Prevalence of potentially inappropriate medications and risk of adverse clinical outcome in a cohort of hospitalized elderly patients: results from the REPOSI Study

Abstract

This study found no significant effect of inappropriate drug use according to Beers' criteria on health outcomes among older adults 3 month after discharge. Even though these criteria have been suggested as helpful in promoting appropriate prescribing, reducing drug-related adverse events and associated healthcare costs, to date there is no clear evidence that their application can achieve objective and quantifiable improvements in clinical outcomes. A possible explanation is that both versions of the Beers' criteria have several recognized limitations, one of the main ones being the restricted availability of some drugs in Europe or their limited prescription in everyday clinical practice.

The Association Between Potentially Inappropriate Prescribing and Medication-Related Hospital Admissions in Older Patients: A Nested Case Control Study

“…Our findings are also similar to those of other studies with regard to the prevalence of PIMs identified with the Beers 2012 and STOPP 2008 criteria, although it should be remembered that our study population consisted of patients hospitalized because of ADEs. We found that the prevalence of Beers 2012 criteria PIMs in the total cohort was 44.4 %, whereas other studies reported a prevalence of between 22.9 and 58.4 % [13,14,29,30]. We found the prevalence of STOPP & START 2008 criteria PIMs and PPOs to be, respectively, 34.1 and 57.7 %, whereas Castillo-Páramo et al [31] reported a prevalence of PIMs of 37.5 % in a primary care setting; the prevalence of PPOs was 45.9 %.…”

“…There was no significant association between the number of hospital visits and the Beers 2012 criteria [28]. Pasina et al [29] also found inappropriate drug use according to the Beers 2012 criteria not to be significantly associated with health outcomes (adverse clinical events, re-hospitalization, and all-cause mortality) 3 months after discharge. In general, the results of our study are in line with most of these earlier studies as far as they are comparable.…”

Exposure to potentially inappropriate medications in Brazilian elderly outpatients with metabolic diseases

“…Moreover 65% of the 40 Beers-detected PIMs had high level of severity. Other works have reported that long-acting benzodiazepines are the most frequent PIMs prescribed for North American and European older adults according to the 2003 Beers list (Stafford, Alswayan, Tenni, 2011;Gorzoni, Fabbri, Pires, 2012;Pasina et al, 2014).…”

“…Prevalence of PIMs according to 2003 Beers criteria varied from 13% to 27% in primary care settings, nursing homes and hospitalized patients from different sample populations (Fick et al, 2003, Ryan et al, 2009, Leikola et al, 2011Pasina et al, 2014). Using STOPP criteria PIMs were found in 29-44% of acutely ill hospitalized patients, primary care centers and nursing homes from different countries (Gallagher, O'Mahony, 2008;Cahir et al, 2010;Liu et al, 2012;Ubeda et al, 2012;Bradley et al, 2014).…”

Inappropriate prescribing, non-adherence to long-term medications and related morbidities : Pharmacoepidemiological aspects

“…Since STOPP criteria are currently largely used to evaluate the quality of prescribing in the elderly, this finding extends the evidence on their predictive value to detect ADRs across healthcare settings, including primary care. The main limitations of other prescribing criteria, including the widely used Beers, is the lack of evidence on causal association with adverse health outcomes including ADRs (109,110,240).…”