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Inappropriate Prescribing in Older Hospitalized Adults: A Comparison of Medical Specialties
Author(s) -
Juliano Ana Carmen dos Santos Ribeiro Simoes,
Lucchetti Alessandra Lamas Granero,
Silva Jéssica Teixeira Santos da,
Santos Letícia Gomes,
Nunes Jéssica Borges Taranto,
Fernandes Guilherme Cortes,
Lucchetti Giancarlo
Publication year - 2018
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1111/jgs.15138
Subject(s) - medicine , beers criteria , medical prescription , specialty , neurology , retrospective cohort study , geriatrics , psychological intervention , cohort , emergency medicine , pediatrics , family medicine , polypharmacy , psychiatry , pharmacology
Objectives To evaluate the prevalence and number of potentially inappropriate medications ( PIM s) in hospitalized older adults, comparing prescription patterns of medical specialties. Design Retrospective cohort study. Setting Tertiary general hospital. Participants All older adults hospitalized from January through May 2015 (N = 1,900). Measurements Information on medications prescribed during the first and last days of hospitalization was collected and evaluated regarding PIM s using Beers and Screening Tool of Older People's Prescriptions ( STOPP ) criteria. Medical specialties (internal medicine, cardiology, gastroenterology, infectious disease, nephrology, neurology, pneumology) were compared regarding the prevalence of PIM s and the increase in the number of PIM s during hospitalization. Results The number of individuals with PIM s increased significantly according to both criteria (62.3% to 66.6% according to Beers criteria, 43.4% to 50.0% according to STOPP criteria). The most common PIM s were sliding‐scale insulin (26.9%), clonazepam (9.5%), and periciazine (6.4%) using Beers criteria and spironolactone (10.3%), acetylsalicylic acid (9.8%), and periciazine (8.7%) using STOPP criteria. Neurology, infectious disease, and pneumology had the highest numbers of PIM s, and neurology, pneumology, and cardiology had a greater increase in PIM s during hospitalization than the other specialties. Conclusion This study demonstrates the high and growing prevalence of PIM s in the hospital environment, according to Beers and STOPP criteria. Educational measures and specific pharmaceutical interventions for each specialty are needed to change this situation.