학술논문

Prevalence and predictors of inappropriate prescribing according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria in older patients discharged from geriatric and internal medicine wards: A prospective observational multicenter study
Document Type
Article
Source
Geriatrics & Gerontology International. Jan2019, Vol. 19 Issue 1, p5-11. 7p.
Subject
*ACE inhibitors
*BENZODIAZEPINES
*ENZYME inhibitors
*STATINS (Cardiovascular agents)
*PROTON pump inhibitors
*TRANQUILIZING drugs
*GERIATRIC assessment
*CONFIDENCE intervals
*GERIATRICS
*HOSPITAL wards
*INTERNAL medicine
*LONGITUDINAL method
*MEDICAL cooperation
*MULTIVARIATE analysis
*SCIENTIFIC observation
*QUALITY assurance
*RESEARCH
*COMORBIDITY
*MULTIPLE regression analysis
*DISCHARGE planning
*DISEASE prevalence
*POLYPHARMACY
*INAPPROPRIATE prescribing (Medicine)
*ODDS ratio
Language
ISSN
1444-1586
Abstract
Aim: To evaluate the prevalence and predictors of potentially inappropriate medications (PIM) and potential prescribing omissions (PPO) in hospital‐discharged older patients, according to the recently updated Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria. Methods: This was a multicenter prospective observational study of patients aged ≥65 years consecutively discharged from geriatric and internal medicine wards. Each patient underwent a comprehensive geriatric assessment, and PIM and PPO at discharge were determined according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version 2 criteria. A multivariate logistic regression was carried out to identify variables independently associated with PIM and PPO. Results: Among 726 participants (mean age 81.5 years, 47.8% women), the prevalence of PIM and PPO were 54.4% and 44.5%, respectively. Benzodiazepines and proton‐pump inhibitors were the drugs most frequently involved with PIM, whereas PPO were often related to 5‐alpha reductase inhibitors, angiotensin‐converting enzyme inhibitors, statins and drugs for osteoporosis. The number of medications (OR 1.22, 95% CI 1.15–1.28) and discharge from geriatric units (OR 0.55, 95% CI 0.40–0.75) were associated with PIM, whereas PPO were independently associated with discharge from geriatric wards (OR 0.44, 95% CI 0.31–0.62), age (OR 1.04, 95% CI 1.02–1.07), comorbidities (OR 1.17, 95% CI 1.04–1.30) and the number of drugs (OR 1.12, 95% CI 1.05–1.18). Conclusions: Inappropriate prescribing is highly prevalent among hospital‐discharged older patients, and is associated with polypharmacy and discharge from internal medicine departments. Geriatr Gerontol Int 2019; 19: 5–11. [ABSTRACT FROM AUTHOR]