Prevalence of potentially inappropriate prescribing among older adults: A comparison of the Beers 2012 and Screening Tool of Older Person's Prescriptions criteria version 2.

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Bahat G., Bay İ., Tufan A., Tufan F., Kılıç C., Karan M. A.

Geriatrics & gerontology international, cilt.17, sa.9, ss.1245-1251, 2017 (SCI-Expanded) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 17 Sayı: 9
  • Basım Tarihi: 2017
  • Doi Numarası: 10.1111/ggi.12850
  • Dergi Adı: Geriatrics & gerontology international
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Social Sciences Citation Index (SSCI), Scopus
  • Sayfa Sayıları: ss.1245-1251
  • Anahtar Kelimeler: Beers 2012, comparison, potentially inappropriate prescribing, Screening Tool of Older Person's Prescriptions version 2, ADVERSE DRUG EVENTS, ELDERLY-PATIENTS, STOPP CRITERIA, ALERT DOCTORS, MEDICATIONS, POLYPHARMACY, RISK
  • İstanbul Üniversitesi Adresli: Evet

Özet

Aim: To date, there is no study comparing the Beers 2012 and Screening Tool of Older Person's Prescriptions (STOPP) version 2 criteria, nor reporting a comparison of the prevalence of potentially inappropriate Prescribing (PIM) with STOPP version 2. We aimed to evaluate the prescriptions of patients admitted to a geriatric outpatient clinic with these tools, and to document the factors related to PIM use.

Methods: Older patients (aged ≥65 years) admitted to the outpatient clinic of a university hospital were retrospectively evaluated for PIM with Beers 2012 and STOPP version 2 criteria. Age; sex; chronic disease and number of drugs; and functional, depression and nutritional statuses were studied with regression analysis as possible factors related to PIM.

Results: The study included 667 participants (63.1% women, mean age 77.6 ± 6.3 years). The mean number of drugs was 6.1 ± 3.4. PIM prevalence detected by STOPP version 2 was higher than that of the Beers 2012 criteria (39.1% vs 33.3%, respectively; P < 0.001; Z = -3.5) with moderate agreement in between (kappa = 0.44). Antipsychotics, over-the-counter vitamin/supplements, aspirin, selective-serotonin-reuptake-inhibitors and anticholinergics were the leading drug classes for PIM. The extent of polypharmacy (P < 0.001, OR 1.29, 95% CI 1.20-1.38) was the most important variable related to PIM, along with the multiple comorbidities (P = 0.005, OR 1.16, 95% CI 1.05-1.30). Higher level of functionality was inversely associated with PIM (P = 0.009, OR 0.90, 95% CI 0.83-0.97).

Conclusions: Inappropriate prescription prevalence of ~40% by STOPP version 2 was similar to the global worldwide prevalence - yet at the upper end. STOPP version 2 was more successful than Beers 2012 to detect PIM. Patients with multiple drug use, multiple comorbidities and more dependency were more likely to have PIM requiring special attention during prescription.