Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.

Hdl Handle:
http://hdl.handle.net/10147/209292
Title:
Inappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.
Authors:
Barry, P J; O'Keefe, N; O'Connor, K A; O'Mahony, D
Affiliation:
Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork,, Ireland. pat_barry@eircom.net
Citation:
J Clin Pharm Ther. 2006 Dec;31(6):617-26.
Journal:
Journal of clinical pharmacy and therapeutics
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209292
DOI:
10.1111/j.1365-2710.2006.00783.x
PubMed ID:
17176367
Abstract:
BACKGROUND: In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. OBJECTIVES: The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. METHODS: A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +/- 6.1 years) and all patients had both Beers' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. RESULTS: The results of the study identified a high rate of inappropriate prescribing among this population of community-dwelling subjects. The total number of inappropriate prescriptions identified using the Beers' criteria (ID) was 148 affecting 121 patients. The Beers' criteria (CD) identified 69 inappropriate prescriptions in 60 patients and the IPET identified 112 inappropriate prescriptions in 78 patients. The Beers criteria (ID and CD combined) identified at least one inappropriate prescription in 34% of subjects and the IPET identified one in at least 22% of subjects. CONCLUSIONS: This study identifies high rates of use of inappropriate medications in community-dwelling elderly presenting with acute illness to hospital. These are comparable with inappropriate prescribing rates identified in previous studies. The revised Beers' criteria (2003) identified more inappropriate prescriptions than the IPET in this population of elders.
Language:
eng
MeSH:
Aged; Aged, 80 and over; Drug Prescriptions/*standards; Drug Utilization/*standards; Female; Humans; Male; Medication Errors/*statistics & numerical data; Physician's Practice Patterns
ISSN:
0269-4727 (Print); 0269-4727 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorBarry, P Jen_GB
dc.contributor.authorO'Keefe, Nen_GB
dc.contributor.authorO'Connor, K Aen_GB
dc.contributor.authorO'Mahony, Den_GB
dc.date.accessioned2012-02-03T15:17:23Z-
dc.date.available2012-02-03T15:17:23Z-
dc.date.issued2012-02-03T15:17:23Z-
dc.identifier.citationJ Clin Pharm Ther. 2006 Dec;31(6):617-26.en_GB
dc.identifier.issn0269-4727 (Print)en_GB
dc.identifier.issn0269-4727 (Linking)en_GB
dc.identifier.pmid17176367en_GB
dc.identifier.doi10.1111/j.1365-2710.2006.00783.xen_GB
dc.identifier.urihttp://hdl.handle.net/10147/209292-
dc.description.abstractBACKGROUND: In appropriate prescribing is a significant and persistent problem in elderly people, both in hospital and the community and has been described in several countries in Europe and also the USA. The problem of inappropriate prescribing has not been quantified in the Republic of Ireland. The most commonly used criteria for the identification of inappropriate prescribing are the Beers' criteria [both independent of diagnosis (ID) and considering diagnosis (CD) - 2003 version]. The Beers' criteria ID includes 48 different categories of either single medications or multiple medications of a similar class identified as inappropriate prescriptions and the Beers' criteria CD contains 19 different categories containing possible drug-disease interactions. A second tool, the improved prescribing in the elderly tool (IPET) has also been validated and used in hospital and community studies and has 14 categories of either explicitly contraindicated medications or possible drug-disease interactions. OBJECTIVES: The primary aim of the study is to measure the incidence of inappropriate prescribing among older community-dwelling individuals presenting to an acute hospital in the Republic of Ireland. A secondary aim of this study was also therefore to compare the efficacy of the above two tools in identifying inappropriate prescribing. METHODS: A prospective, consecutive observational cohort study was carried out over a 4-month period. The setting was an urban-based university hospital acute geriatric medicine assessment unit. Subjects in this study (n = 350) were consecutively screened on admission to hospital (mean age = 80.3 +/- 6.1 years) and all patients had both Beers' criteria ID and CD and IPET applied to their list of prescription drugs on admission, cross-referenced with their list of current active medical diagnosis. RESULTS: The results of the study identified a high rate of inappropriate prescribing among this population of community-dwelling subjects. The total number of inappropriate prescriptions identified using the Beers' criteria (ID) was 148 affecting 121 patients. The Beers' criteria (CD) identified 69 inappropriate prescriptions in 60 patients and the IPET identified 112 inappropriate prescriptions in 78 patients. The Beers criteria (ID and CD combined) identified at least one inappropriate prescription in 34% of subjects and the IPET identified one in at least 22% of subjects. CONCLUSIONS: This study identifies high rates of use of inappropriate medications in community-dwelling elderly presenting with acute illness to hospital. These are comparable with inappropriate prescribing rates identified in previous studies. The revised Beers' criteria (2003) identified more inappropriate prescriptions than the IPET in this population of elders.en_GB
dc.language.isoengen_GB
dc.subject.meshAgeden_GB
dc.subject.meshAged, 80 and overen_GB
dc.subject.meshDrug Prescriptions/*standardsen_GB
dc.subject.meshDrug Utilization/*standardsen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshMaleen_GB
dc.subject.meshMedication Errors/*statistics & numerical dataen_GB
dc.subject.meshPhysician's Practice Patternsen_GB
dc.titleInappropriate prescribing in the elderly: a comparison of the Beers criteria and the improved prescribing in the elderly tool (IPET) in acutely ill elderly hospitalized patients.en_GB
dc.contributor.departmentDepartment of Geriatric Medicine, Cork University Hospital, Wilton, Cork,, Ireland. pat_barry@eircom.neten_GB
dc.identifier.journalJournal of clinical pharmacy and therapeuticsen_GB
dc.description.provinceMunster-
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