Abstract
Purpose
To comparatively assess the prevalence rates of potentially inappropriate medications (PIMs) obtained by the former and latest versions of American Geriatrics Society Beers Criteria (AGS BC) and screening tool of older person’s potentially inappropriate prescriptions (STOPP), and analyze the factors of influence on PIM.
Methods
Cross-sectional study including 582 community-dwelling older adults over the age of 65. Sociodemographic, clinical, functional, and comprehensive drug therapy data were collected. The primary endpoint was the percentage of patients receiving at least one PIM.
Results
A total of 3626 prescriptions were analyzed. PIMs were detected in 35.4% and 47.9% of patients according to the STOPP v1 and the 2012 AGS BC, respectively. This percentage rose to 54% when 2015 AGS BC were used and reached 66.8% with STOPP v2. The kappa coefficient between STOPP v2 and its former version was lower than the one between the updated Beers Criteria and their former version (0.41 vs 0.85). The agreement was good (0.65) between both latest criteria. The number of medications, psychological disorders, and insomnia were predictors of PIM. A novel finding was that bone and joint disorders increased the odds for PIM by 78%.
Conclusions
The 2015 AGS BC showed high sensitivity and good applicability to the European older patients. Both updated tools identified some pharmacological groups (benzodiazepines, PPIs, and opioids, among others) and certain health problems (insomnia, psychological disorders, and osteoarticular diseases) as factors of influence on PIM. Based on these findings, interventions aimed at promoting appropriate use of medications should be developed.
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Acknowledgments
The authors wish to thank the Primary Care Management Team (Health District of Málaga) for providing access to the health centers and patient lists.
Funding
This research has been supported by grant funding provided by the Fundación Pública Andaluza Progreso y Salud, Consejería de Salud, Junta de Andalucía, through the Programme Proyectos de Investigación Biomédica (Grant number PI 0234/14).
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Contributions
Study concept and design: EBR, GAZ. Data collection: JV, LAC, MRGM. Data analysis: EBR, ROR. Interpretation: EBR, GAZ, IBE, ROR, JV, LAC, MRGM. Drafting of the manuscript: EBR, IBE. Revision and final approval: EBR, JV, LAC, MRGM, ROR, IBE, GAZ. Funding acquisition: EBR.
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The study has been approved by the Clinical Research Ethics Committee of Málaga and is being conducted in accordance with the 1964 Helsinki declaration and its later amendments. Written informed consent was obtained from all individual participants prior to their inclusion.
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All authors declare that they have no conflict of interest.
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Blanco-Reina, E., Valdellós, J., Aguilar-Cano, L. et al. 2015 Beers Criteria and STOPP v2 for detecting potentially inappropriate medication in community-dwelling older people: prevalence, profile, and risk factors. Eur J Clin Pharmacol 75, 1459–1466 (2019). https://doi.org/10.1007/s00228-019-02722-0
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DOI: https://doi.org/10.1007/s00228-019-02722-0