Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing

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 hospi...

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Autores: San-José, Antonio|||0000-0001-8198-6112, Agustí Escasany, M. Antònia|||0000-0003-4594-1122, Vidal Guitart, Xavier|||0000-0001-6705-4298, Formiga, F.|||0000-0002-3587-298X, Lopez Soto, Alfonso, Fernández-Moyano, Antonio, García, Juana, Ramírez-Duque, Nieves, Torres Bonafonte, Olga H.|||0000-0002-0305-8211, Barbé, José
Tipo de documento: artigo
Data de publicação:2014
País:España
Recursos:Universitat Autònoma de Barcelona
Repositório:Dipòsit Digital de Documents de la UAB
Idioma:inglês
OAI Identifier:oai:ddd.uab.cat:306799
Acesso em linha:https://ddd.uab.cat/record/306799
https://dx.doi.org/urn:doi:10.1016/j.ejim.2014.07.011
Access Level:Acceso aberto
Palavra-chave:Inappropriate prescribing
Older multimorbidity patients
Polypharmacy
Potentially Prescribing Omissions
Potentially inappropriate medicines
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spelling Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribingSan-José, Antonio|||0000-0001-8198-6112Agustí Escasany, M. Antònia|||0000-0003-4594-1122Vidal Guitart, Xavier|||0000-0001-6705-4298Formiga, F.|||0000-0002-3587-298XLopez Soto, AlfonsoFernández-Moyano, AntonioGarcía, JuanaRamírez-Duque, NievesTorres Bonafonte, Olga H.|||0000-0002-0305-8211Barbé, JoséInappropriate prescribingOlder multimorbidity patientsPolypharmacyPotentially Prescribing OmissionsPotentially inappropriate medicinesPurpose: 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. 22014-01-0120142014-01-01Articlehttp://purl.org/coar/resource_type/c_6501SMURhttp://purl.org/coar/version/c_71e4c1898caa6e32info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/306799https://dx.doi.org/urn:doi:10.1016/j.ejim.2014.07.011reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest material està protegit per drets d'autor i/o drets afins. Podeu utilitzar aquest material en funció del que permet la legislació de drets d'autor i drets afins d'aplicació al vostre cas. Per a d'altres usos heu d'obtenir permís del(s) titular(s) de drets.https://rightsstatements.org/vocab/InC/1.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:3067992026-06-06T12:50:31Z
dc.title.none.fl_str_mv Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
title Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
spellingShingle Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
San-José, Antonio|||0000-0001-8198-6112
Inappropriate prescribing
Older multimorbidity patients
Polypharmacy
Potentially Prescribing Omissions
Potentially inappropriate medicines
title_short Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
title_full Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
title_fullStr Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
title_full_unstemmed Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
title_sort Inappropriate prescribing to older patients admitted to hospital: a comparison of different tools of misprescribing and underprescribing
dc.creator.none.fl_str_mv San-José, Antonio|||0000-0001-8198-6112
Agustí Escasany, M. Antònia|||0000-0003-4594-1122
Vidal Guitart, Xavier|||0000-0001-6705-4298
Formiga, F.|||0000-0002-3587-298X
Lopez Soto, Alfonso
Fernández-Moyano, Antonio
García, Juana
Ramírez-Duque, Nieves
Torres Bonafonte, Olga H.|||0000-0002-0305-8211
Barbé, José
author San-José, Antonio|||0000-0001-8198-6112
author_facet San-José, Antonio|||0000-0001-8198-6112
Agustí Escasany, M. Antònia|||0000-0003-4594-1122
Vidal Guitart, Xavier|||0000-0001-6705-4298
Formiga, F.|||0000-0002-3587-298X
Lopez Soto, Alfonso
Fernández-Moyano, Antonio
García, Juana
Ramírez-Duque, Nieves
Torres Bonafonte, Olga H.|||0000-0002-0305-8211
Barbé, José
author_role author
author2 Agustí Escasany, M. Antònia|||0000-0003-4594-1122
Vidal Guitart, Xavier|||0000-0001-6705-4298
Formiga, F.|||0000-0002-3587-298X
Lopez Soto, Alfonso
Fernández-Moyano, Antonio
García, Juana
Ramírez-Duque, Nieves
Torres Bonafonte, Olga H.|||0000-0002-0305-8211
Barbé, José
author2_role author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Inappropriate prescribing
Older multimorbidity patients
Polypharmacy
Potentially Prescribing Omissions
Potentially inappropriate medicines
topic Inappropriate prescribing
Older multimorbidity patients
Polypharmacy
Potentially Prescribing Omissions
Potentially inappropriate medicines
description 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.
publishDate 2014
dc.date.none.fl_str_mv 2
2014-01-01
2014
2014-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
SMUR
http://purl.org/coar/version/c_71e4c1898caa6e32
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/306799
https://dx.doi.org/urn:doi:10.1016/j.ejim.2014.07.011
url https://ddd.uab.cat/record/306799
https://dx.doi.org/urn:doi:10.1016/j.ejim.2014.07.011
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://rightsstatements.org/vocab/InC/1.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
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https://rightsstatements.org/vocab/InC/1.0/
eu_rights_str_mv openAccess
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dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
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