Abstract
Drug prescribing to the elderly increases the risk of potential adverse drug reactions as well as potentially inappropriate medications. The goal of this study was to describe drug prescribing patterns in elderly patients and to measure the prevalence of potentially inappropriate medications using updated Beers’ criteria and the STOPP criteria. This was a retrospective cross-sectional study for all patients aged ≥65 years who attended regularly a primary care clinic at Sultan Qaboos University Hospital in Oman. Data of 377 patients were analyzed using the software Statistical Package for Social Sciences version 23.0 (SPSS™, Chicago, IL, USA). Using Beers criteria, the prevalence of potentially inappropriate medications was 12.7% as 48 patients had at least one potentially inappropriate medication. Beers criteria revealed a statistical association between the occurrence of potentially inappropriate medications with polypharmacy (p < 0.001), with female gender (p = 0.002) and with asthma as a comorbidity (p = 0.020). STOPP criteria showed that the prevalence of potentially inappropriate medications was 17.2% as 65 patients had at least one potentially inappropriate medication. STOPP criteria revealed a statistical association between the occurrence of potentially inappropriate medications and osteoarthritis as a comorbidity (p = 0.032). The study revealed moderate prevalence of potentially inappropriate medications prescribing in elderly patients which was mainly associated with polypharmacy and female gender. Safe prescribing practices in the elderly requires increasing the awareness of healthcare providers and efficiently reporting drug-related problems.
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References
Agostini, J. V. (2007). Measuring drug burden: A step forward. Archives of Internal Medicine, 167, 753–754.
American Geriatrics Society. (2015). Updated beers criteria for potentially inappropriate medication use in older adults. By the American Geriatrics Society 2015 beers criteria update expert panel. Journal of the American Geriatrics Society, 63(11), 2227–2246.
Arellano, C., Saldivia, G., Córdova, P., Fernández, P., Morales, F., López, M., & Villa, L. (2016). Using two tools to identify Potentially Inappropriate Medications (PIM) in elderly patients in Southern Chile. Archives of Gerontology and Geriatrics, 67, 139–144.
Arnett III, R. H., Blank, L. A., Brown, A. P., et al. (1990). National health expenditures 1988. Office of National Cost Estimates. Health Care Financing Review, 11, 1–41.
Ay, P., Akici, A., & Harmanc, H. (2005). Drug utilization and potentially inappropriate drug use in elderly residents of a community in Istanbul, Turkey. International Journal of Clinical Pharmacology and Therapeutics, 43(4), 195–202.
Cahir, C., Fahey, T., Teeling, M., Teljeur, C., Feely, J., & Bennett, K. (2010). Potentially inappropriate prescribing and cost outcomes for older people: A national population study. British Journal of Clinical Pharmacology, 69(5), 543–552.
Carey, I. M., De Wilde, S., Harris, T., Victor, C., Richards, N., Hilton, S. R., & Cook, D. G. (2008). What factors predict potentially inappropriate primary care prescribing in older people? Drugs & Aging, 25, 639–706.
Christchilles, E. A., Foley, D. J., Wallace, R. B., et al. (1992). Use of medications by persons 65 and over: Data from the established populations for epidemiologic studies of the elderly. Journal of Gerontology, 47, 137–144.
Fadare, J. O., Agboola, S. M., Opeke, O. A., & Alabi, R. A. (2013). Prescription pattern and prevalence of potentially inappropriate medications among elderly patients in a Nigerian rural tertiary hospital. Therapeutics and Clinical Risk Management, 9, 115–120.
Gallagher, P., Barry, P., & O'Mahony, D. (2007). Inappropriate prescribing in the elderly. Journal of Clinical Pharmacy and Therapeutics, 32, 113–121.
Gallagher, P., Ryan, C., Byrne, S., Kennedy, J., & O’Mahony, D. (2008). STOPP (Screening Tool of Older Person’s Prescriptions) and START (Screening Tool to Alert Doctors to Right Treatment). Consensus validation. International Journal of Clinical Pharmacology and Therapeutics, 46(2), 72–83.
