PMID- 23229766
OWN - NLM
STAT- MEDLINE
DCOM- 20140109
LR  - 20220330
IS  - 1179-1969 (Electronic)
IS  - 1170-229X (Linking)
VI  - 30
IP  - 1
DP  - 2013 Jan
TI  - A prevalence study of potentially inappropriate prescribing in Irish long-term 
      care residents.
PG  - 39-49
LID - 10.1007/s40266-012-0039-7 [doi]
AB  - BACKGROUND: Older individuals often suffer from multiple co-morbidities and are 
      particularly vulnerable to potentially inappropriate prescribing (PIP). One 
      method of defining instances of PIP is to use validated, evidence-based, explicit 
      criteria. Two sets of criteria have gained international recognition: the 
      Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) 
      and Beers' criteria. OBJECTIVES: The study aims were to (1) determine the 
      prevalence of PIP in older residents residing in long-term care (LTC) facilities 
      in the greater Cork region of Ireland using these tools; (2) assess the 
      applicability of the STOPP and Beers' criteria and compare the prevalence of PIP 
      determined by each set of criteria; and (3) investigate the association between 
      the occurrence of PIP determined by both tools and the number of medications 
      prescribed, age, sex and Charlson Comorbidity Index (CCI) score. METHOD: All 15 
      publically funded LTC facilities in the greater Cork region of Ireland were 
      approached, and 14 agreed to participate. Residents aged >/=65 years were included. 
      Exclusion criteria included terminally ill residents or residents receiving 
      respite care. The prevalence of PIP was determined by applying the STOPP and 
      Beers' criteria to each resident's medication profile. Two multivariate logistic 
      regression models examined the association between the occurrence of PIP as 
      determined by STOPP criteria and by Beers' criteria and the number of drugs 
      prescribed, age, sex and CCI score. RESULTS: The sample population in this study 
      included 732 residents from 14 LTC facilities; the median age was 85 years 
      (interquartile range [IQR] 79-89) and 514 residents (70.2 %) were female. The 
      total number of medications prescribed was 8,325 (median 11, IQR 9-14; range 
      2-25). At least one instance of PIP was experienced by approximately 70 % of 
      patients when evaluated using the STOPP criteria, while the corresponding figure 
      was 53.4 % using Beers' criteria. STOPP identified 1,280 instances of PIP 
      relating to 1,140 potentially inappropriate medications (PIMs), while Beers' 
      criteria identified 833 instances of PIP relating to 704 PIMs. Multivariate 
      regression analysis, taking age, sex, disease burden and number of medications 
      into consideration, showed a significant positive association between the number 
      of medications and PIP as defined by STOPP (odds ratio [OR] 1.295, 95% CI 1.223, 
      1.372; p < 0.001) and Beers' criteria (OR 1.263, 95% CI 1.201, 1.327; p < 0.001). 
      Significant negative associations were also found between CCI score and the 
      occurrence of PIP as defined by STOPP (OR 0.857, 95% CI 0.760, 0.966; p < 0.05) 
      and the occurrence of PIP as defined by the Beers criteria (OR 0.843, 95% CI 
      0.754, 0.943; p < 0.05). CONCLUSION: In this LTC population, STOPP criteria 
      identified a higher percentage of PIMs and a higher prevalence of PIP than the 
      Beers criteria. The higher prevalence of PIP determined using the STOPP criteria 
      is of uncertain relevance, but may be because STOPP was designed and validated 
      for use in an Irish setting.
FAU - O'Sullivan, David P
AU  - O'Sullivan DP
AD  - Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, 
      Cork, Ireland. dos1984ucc@gmail.com
FAU - O'Mahony, Denis
AU  - O'Mahony D
FAU - Parsons, Carole
AU  - Parsons C
FAU - Hughes, Carmel
AU  - Hughes C
FAU - Murphy, Kevin
AU  - Murphy K
FAU - Patterson, Susan
AU  - Patterson S
FAU - Byrne, Stephen
AU  - Byrne S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - New Zealand
TA  - Drugs Aging
JT  - Drugs & aging
JID - 9102074
SB  - IM
MH  - Age Factors
MH  - Aged
MH  - Aged, 80 and over
MH  - Comorbidity
MH  - Female
MH  - Humans
MH  - Inappropriate Prescribing/*statistics & numerical data
MH  - Ireland/epidemiology
MH  - Long-Term Care
MH  - Male
MH  - Prevalence
MH  - Reference Standards
MH  - Sex Factors
EDAT- 2012/12/12 06:00
MHDA- 2014/01/10 06:00
CRDT- 2012/12/12 06:00
PHST- 2012/12/12 06:00 [entrez]
PHST- 2012/12/12 06:00 [pubmed]
PHST- 2014/01/10 06:00 [medline]
AID - 10.1007/s40266-012-0039-7 [doi]
PST - ppublish
SO  - Drugs Aging. 2013 Jan;30(1):39-49. doi: 10.1007/s40266-012-0039-7.