Clinical factors affecting potentially inappropriate medications at discharge in older stroke patients

Introduction Factors for increased in potentially inappropriate medications (PIMs) are poorly documented in a rehabilitation setting. The goal of this study is to identify clinical factors that are strongly associated with increased PIMs in stroke patients. Methods This retrospective cohort study included consecutive geriatric stroke patients in convalescent rehabilitation wards between 2010 and 2016. We investigated functional independence measure (FIM) and the characteristics of patients with and without PIMs at discharge. We used the 2015 American Geriatrics Society Beers Criteria to screen for PIMs. Multiple linear regression analysis was performed to analyze the relationship between PIM use and functional recovery. Results In total, 418 participants (171 males, 247 females; median age 78 years; interquartile range 72-84 years) were included in the present study. Multiple linear regression analysis of PIMs use at discharge adjusting for potential confounders showed that gender, cardiac disease, diabetes mellitus, number of drugs at discharge, FIM-cognitive gain, and age are independent factors associated with PIMs prescribed at discharge (R-2 = 0.384; p < 0.0001). Conclusion Potentially inappropriate medications use at discharge is negatively correlated with cognitive recovery of activities of daily living. This suggests that PIMs increase might have caused cognitive deterioration.