Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
San-José, Antonio (Universitat Autònoma de Barcelona. Departament de Medicina)
Agustí Escasany, M. Antònia (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Vidal Guitart, Xavier (Universitat Autònoma de Barcelona. Departament de Farmacologia, de Terapèutica i de Toxicologia)
Formiga, Francesc (Hospital Universitari de Bellvitge)
Lopez Soto, Alfonso (Hospital Clínic i Provincial de Barcelona)
Fernández-Moyano, Antonio (Hospital San Juan de Dios del Aljarafe (Sevilla, Andalusia))
García, Juana (Hospital Juan Ramón Jiménez (Huelva))
Ramírez-Duque, Nieves (Hospital Universitario Virgen del Rocío (Sevilla, Andalusia))
Torres, Olga H. (Hospital de la Santa Creu i Sant Pau (Barcelona, Catalunya))
Barbé, José (Hospital Universitari Vall d'Hebron)

Data:	2014
Resum:	Purpose: This study aims to assess inappropriate prescribing (IP) to elderly patients during the month prior to hospitalization and to compare different IP criteria. Methods: An observational, prospective and multicentric study was carried out in the internal medicine services of seven Spanish hospitals. Patients aged 75years and older were randomly selected after hospital admission for a year. To assess potentially inappropriate medicines (PIMs), the Beers and STOPP criteria were used and to assess potentially prescribing omissions (PPOs), the START criteria and ACOVE-3 medicine quality indicators were used. An analysis to assess factors associated with IP was performed. Results: 672 patients [median age (Q1-Q3) 82 (79-86) years, 55. 9% female] were included. Median prescribed medicines in the month prior to hospitalization were 10(Q1-Q3 7-13). The prevalence of IP was 87. 6%, and 54. 3% of patients had PIMs and PPOs concurrently. A higher prevalence rate of PIMs was predicted using the STOPP criteria than with the Beers criteria (p<0. 001) and a higher prevalence of PPOs using the ACOVE-3 criteria than using the START criteria (p<0. 001) was observed. Polypharmacy (≥ 10 medicines) was the strongest predictor of IP [OR=11. 34 95% confidence interval (CI) 4. 96-25. 94], PIMs [OR=14. 16, 95% CI 6. 44-31. 12], Beers-listed PIMs [OR=8. 19, 95% CI 3. 01-22. 28] and STOPP-listed PIMs [OR=8. 21, 95% CI 3. 47-19. 44]. PIMs was the strongest predictor of PPOs [OR=2. 79, 95% CI 1. 81-4. 28]. Conclusions: A high prevalence of polypharmacy and PIMs and PPOs were reported. More than half the patients had simultaneous PIMs and PPOs. The related factors to PIMs and PPOs were different.
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Llengua:	Anglès
Document:	Article ; recerca ; Versió sotmesa a revisió
Matèria:	Inappropriate prescribing ; Older multimorbidity patients ; Polypharmacy ; Potentially Prescribing Omissions ; Potentially inappropriate medicines
Publicat a:	Eur J Intern Med, Vol. 25, Núm. 8 (October 2014) , p. 710-716, ISSN 0953-6205

DOI: 10.1016/j.ejim.2014.07.011

Preprint 22 p, 382.7 KB

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