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Polypharmacy and potentially inappropriate prescriptions identified by B eers and STOPP criteria in co‐morbid older patients at hospital discharge
Author(s) -
Hudhra Klejda,
GarcíaCaballos Marta,
CasadoFernandez Eloisa,
Jucja Besnik,
Shabani Driton,
BuenoCavanillas Aurora
Publication year - 2016
Publication title -
journal of evaluation in clinical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.737
H-Index - 73
eISSN - 1365-2753
pISSN - 1356-1294
DOI - 10.1111/jep.12452
Subject(s) - polypharmacy , medicine , beers criteria , odds ratio , medical prescription , confidence interval , medical record , population , confounding , emergency medicine , cross sectional study , pediatrics , environmental health , pathology , pharmacology
Rationale, aims and objectives The objective of this study was to evaluate the prevalence of potentially inappropriate prescriptions ( PIP ) and the association with polypharmacy (more than six drugs prescribed) in co‐morbid older patients in a critical moment of care transition such as hospital discharge by means of two explicit criteria ( B eers 2012 and STOPP 2008). Method Cross‐sectional study carried out in an older patients' population (≥65 years old) discharged from a university hospital in S pain. We recorded patients' information regarding demographics, diagnosis, drugs prescribed and associated pathological conditions and calculated the C harlson co‐morbidity index. Data were obtained from the electronic medical records of hospital discharge. B eers (2012) and STOPP criteria (2008) were applied for PIP detection. The strength of association between polypharmacy and the presence of PIP was assessed by calculating the crude and adjusted odds ratio and its 95% confidence interval. Results From 1004 patients of a 15% random sample, just 624 that fulfilled the inclusion criteria were included in the study. The number of prescribed drugs was a risk factor for PIP according to both criteria, even after adjusting for confounding variables. PIP frequency was higher in patients who received more than 12 medications ( B eers: 34.8%, STOPP : 54.4%). Each additional medication increased the risk of PIP by 14 or 15% ( B eers or STOPP ). Conclusions Our results suggest that the strategies used for PIP reduction in co‐morbid older patients should focus on the management of polypharmacy. Medication review at hospital discharge is highly recommended for patients taking more than six drugs.