A combination of Beers and STOPP criteria better detects potentially inappropriate medications use among older hospitalized patients with chronic diseases and polypharmacy: a multicenter cross-sectional study

Abstract

Background Research on potentially inappropriate medications (PIM) and medication-related problems (MRP) among the Chinese population with chronic diseases and polypharmacy is insufficient. Objectives This study aimed to investigate the prevalence of PIM and MRP among older Chinese hospitalized patients with chronic diseases and polypharmacy and analyze the associated factors. Methods A retrospective cross-sectional study was conducted in five tertiary hospitals in Beijing. Patients aged ≥ 65 years with at least one chronic disease and taking at least five or more medications were included. Data were extracted from the hospitals’ electronic medical record systems. PIM was evaluated according to the 2015 Beers criteria and the 2014 Screening Tool of Older Persons’ Prescriptions (STOPP) criteria. MRPs were assessed and classified according to the Helper-Strand classification system. The prevalence of PIM and MRP and related factors were analyzed. Results A total of 852 cases were included. The prevalence of PIM was 85.3% and 59.7% based on the Beers criteria and the STOPP criteria. A total of 456 MRPs occurred in 247 patients. The most prevalent MRP categories were dosages that were too low and unnecessary medication therapies. Hyperpolypharmacy (taking ≥ 10 drugs) (odds ratio OR 3.736, 95% confidence interval CI 1.541–9.058, P = 0.004) and suffering from coronary heart disease (OR 2.620, 95%CI 1.090–6.297, P = 0.031) were the influencing factors of inappropriate prescribing (the presence of either PIM or MRP in a patient). Conclusion PIM and MRP were prevalent in older patients with chronic disease and polypharmacy in Chinese hospitals. More interventions are urgently needed to reduce PIM use and improve the quality of drug therapies.

Potentially Inappropriate Medications in Hospitalized Older Patients in Tabuk, Saudi Arabia Using 2023 Beers Criteria: A Retrospective Multi-Centric Study

“…A higher prevalence rate has also been observed in other studies. A study conducted in China reported 93.8% of PIM prevalence 25 and a Portuguese study reported the prevalence of PIMs to be 92%. 26 However, a study conducted in Riyadh, Saudi Arabia, reported that the prevalence of PIM in older adults was 57.2%, 63.6% and 60.4% in 2017, 2018 and 2019, respectively.…”

The Status of Drug Prescription Based on Beers Criteria (Edition 2022) in the Community-dwelling Older Adults Living in Tabriz, Iran: Data From Tabriz Older People Health Survey (TOPS)

“…The researchers of this study stated that one of the main causes is high polypharmacy ( ≥ 10 drugs) in older adults. 16 The difference in the type of used drugs can be one of the reasons for obtaining different results in different countries. Further, there may be several inappropriate drugs according to the Beers criteria in the essential drug list of some countries.…”

Medication-Related Problems and Their Intervention in the Geriatric Population: A Review of the Literature

“…Hyperpolypharmacy (taking ≥10 medications) and the presence of coronary heart disease were the main factors of PIM [ 40 ]. Studies from Europe and North America indicate that PIMs and subsequent adverse drug reactions may cause 1.5-15% of emergency department visits and unplanned hospitalizations among older people [ 41 ]. In two cross-sectional retrospective studies conducted in the central region of Saudi Arabia, almost one out of two older adult patients (age ≥ 65 years) treated in an ambulatory care setting had used PIMs.…”