PhD Candidate School of Population Health, RCSI University of Medicine and Health Sciences, Dublin 2, Ireland. Dublin, Ireland
Background: Studies have indicated that potentially inappropriate prescribing may contribute to between 7% and 17% of unplanned hospitalizations in older populations.
Objectives: This study aims to examine the prevalence of potentially inappropriate prescribing (PIP) and Potential Prescription Omissions (PPO) among older adults (≥65 years) and their associations with adverse drug reaction (ADR)-related hospital admissions.
Methods: This study used the Adverse Drug Reactions in an Ageing Population (ADAPT) cohort (N=361 ADR-related hospital admissions; 437 non-ADR related admissions). Information on patient medications, primary presenting issue and co-morbidities at hospital admission were extracted. All medications were coded using WHO ATC codes. PIPs were assessed using Beers Criteria (2019) and STOPP Version 2. PPOs were assessed using the START criteria. Multivariable logistic regression was used to examine the association between PIP, PPO and where the admission was ADR-related or not, adjusting for covariates (age, gender, comorbidity, polypharmacy).
Results: In total 715 (90%; 95%CI 87%-92%) patients had at least one Beers PIP criteria, 555 (70%; 95%CI 66%-73%) had at least one STOPP PIP criteria and 671 patients (84%; 95%CI 81%-86%) had at least one START PPO criteria. Being prescribed at least one Beers PIP was not significantly associated with the admission being ADR-related, after adjusting for covariates (adjusted OR=1.66, 95%CI=1.00–2.77, p=0.05), as was the case for having a STOPP PIP criteria or a START PPO criteria (STOPP OR=1.07, 95%CI=0.79-1.45) and (START OR=0.72; 95%CI=0.50-1.06). Results were similar considering number of PIP/PPO criteria.
Conclusions: Despite a high prevalence of PIP and PPO in this hospital admissions cohort, there was no association with the admission being ADR-related. Predictive factors for ADR-related admissions are still poorly understood.
