Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.

Hdl Handle:
http://hdl.handle.net/10147/209257
Title:
Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.
Authors:
Gallagher, Paul F; Barry, Pat J; Ryan, Cristin; Hartigan, Irene; O'Mahony, Denis
Affiliation:
Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland., pfgallagher77@eircom.net
Citation:
Age Ageing. 2008 Jan;37(1):96-101. Epub 2007 Oct 11.
Journal:
Age and ageing
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209257
DOI:
10.1093/ageing/afm116
PubMed ID:
17933759
Abstract:
INTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.
Language:
eng
MeSH:
Aged; Aged, 80 and over; Anti-Inflammatory Agents, Non-Steroidal/adverse effects; Cardiovascular Agents/adverse effects; Comorbidity; Cross-Sectional Studies; Drug Interactions; Drug Prescriptions/*standards; Drug Therapy, Combination; Female; Humans; Ireland; Male; Medication Errors/*statistics & numerical data; Patient Admission/statistics & numerical data; Pharmaceutical Preparations/*adverse effects; Prospective Studies; Psychotropic Drugs/adverse effects; Risk Factors
ISSN:
1468-2834 (Electronic); 0002-0729 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorGallagher, Paul Fen_GB
dc.contributor.authorBarry, Pat Jen_GB
dc.contributor.authorRyan, Cristinen_GB
dc.contributor.authorHartigan, Ireneen_GB
dc.contributor.authorO'Mahony, Denisen_GB
dc.date.accessioned2012-02-03T15:16:25Z-
dc.date.available2012-02-03T15:16:25Z-
dc.date.issued2012-02-03T15:16:25Z-
dc.identifier.citationAge Ageing. 2008 Jan;37(1):96-101. Epub 2007 Oct 11.en_GB
dc.identifier.issn1468-2834 (Electronic)en_GB
dc.identifier.issn0002-0729 (Linking)en_GB
dc.identifier.pmid17933759en_GB
dc.identifier.doi10.1093/ageing/afm116en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209257-
dc.description.abstractINTRODUCTION: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. METHODS: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers' Criteria applied. RESULTS: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects. CONCLUSION: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshAnti-Inflammatory Agents, Non-Steroidal/adverse effectsen_GB
dc.subject.meshCardiovascular Agents/adverse effectsen_GB
dc.subject.meshComorbidityen_GB
dc.subject.meshCross-Sectional Studiesen_GB
dc.subject.meshDrug Interactionsen_GB
dc.subject.meshDrug Prescriptions/*standardsen_GB
dc.subject.meshDrug Therapy, Combinationen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshIrelanden_GB
dc.subject.meshMaleen_GB
dc.subject.meshMedication Errors/*statistics & numerical dataen_GB
dc.subject.meshPatient Admission/statistics & numerical dataen_GB
dc.subject.meshPharmaceutical Preparations/*adverse effectsen_GB
dc.subject.meshProspective Studiesen_GB
dc.subject.meshPsychotropic Drugs/adverse effectsen_GB
dc.subject.meshRisk Factorsen_GB
dc.titleInappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.en_GB
dc.contributor.departmentGeriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland., pfgallagher77@eircom.neten_GB
dc.identifier.journalAge and ageingen_GB
dc.description.provinceMunster-
All Items in Lenus, The Irish Health Repository are protected by copyright, with all rights reserved, unless otherwise indicated.