TY - JOUR
T1 - Potentially inappropriate drug use among hospitalised older adults
T2 - Results from the CRIME study
AU - Tosato, Matteo
AU - Landi, Francesco
AU - Martone, Anna Maria
AU - Cherubini, Antonio
AU - Corsonello, Andrea
AU - Volpato, Stefano
AU - Bernabei, Roberto
AU - Onder, Graziano
PY - 2014/11/1
Y1 - 2014/11/1
N2 - Background: Beers criteria and screening tool of older person's prescriptions (STOPP) criteria are widely used to assess potentially inappropriate drug use (PIDU). Objective: the aims of the present study are (i) to assess the prevalence of PIDU based on 2012 Beers criteria and STOPP criteria and (ii) to determine the impact of PIDU, as defined by these criteria, on health outcomes among older in-hospital patients. Design: prospective observational study. Setting and subjects: a total of 871 in-hospital patients participating to the CRIteria to Assess Appropriate Medication Use among Elderly Complex Patients project. Methods: outcome measures were (i) adverse drug reactions (ADR); (ii) decline in functional status; (iii) combined outcome (ADR or declined in functional status). Results: the prevalence of PIDU was 58.4% applying Beers criteria, 50.4% applying STOPP criteria and 75.0% combining both sets of criteria. PIDU defined based on STOPP criteria was significantly associated with ADR [odds ratio (OR) 2.36; 95% confidence interval (CI) 1.10-5.06], and decline in physical function (OR: 2.00; 95% CI: 1.10-3.64), while, despite a positive trend, no significant association was observed for Beers criteria or the combination of both criteria. The combined outcome was significantly associated with PIDU defined based on Beers (OR: 1.74; 95% CI: 1.06-2.85), STOPP criteria (OR: 2.14; 95% CI: 1.32-3.47) or both (OR 2.02; 95% CI: 1.06-3.84). Conclusions: PIDU is common in hospitalised older adults and the combination of Beers and STOPP criteria might lead to the identification of a larger number of cases of PIDU than the application of a single set of criteria. STOPP criteria significantly predict all in-hospital outcomes considered, while Beers criteria were significantly associated with the combined outcome only.
AB - Background: Beers criteria and screening tool of older person's prescriptions (STOPP) criteria are widely used to assess potentially inappropriate drug use (PIDU). Objective: the aims of the present study are (i) to assess the prevalence of PIDU based on 2012 Beers criteria and STOPP criteria and (ii) to determine the impact of PIDU, as defined by these criteria, on health outcomes among older in-hospital patients. Design: prospective observational study. Setting and subjects: a total of 871 in-hospital patients participating to the CRIteria to Assess Appropriate Medication Use among Elderly Complex Patients project. Methods: outcome measures were (i) adverse drug reactions (ADR); (ii) decline in functional status; (iii) combined outcome (ADR or declined in functional status). Results: the prevalence of PIDU was 58.4% applying Beers criteria, 50.4% applying STOPP criteria and 75.0% combining both sets of criteria. PIDU defined based on STOPP criteria was significantly associated with ADR [odds ratio (OR) 2.36; 95% confidence interval (CI) 1.10-5.06], and decline in physical function (OR: 2.00; 95% CI: 1.10-3.64), while, despite a positive trend, no significant association was observed for Beers criteria or the combination of both criteria. The combined outcome was significantly associated with PIDU defined based on Beers (OR: 1.74; 95% CI: 1.06-2.85), STOPP criteria (OR: 2.14; 95% CI: 1.32-3.47) or both (OR 2.02; 95% CI: 1.06-3.84). Conclusions: PIDU is common in hospitalised older adults and the combination of Beers and STOPP criteria might lead to the identification of a larger number of cases of PIDU than the application of a single set of criteria. STOPP criteria significantly predict all in-hospital outcomes considered, while Beers criteria were significantly associated with the combined outcome only.
KW - Adverse drug reactions
KW - Disability
KW - In-hospital
KW - Inappropriate drug use
KW - Older adults
KW - Older people
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U2 - 10.1093/ageing/afu029
DO - 10.1093/ageing/afu029
M3 - Article
C2 - 24637848
AN - SCOPUS:84911440157
VL - 43
SP - 767
EP - 773
JO - Age and Ageing
JF - Age and Ageing
SN - 0002-0729
IS - 6
ER -