Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients.
Affiliation
Department of Medicine, School of Medicine, University College Cork, Ireland.Issue Date
2011-06-13MeSH
Adverse Drug Reaction Reporting SystemsAged
Aged, 80 and over
Chi-Square Distribution
Comorbidity
Drug Toxicity
Humans
Inappropriate Prescribing
Inpatients
Ireland
Medication Errors
Pharmaceutical Preparations
Polypharmacy
Prospective Studies
Regression Analysis
Risk
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Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients. 2011, 171 (11):1013-9 Arch. Intern. Med.Journal
Archives of internal medicineDOI
10.1001/archinternmed.2011.215PubMed ID
21670370Abstract
Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness.We prospectively studied 600 consecutive patients 65 years or older who were admitted with acute illness to a university teaching hospital over a 4-month interval. Potentially inappropriate medicines were defined by both Beers and STOPP criteria. Adverse drug events were defined by World Health Organization-Uppsala Monitoring Centre criteria and verified by a local expert consensus panel, which also assessed whether ADEs were causal or contributory to current hospitalization. Hallas criteria defined ADE avoidability. We compared the proportions of patients taking Beers criteria PIMs and STOPP criteria PIMs with avoidable ADEs that were causal or contributory to admission.
A total of 329 ADEs were detected in 158 of 600 patients (26.3%); 219 of 329 ADEs (66.6%) were considered causal or contributory to admission. Of the 219 ADEs, 151 (68.9%) considered causal or contributory to admission were avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when STOPP PIMs were prescribed (odds ratio, 1.847; 95% confidence interval [CI], 1.506-2.264; P < .001); prescription of Beers criteria PIMs did not significantly increase ADE risk (odds ratio, 1.276; 95% CI, 0.945-1.722; P = .11).
STOPP criteria PIMs, unlike Beers criteria PIMs, are significantly associated with avoidable ADEs in older people that cause or contribute to urgent hospitalization.
Item Type
ArticleLanguage
enISSN
1538-3679ae974a485f413a2113503eed53cd6c53
10.1001/archinternmed.2011.215
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