Goldberg, R. M., Mabee, J., Chan, L., & Wong, S. (1996). Drug-drug and drug-disease interactions in the emergency department: Analysis of a high-risk population. American Journal of Emergency Medicine, 14, 447–450.
Guaraldo, L., Cano, F. G., Damasceno, G. S., & Rozenfeld, S. (2011). Inappropriate medication use among the elderly: A systematic review of administrative databases. BMC Geriatrics, 11, 79.
Juurlink, D. N., Mamdani, M., Kopp, A., Laupacis, A., & Redelmeier, D. A. (2003). Drug–drug interactions among elderly patients hospitalized for drug toxicity. JAMA, 289(13), 1652–1658.
Liu, G. G., & Christensen, D. B. (2002). The continuing challenge of inappropriate prescribing in the elderly: An update of the evidence. Journal of the American Pharmacists Association, 42(6), 847–857.
Narvekar, R. S., Bhandare, N. N., Gouveia, J. J., & Bhandare, P. N. (2017). Utilization pattern of potentially inappropriate medications in geriatric patients in a tertiary care hospital: A retrospective observational study. Journal of Clinical and Diagnostic Research, 11(4), FC04–FC08.
O’Mahony, D., Gallagher, P., Ryan, C., Byrne, S., Hamilton, H., Barry, P., O’Connor, M., & Kennedy, J. (2010). STOPP & START criteria: A new approach to detecting potentially inappropriate prescribing in old age. European Geriatric Medicine, 1(1), 45–51.
O'Neill, C., Hughes, C. M., Jamison, J., & Schweizer, A. (2003). Cost of pharmacological care of the elderly: Implications for healthcare resources. Drugs & Aging, 20(4), 253–261.
Perri 3rd, M., Menon, A. M., Deshpande, A. D., Shinde, S. B., Jiang, R., Cooper, J. W., Cook, C. L., Griffin, S. C., & Lorys, R. A. (2005). Adverse outcomes associated with inappropriate drug use in nursing homes. The Annals of Pharmacotherapy, 39(3), 405–411.
Rajska-Neumann, A., & Wieczorowska-Tobis, K. (2007). Polypharmacy and potential inappropriateness of pharmaco-logical treatment among community-dwelling elderly patients. Archives of Gerontology and Geriatrics, 44(Suppl 1), 303–309.
Ryan, C., O'Mahony, D., Kennedy, J., Weedle, P., & Byrne, S. (2009). Potentially inappropriate prescribing in an Irish elderly population in primary care. British Journal of Clinical Pharmacology, 68(6), 936–947.
Spinewine, A., Schmader, K. E., Barber, N., Hughes, C., Lapane, K. L., Swine, C., & Hanlon, J. T. (2007). Appropriate prescribing in elderly people: How well can it be measured and optimised? Lancet, 370(9582), 173–184.
Steinman, M. A., Landefeld, C. S., Rosenthal, G. E., Berthenthal, D., Sen, S., & Kaboli, P. J. (2006). Polypharmacy and prescribing quality in older people. Journal of the American Geriatrics Society, 54(10), 1516–1523.
Ubeda, A., Ferrándiz, L., Maicas, N., Gomez, C., Bonet, M., & Peris, J. E. (2012). Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria. Pharmacy Practice (Granada), 10(2), 83–91.
World Health Organization, Geneva (1993). How to investigate drug use in health facilities: selected drug use indicators. EDM Research, Series No. 007.
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Al-Busaidi, S., Al-Kharusi, A., Al-Hinai, M. et al. Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman. J Cross Cult Gerontol 35, 209–216 (2020). https://doi.org/10.1007/s10823-019-09393-5
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DOI: https://doi.org/10.1007/s10823-019-09393-5