Willebrand Diseases* / chemically induced
  • von Willebrand Diseases* / drug therapy

Substances

  • Cholinergic Antagonists
  • Hypnotics and Sedatives