Potentially Inappropriate Prescribing in Disabled Older Patients with Chronic Diseases: A Screening Tool of Older Persons' Potentially Inappropriate Prescriptions versus Beers 2012 Criteria

Abstract

Objective: To evaluate the prescription of potentially inappropriate medications (PIM), using the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Beers criteria, to disabled older people. Subjects and Methods: One hundred and forty-one patients aged ≥65 years with Barthel scale scores ≤60 and a regular intake of medication for chronic diseases at Chung Shan Medical University Hospital from July to December 2012 were included, and their medical records were reviewed. Comprehensive patient information was extracted from the patients' medical notes. The STOPP and Beers 2012 criteria were used separately to identify PIM, and logistic regression analyses were performed to identify risk factors for PIM. The optimal cutoff for the number of medications prescribed for predicting PIM was estimated using the Youden index. Results: Of the 141 patients, 94 (66.7%) and 94 (66.7%) had at least one PIM identified by the STOPP and Beers criteria, respectively. In multivariate analysis, PIM identified by the Beers criteria were associated with the prescription of multiple medications (p = 0.013) and the presence of psychiatric diseases (p < 0.001), whereas PIM identified by the STOPP criteria were only associated with the prescription of multiple medications (p = 0.008). The optimal cutoff for the number of medications prescribed for predicting PIM by using the STOPP or Beers criteria was 6. After adjustment for covariates, patients prescribed ≥6 medications had a significantly higher risk of PIM, identified using the STOPP or Beers criteria, compared to patients prescribed <6 medications (both p < 0.05). Conclusion: This study revealed a high frequency of PIM in disabled older patients with chronic diseases, particularly those prescribed ≥6 medications.

Hospital readmissions, mortality and potentially inappropriate prescribing: a retrospective study of older adults discharged from hospital

“…Consistent with previous studies using both versions 1 and 2 of the STOPP criteria, this study identified a significant association between polypharmacy (>5 medications) and prescription of at least one PIM [25,30,32,33,[35][36][37][38][39][40][41][42][43][44][45]. The association between PPO occurrence and polypharmacy identified in this study has been less consistently reported elsewhere [33,36,37,46].…”

Comparison of four criteria for potentially inappropriate medications in Brazilian community‐dwelling older adults

“…In a study carried out by Yang et al ., a high prevalence of PIM (66.7% by Beers 2012 and 2008 STOPP criteria) was found in elderly patients with chronic diseases . Comparison of the two criteria showed that the STOPP criteria had sensitivity of 79% and specificity of 38%, whereas the Beers criteria had sensitivity of 81% and specificity of 43% for polypharmacy .…”

“…However, few studies have compared these criteria to determine differences, applicability, ability to identify PIM and adaptability in different cultural contexts. Likewise, the studies carrying out this comparison focused only on the two most used criteria (Beers and Screening Tool of Older People's Potentially Inappropriate Prescriptions [STOPP]) …”

Potentially Inappropriate Prescribing in Older Adults with Hypertension or Diabetes Mellitus and Hypertension in a Primary Care Setting in Bahrain

“…Inappropriate prescribing has been recognized as one of the 5 most important quality-of-care problems in the older adults [5]. In addition to advanced age, multiple comorbidities and polypharmacy, or the concurrent use of multiple medications, are major risk factors for potentially inappropriate prescribing (PIP) in older adults [4, 6]. …”