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Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals
Paul Gallagher, Pierre Olivier Lang, Antonio Cherubini, Eva Topinková, Alfonso Cruz-Jentoft, Beatriz Montero Errasquín, Pavla Mádlová, Beatrice Gasperini, Hilde Baeyens, Jean-Pierre Baeyens, Jean-Pierre Michel, Denis O'Mahony
Language English Country Germany
Document type Multicenter Study, Research Support, Non-U.S. Gov't
Grant support
NS10029
MZ0
CEP Register
Digital library NLK
Full text - Article
Source
NLK
ProQuest Central
from 1997-01-01 to 1 year ago
CINAHL Plus with Full Text (EBSCOhost)
from 2008-01-01 to 1 year ago
Medline Complete (EBSCOhost)
from 2000-01-01 to 1 year ago
Nursing & Allied Health Database (ProQuest)
from 1997-01-01 to 1 year ago
Health & Medicine (ProQuest)
from 1997-01-01 to 1 year ago
PubMed
21584788
Knihovny.cz E-resources
- MeSH
- Acute Disease * epidemiology MeSH
- Drug Utilization Review statistics & numerical data trends MeSH
- Prescription Drugs * administration & dosage adverse effects therapeutic use MeSH
- Humans MeSH
- Hospitals, University * standards statistics & numerical data MeSH
- Inappropriate Prescribing statistics & numerical data trends MeSH
- Prevalence MeSH
- Prospective Studies MeSH
- Risk Factors MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Health Services for the Aged standards statistics & numerical data MeSH
- Check Tag
- Humans MeSH
- Male MeSH
- Aged, 80 and over MeSH
- Aged MeSH
- Female MeSH
- Publication type
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Geographicals
- Europe MeSH
PURPOSE: Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe. METHODS: Prospective data were collected from 900 consecutive older patients admitted to six university teaching hospitals (150 patients per centre) in Geneva (Switzerland), Madrid (Spain), Oostende (Belgium), Perugia (Italy), Prague (Czech Republic) and Cork (Ireland). Age, gender, comorbidity, cognitive status, prescription medicines taken before admission and baseline haematological, biochemical and electrocardiographic data were recorded. STOPP and Beers' criteria were applied to detect potentially inappropriate medicines (PIMs). START criteria were applied to detect potentially inappropriate prescribing omissions (PPOs). RESULTS: The overall PIM prevalence rate was 51.3% using STOPP criteria, varying from 34.7% in Prague to 77.3% in Geneva, and 30.4% using Beer's criteria, varying from 22.7% in Prague to 43.3% in Geneva. Using START criteria, the overall PPO prevalence rate was 59.4%, ranging from 51.3% in Cork to 72.7% in Perugia. Polypharmacy predicted the presence of PIMs using STOPP criteria [with>10 medications: odds ratio (OR)7.22, 95% confidence interval (CI) 4.30-12.12, p<0.001] and Beers' criteria (with>10 medications: OR4.87, 95% CI 3.00-7.90, p<0.001). Increasing co-morbidity (Charlson Index>2) and age>85 years significantly predicted PPOs. CONCLUSION: Potentially inappropriate drug prescribing and the omission of beneficial drugs are highly prevalent in acutely ill hospitalized older people in six European centres.
Department of Geriatric Medicine 1st Faculty of Medicine Charles University Prague Czech Republic
Department of Geriatric Medicine AZ Alma Eeklo Belgium
Department of Geriatric Medicine AZ Damiaan Oostende Belgium
Department of Geriatric Medicine Cork University Hospital Wilton Cork Ireland
Department Servicio de Geriatría Hospital Universitario Ramón y Cajal Madrid Spain
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- $a Gallagher, Paul $u Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland. pfgallagher77@eircom.net
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- $a PURPOSE: Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe. METHODS: Prospective data were collected from 900 consecutive older patients admitted to six university teaching hospitals (150 patients per centre) in Geneva (Switzerland), Madrid (Spain), Oostende (Belgium), Perugia (Italy), Prague (Czech Republic) and Cork (Ireland). Age, gender, comorbidity, cognitive status, prescription medicines taken before admission and baseline haematological, biochemical and electrocardiographic data were recorded. STOPP and Beers' criteria were applied to detect potentially inappropriate medicines (PIMs). START criteria were applied to detect potentially inappropriate prescribing omissions (PPOs). RESULTS: The overall PIM prevalence rate was 51.3% using STOPP criteria, varying from 34.7% in Prague to 77.3% in Geneva, and 30.4% using Beer's criteria, varying from 22.7% in Prague to 43.3% in Geneva. Using START criteria, the overall PPO prevalence rate was 59.4%, ranging from 51.3% in Cork to 72.7% in Perugia. Polypharmacy predicted the presence of PIMs using STOPP criteria [with>10 medications: odds ratio (OR)7.22, 95% confidence interval (CI) 4.30-12.12, p<0.001] and Beers' criteria (with>10 medications: OR4.87, 95% CI 3.00-7.90, p<0.001). Increasing co-morbidity (Charlson Index>2) and age>85 years significantly predicted PPOs. CONCLUSION: Potentially inappropriate drug prescribing and the omission of beneficial drugs are highly prevalent in acutely ill hospitalized older people in six European centres.
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