Potentially inappropriate medication in acute hospitalized elderly patients with polypharmacy: an observational study co
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PHARMACOEPIDEMIOLOGY AND PRESCRIPTION
Potentially inappropriate medication in acute hospitalized elderly patients with polypharmacy: an observational study comparing PRISCUS, STOPP, and Beers criteria Lorena de Agustín Sierra 1 & Jaime Rodríguez Salazar 2 & Ana Belén Jiménez-Muñoz 3 & María Jesús Molina Hernández 2 & Paloma Bermejo Bescós 4 & Irene Iglesias Peinado 4 & Benito García Díaz 1 Received: 29 May 2020 / Accepted: 14 October 2020 # Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose To compare the prevalence of potentially inappropriate medication (PIM) in the elderly according to the PRISCUS list, STOPP criteria, and Beers criteria. Secondary, to describe the differences using the three criteria focused on the inappropriate prescription of psychotropic drugs in the elderly. Methods A retrospective study was performed at Severo Ochoa University Hospital. The study included 365 patients, aged 80 years and older, living in Madrid, Spain. Results 93.42% of patients received at least one PIM during hospitalization. Using the PRISCUS list, this changed from 32.6 to 2.7% at discharge. Applying STOPP criteria lowered the percentage from 65.20 to 10.95%, and with Beers criteria from 80.27 to 10.13. Lower Barthel index at admission was associated with an increased relative risk for receiving at least one PIM (OR 1.79, 95% CI 1.15–2.80, p = 0.024) using PRISCUS list as a tool in conjunction with STOPP criteria (OR 1.44, 95% CI 0.89–2.33, p = 0.037). Polypharmacy at admission predicted the presence of PIMs with STOPP criteria (OR 1.74, 95% CI 1.07–2.84, p = 0.001). Regarding psychotropic medicines, 208 patients (56.98%) received at least one psychotropic medicine during hospitalization. A total of 26.30% of patients were treated with psychotropic medicines, detected by the PRISCUS list, and 53.97% and 29.85% with STOPP and Beers, respectively. Conclusions Explicit criteria are a useful tool for identifying during hospitalization of the elderly patients. As indicated by the results, new research is needed to carry out an adaptation in our country that includes an evaluation of the strengths of the three tools to decrease PIMs and improve prescription in the elderly. Keywords Beers criteria . STOPP/START . PRISCUS list . Elderly . Potentially inappropriate medication
Supplementary Information The online version of this article (https:// doi.org/10.1007/s00228-020-03022-8) contains supplementary material, which is available to authorized users. * Lorena de Agustín Sierra [email protected]
Benito García Díaz [email protected]
Jaime Rodríguez Salazar [email protected]
1
Servicio de Farmacia, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n., Leganés, Spain
Ana Belén Jiménez-Muñoz [email protected]
2
María Jesús Molina Hernández [email protected]
Servicio de Geriatría, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n, Leganés, Spain
3
Paloma Bermejo Bescós [email protected]
Servicio de Medicin
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