ABSTRACT
INTRODUCTION: Older adults are among the most vulnerable groups during the COVID-19 epidemic, contributing to a large proportion of COVID-19-related death. Medication review and reconciliation by pharmacist can help reduce the number of potentially inappropriate medications but these services were halted during COVID-19. AIM: To assess the prevalence and factors associated with inappropriate medicine use among older populations with COVID-19. METHODS: This was a cross-sectional, retrospective analysis of medications among hospitalized older adults with COVID-19. Potentially inappropriate medication use was categorized using the Beer's and STOPP criteria. RESULTS: Combining both criteria, 181 (32.7%) of the 553 patients were identified to have used at least one or more potentially inappropriate medication. A marginally higher number of inappropriate medications was documented using the Beers 2019 criteria (151 PIM in 124 patients) compared to STOPP criteria (133 PIMS in 104 patients). The long-term use of proton pump inhibitors (n = 68; 12.3%) and drugs which increases the risk of postural hypotension were the most commonly reported PIM (n = 41; 7.4%). Potentially inappropriate medication use was associated with previous history of hospital admission in the past 12 months (Odds ratio [OR]: 2.27; 95% CI 1.29-3.99) and higher number of discharge medications. CONCLUSIONS: Nearly, one in three older adults with COVID-19 had been prescribed a PIM, and the proportion of older adults with polypharmacy increased after discharge. This highlights the importance of having clinical pharmacist conducting medication reviews to identify PIMs and ensure medication appropriateness.
ABSTRACT
BACKGROUND: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), or 2019 coronavirus disease (COVID-19), was declared as pandemic in early 2020. While several studies reported the short-term adverse events (AE) of the mRNA COVID-19 vaccines, medium-term AE have not been extensively evaluated. This study aimed to evaluate the 6-month side effect profiles of the BNT162b2 mRNA vaccine. METHODS: This was a descriptive cross-sectional study conducted in a tertiary hospital. Hospital workers who received two doses of the Cominarty (BNT162b2) mRNA vaccine, six months post-vaccination, were invited to participate in this study. All participants completed a self-reported survey assessing AEs occurrence and severity, duration of onset and recovery and if they previously reported these AEs. RESULTS: Of the 670 respondents who completed the survey, 229 (34.2%) experienced at least one AEs, with a total of 937 AEs reported during the 6-month period. After the first dose, the most common reported localized symptoms were pain (n = 106, 27.2%), swelling (n = 38, 9.8%) and erythematous (n = 12, 3.1%) at injection site. Systemic symptoms reported include fatigue (n = 72, 18.5%), fever (n = 55, 14.1%) and headache (n = 46, 11.8%). After the second dose, pain at site of injection (n = 112, 20.4%), swelling (n = 42, 7.7%) and erythematous (n = 14, 2.6%) were among the localized AE reported, while fever (n = 121, 22.1%), fatigue (n = 101, 18.4%) and headache (n = 61, 11.1%) were the most common systemic AE. The proportion of respondents who experienced moderate (first dose: 156 events; second dose: 272 events) and severe (1st dose: 21 events; 2nd dose: 30 events) AEs were higher after the second dose. Most AEs commonly resolved within 1-2 days, and none required hospitalization. No new onset of AE was observed 7 days post-vaccination. A total of 137 (59.8%) participants did not proceed to formal AE reporting. CONCLUSION: Most of the AEs reported were of mild to moderate intensity and short-term, consistent with those reported in previous studies. No medium-term finding was detected in the survey. AE reporting was not routinely performed, necessitating the attention of health authorities in order to enhance pharmacovigilance.
