Potentially inappropriate prescribing among older people in the United Kingdom

Hdl Handle:
http://hdl.handle.net/10147/323381
Title:
Potentially inappropriate prescribing among older people in the United Kingdom
Authors:
Bradley, Marie C; Motterlini, Nicola; Padmanabhan, Shivani; Cahir, Caitriona; Williams, Tim; Fahey, Tom; Hughes, Carmel M
Citation:
Bradley MC. et al. Potentially inappropriate prescribing among older people in the United Kingdom. BMC Geriatrics. 2014 Jun 12;14(1):72
Issue Date:
12-Jun-2014
URI:
http://dx.doi.org/10.1186/1471-2318-14-72; http://hdl.handle.net/10147/323381
Abstract:
Abstract Background Potentially inappropriate prescribing (PIP) in older people is associated with increases in morbidity, hospitalisation and mortality. The objective of this study was to estimate the prevalence of and factors associated with PIP, among those aged ≥70 years, in the United Kingdom, using a comprehensive set of prescribing indicators and comparing these to estimates obtained from a truncated set of the same indicators. Methods A retrospective cross-sectional study was carried out in the UK Clinical Practice Research Datalink (CPRD), in 2007. Participants included those aged ≥ 70 years, in CPRD. Fifty-two PIP indicators from the Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) criteria were applied to data on prescribed drugs and clinical diagnoses. Overall prevalence of PIP and prevalence according to individual STOPP criteria were estimated. The relationship between PIP and polypharmacy (≥4 medications), comorbidity, age, and gender was examined. A truncated, subset of 28 STOPP criteria that were used in two previous studies, were further applied to the data to facilitate comparison. Results Using 52 indicators, the overall prevalence of PIP in the study population (n = 1,019,491) was 29%. The most common examples of PIP were therapeutic duplication (11.9%), followed by use of aspirin with no indication (11.3%) and inappropriate use of proton pump inhibitors (PPIs) (3.7%). PIP was strongly associated with polypharmacy (Odds Ratio 18.2, 95% Confidence Intervals, 18.0-18.4, P < 0.05). PIP was more common in those aged 70–74 years vs. 85 years or more and in males. Application of the smaller subset of the STOPP criteria resulted in a lower PIP prevalence at 14.9% (95% CIs 14.8-14.9%) (n = 151,598). The most common PIP issues identified with this subset were use of PPIs at maximum dose for > 8 weeks, NSAIDs for > 3 months, and use of long-term neuroleptics. Conclusions PIP was prevalent in the UK and increased with polypharmacy. Application of the comprehensive set of STOPP criteria allowed more accurate estimation of PIP compared to the subset of criteria used in previous studies. These findings may provide a focus for targeted interventions to reduce PIP.
Item Type:
Article
Language:
en
Keywords:
OLDER PEOPLE; PRESCRIBING

Full metadata record

DC FieldValue Language
dc.contributor.authorBradley, Marie Cen_GB
dc.contributor.authorMotterlini, Nicolaen_GB
dc.contributor.authorPadmanabhan, Shivanien_GB
dc.contributor.authorCahir, Caitrionaen_GB
dc.contributor.authorWilliams, Timen_GB
dc.contributor.authorFahey, Tomen_GB
dc.contributor.authorHughes, Carmel Men_GB
dc.date.accessioned2014-07-18T10:51:48Z-
dc.date.available2014-07-18T10:51:48Z-
dc.date.issued2014-06-12-
dc.identifier.citationBradley MC. et al. Potentially inappropriate prescribing among older people in the United Kingdom. BMC Geriatrics. 2014 Jun 12;14(1):72en_GB
dc.identifier.urihttp://dx.doi.org/10.1186/1471-2318-14-72-
dc.identifier.urihttp://hdl.handle.net/10147/323381-
dc.description.abstractAbstract Background Potentially inappropriate prescribing (PIP) in older people is associated with increases in morbidity, hospitalisation and mortality. The objective of this study was to estimate the prevalence of and factors associated with PIP, among those aged ≥70 years, in the United Kingdom, using a comprehensive set of prescribing indicators and comparing these to estimates obtained from a truncated set of the same indicators. Methods A retrospective cross-sectional study was carried out in the UK Clinical Practice Research Datalink (CPRD), in 2007. Participants included those aged ≥ 70 years, in CPRD. Fifty-two PIP indicators from the Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) criteria were applied to data on prescribed drugs and clinical diagnoses. Overall prevalence of PIP and prevalence according to individual STOPP criteria were estimated. The relationship between PIP and polypharmacy (≥4 medications), comorbidity, age, and gender was examined. A truncated, subset of 28 STOPP criteria that were used in two previous studies, were further applied to the data to facilitate comparison. Results Using 52 indicators, the overall prevalence of PIP in the study population (n = 1,019,491) was 29%. The most common examples of PIP were therapeutic duplication (11.9%), followed by use of aspirin with no indication (11.3%) and inappropriate use of proton pump inhibitors (PPIs) (3.7%). PIP was strongly associated with polypharmacy (Odds Ratio 18.2, 95% Confidence Intervals, 18.0-18.4, P < 0.05). PIP was more common in those aged 70–74 years vs. 85 years or more and in males. Application of the smaller subset of the STOPP criteria resulted in a lower PIP prevalence at 14.9% (95% CIs 14.8-14.9%) (n = 151,598). The most common PIP issues identified with this subset were use of PPIs at maximum dose for > 8 weeks, NSAIDs for > 3 months, and use of long-term neuroleptics. Conclusions PIP was prevalent in the UK and increased with polypharmacy. Application of the comprehensive set of STOPP criteria allowed more accurate estimation of PIP compared to the subset of criteria used in previous studies. These findings may provide a focus for targeted interventions to reduce PIP.-
dc.language.isoenen
dc.subjectOLDER PEOPLEen_GB
dc.subjectPRESCRIBINGen_GB
dc.titlePotentially inappropriate prescribing among older people in the United Kingdomen_GB
dc.typeArticleen
dc.language.rfc3066en-
dc.rights.holderMarie C Bradley et al.; licensee BioMed Central Ltd.-
dc.description.statusPeer Reviewed-
dc.date.updated2014-07-10T19:04:06Z-
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