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Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland.
J Clin Pharm Ther. 2009 Aug; 34(4):369-76.JC

Abstract

BACKGROUND

Elderly patients are particularly vulnerable to inappropriate prescribing, with increased risk of adverse drug reactions and consequently higher rates of morbidity and mortality. A large proportion of inappropriate prescribing is preventable by adherence to prescribing guidelines, suitable monitoring and regular medication review. As a result, screening tools have been developed to help clinicians improve their prescribing.

OBJECTIVES

To compare identification rates of inappropriate prescribing in elderly patients in primary care using two validated screening tools: Beers' criteria and improved prescribing in the elderly tool (IPET); to calculate the net ingredient cost (NIC) per month (euro) of the potentially inappropriate medicines in this population of patients.

METHOD

A consecutive cohort of 500 patients 65 years of age and over were recruited prospectively from primary care over a 6 month period in a provincial town in Ireland. Patients' medical records (electronic and paper) were screened and all relevant information concerning current illnesses and medications was recorded on a standardized data collection form to which Beers' criteria [considering diagnosis (CD) and independent of diagnosis (ID)] and IPET tools were applied. The NIC was calculated from an edition of the Irish monthly index of medical specialities published concurrently with the data collection.

RESULTS

Beers' criteria identified a total of 69 medicines that were prescribed inappropriately (eight CD and 61 ID) in 65 patients (13%), costing euro824.88 per month while IPET identified 63 potentially inappropriate medicines in 52 (10.4%) patients costing euro381.28 per month.

CONCLUSIONS

Potentially inappropriate medications are prescribed in a significant proportion of elderly people in primary care, with significant economic implications.

Authors+Show Affiliations

Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cork, Ireland.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

19583669

Citation

Ryan, C, et al. "Appropriate Prescribing in the Elderly: an Investigation of Two Screening Tools, Beers Criteria Considering Diagnosis and Independent of Diagnosis and Improved Prescribing in the Elderly Tool to Identify Inappropriate Use of Medicines in the Elderly in Primary Care in Ireland." Journal of Clinical Pharmacy and Therapeutics, vol. 34, no. 4, 2009, pp. 369-76.
Ryan C, O'Mahony D, Kennedy J, et al. Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland. J Clin Pharm Ther. 2009;34(4):369-76.
Ryan, C., O'Mahony, D., Kennedy, J., Weedle, P., Barry, P., Gallagher, P., & Byrne, S. (2009). Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland. Journal of Clinical Pharmacy and Therapeutics, 34(4), 369-76. https://doi.org/10.1111/j.1365-2710.2008.01007.x
Ryan C, et al. Appropriate Prescribing in the Elderly: an Investigation of Two Screening Tools, Beers Criteria Considering Diagnosis and Independent of Diagnosis and Improved Prescribing in the Elderly Tool to Identify Inappropriate Use of Medicines in the Elderly in Primary Care in Ireland. J Clin Pharm Ther. 2009;34(4):369-76. PubMed PMID: 19583669.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Appropriate prescribing in the elderly: an investigation of two screening tools, Beers criteria considering diagnosis and independent of diagnosis and improved prescribing in the elderly tool to identify inappropriate use of medicines in the elderly in primary care in Ireland. AU - Ryan,C, AU - O'Mahony,D, AU - Kennedy,J, AU - Weedle,P, AU - Barry,P, AU - Gallagher,P, AU - Byrne,S, PY - 2009/7/9/entrez PY - 2009/7/9/pubmed PY - 2009/9/23/medline SP - 369 EP - 76 JF - Journal of clinical pharmacy and therapeutics JO - J Clin Pharm Ther VL - 34 IS - 4 N2 - BACKGROUND: Elderly patients are particularly vulnerable to inappropriate prescribing, with increased risk of adverse drug reactions and consequently higher rates of morbidity and mortality. A large proportion of inappropriate prescribing is preventable by adherence to prescribing guidelines, suitable monitoring and regular medication review. As a result, screening tools have been developed to help clinicians improve their prescribing. OBJECTIVES: To compare identification rates of inappropriate prescribing in elderly patients in primary care using two validated screening tools: Beers' criteria and improved prescribing in the elderly tool (IPET); to calculate the net ingredient cost (NIC) per month (euro) of the potentially inappropriate medicines in this population of patients. METHOD: A consecutive cohort of 500 patients 65 years of age and over were recruited prospectively from primary care over a 6 month period in a provincial town in Ireland. Patients' medical records (electronic and paper) were screened and all relevant information concerning current illnesses and medications was recorded on a standardized data collection form to which Beers' criteria [considering diagnosis (CD) and independent of diagnosis (ID)] and IPET tools were applied. The NIC was calculated from an edition of the Irish monthly index of medical specialities published concurrently with the data collection. RESULTS: Beers' criteria identified a total of 69 medicines that were prescribed inappropriately (eight CD and 61 ID) in 65 patients (13%), costing euro824.88 per month while IPET identified 63 potentially inappropriate medicines in 52 (10.4%) patients costing euro381.28 per month. CONCLUSIONS: Potentially inappropriate medications are prescribed in a significant proportion of elderly people in primary care, with significant economic implications. SN - 1365-2710 UR - https://www.unboundmedicine.com/medline/citation/19583669/Appropriate_prescribing_in_the_elderly:_an_investigation_of_two_screening_tools_Beers_criteria_considering_diagnosis_and_independent_of_diagnosis_and_improved_prescribing_in_the_elderly_tool_to_identify_inappropriate_use_of_medicines_in_the_elderly_in_primary_care_in_Ireland_ L2 - https://doi.org/10.1111/j.1365-2710.2008.01007.x DB - PRIME DP - Unbound Medicine ER -