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Potentially inappropriate medication use in Indian elderly: Comparison of Beers' criteria and Screening Tool of Older Persons' potentially inappropriate Prescriptions
Author(s) -
Nagendra Vishwas Hunsur,
Harugeri Anand,
Parthasarathi Gurumurthy,
Ramesh Madhan
Publication year - 2012
Publication title -
geriatrics and gerontology international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.823
H-Index - 57
eISSN - 1447-0594
pISSN - 1444-1586
DOI - 10.1111/j.1447-0594.2011.00806.x
Subject(s) - medicine , beers criteria , medical prescription , medical diagnosis , logistic regression , contingency table , geriatrics , bivariate analysis , polypharmacy , emergency medicine , psychiatry , statistics , mathematics , pathology , pharmacology
Aim: To compare Beers' criteria (BC) and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) for prevalence, specificity, sensitivity and predictors for potentially inappropriate medication (PIM) use. Methods: Patients aged ≥60 years from medicine wards of a tertiary care hospital were included. Comparisons between BC and STOPP were made using Pearson's χ 2 ‐test for categorical variables and Mann–Whitney U ‐test for continuous variables. Specificity and sensitivity were assessed by using 2 × 2 contingency table. Bivariate analysis and subsequent multivariate logistic regression was used to identify the predictors of PIM use. Results: In the 540 patients included, prevalence of PIM use as per BC and STOPP was 24.6% and 13.3%, respectively. Sensitivity and specificity of BC in detecting PIM was 0.65 and 0.53, respectively. Considering the diagnoses/conditions, sensitivity and specificity of BC was 0.12 and 0.48, respectively, whereas independent of diagnoses/conditions, corresponding values were 0.75 and 0.54. PIM as per BC and STOPP accounted for 11 and 6 adverse drug reactions (ADR), respectively. Medications not listed in BC or STOPP were more likely to be associated with ADR. Multiple diseases (≥4) and use of more drugs during hospital stay (10–14) predicted PIM use as per BC, whereas age (60–74 years) predicted PIM use as per STOPP. Conclusion: Overall, BC is useful in the detection of PIM use independent of diagnoses/conditions, whereas STOPP is useful in detection of PIM use considering the diagnoses/conditions. There is a need for consensus on using the tool for detection of PIM use in Indian elderly. Geriatr Gerontol Int 2012; 12: 506–514.