The exposure to potentially inappropriate medications is higher among older patients with hemophilia and von Willebrand disease than the general population of older individuals, according to the results of a multicentre prospective observational study called M’HEMORRH-AGE.

“Interventions focusing on deprescription of these inappropriate medications should be conducted in this specific population,” the authors said in the study published in the Journal of Clinical Pharmacy and Therapeutics.

It is already known that older individuals use multiple medications due to many chronic conditions they may have, which leads to a high risk of adverse effects in this population. However, the exposure to inappropriate medications in patients with hemophilia and von Willebrand disease was not known.


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The M’HEMORRH-AGE study aimed to explore this. A total of 142 patients with hemophilia and 53 patients with von Willebrand disease aged 67 to 79 years were included. The results showed that 45.8% of older patients with hemophilia and von Willebrand disease used potentially inappropriate medications.

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Of those 34.9% were cardiovascular medications, 26.7% were nervous system medications, and 25.6% were alimentary tract and metabolism medications. A little more than 37.3% of patients were exposed to inappropriate anticholinergic and/or sedative medications due to nervous system medications like analgesics.

This distribution of inappropriate medication use is different than the general population of older individuals, the researchers said. Older patients with hemophilia or von Willebrand disease use more analgesics to manage the pain caused by arthropathy and less anti-inflammatory medications.

“To prevent, adverse drug events and their impact on daily life, deprescribing interventions focusing on the reduction of medication number must be considered,” they wrote.

They also said that identifying the main potentially inappropriate medications that are used by these patients can help raise awareness among prescribers and reduce their use.

Reference

Novais T, Prudent C, Cransac A, et al. 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. Published online January 12, 2022. doi:10.1111/jcpt.13607