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Title: Inappropriate prescribing to older patients admitted to hospital: A comparison of different tools of misprescribing and underprescribing
Author: San-José, Antonio
Agustí, Antonia
Vidal, Xavier
Formiga Pérez, Francesc
López-Soto, Alfonso
Fernández Moyano, Antonio
García, Juana
Ramírez Duque, Nieves
Torres, Olga H.
Barbé, José
Keywords: Prescripció de medicaments
Malalties de les persones grans
Administració de medicaments
Drug prescribing
Older people diseases
Administration of drugs
Issue Date: 29-Aug-2014
Publisher: Elsevier B.V.
Abstract: 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 75 years 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<.001) and a higher prevalence of PPOs using the ACOVE-3 criteria than using the START criteria (p<.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.
Note: Versió postprint del document publicat a:
It is part of: European Journal Of Internal Medicine, 2014, vol. 25, num. 8, p. 710-716
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ISSN: 0953-6205
Appears in Collections:Articles publicats en revistes (Patologia i Terapèutica Experimental)

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