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Potentially inappropriate prescribing in older patients admitted to psychiatric hospital.
Int J Geriatr Psychiatry. 2016 Feb; 31(2):137-45.IJ

Abstract

OBJECTIVES

The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.

METHODS

This was a cross-sectional study of older patients hospitalized in a psychiatric hospital (n = 164; mean age 74.9 ± 7.3 years; 62% female). The primary endpoint was the prevalence of participants receiving PIMs and PPOs, which was assessed by using the Beers criteria 2012 and the screening tool of older person's potentially inappropriate prescriptions (STOPP) and screening tool of alert doctors to the right treatment (START) criteria. Univariate and multivariate logistic regression was used to assess significant risk factors for PIMs in this population.

RESULTS

A total of 1269 drugs were prescribed to included patients (range: 0-19 drugs/day). PIMs were identified in 47% and 79% of participants, based on the Beers 2012 and STOPP criteria, respectively. Most PIMs (70%) concerned psychotropic drugs. The STOPP criteria identified more PIMs (331) than the Beers criteria 2012 (199). According to the START criteria, 59% of participants had PPOs. The number of prescribed medications was significantly associated with the occurrence of PIMs according to the Beers 2012 [OR 1.2 (95% CI 1.1-1.3)] and STOPP [OR 1.5 (95% CI 1.3-1.8)] criteria.

CONCLUSION

Potentially inappropriate prescribing, as identified by the Beers and STOPP/START criteria, is highly prevalent among older patients hospitalized with major psychiatric illness. However, the focus on psychotropic drugs prescription without taking into account the benefit of these drugs to individual patients may limit the application of the Beers and STOPP criteria in psychiatric hospitals.

Authors+Show Affiliations

Department of Psychogeriatric Medicine, Vincent van Gogh Institute, Venray, The Netherlands. Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands. Department of Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands. Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland. School of Medicine, University College Cork, Cork, Ireland.Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Geriatric Medicine, Radboud Alzheimer Centre and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands. Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.Department of Psychogeriatric Medicine, Vincent van Gogh Institute, Venray, The Netherlands. Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands. Department of Geriatric Medicine, Radboud Alzheimer Centre and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

26032252

Citation

Rongen, Sara, et al. "Potentially Inappropriate Prescribing in Older Patients Admitted to Psychiatric Hospital." International Journal of Geriatric Psychiatry, vol. 31, no. 2, 2016, pp. 137-45.
Rongen S, Kramers C, O'Mahony D, et al. Potentially inappropriate prescribing in older patients admitted to psychiatric hospital. Int J Geriatr Psychiatry. 2016;31(2):137-45.
Rongen, S., Kramers, C., O'Mahony, D., Feuth, T. B., Olde Rikkert, M. G., & Ahmed, A. I. (2016). Potentially inappropriate prescribing in older patients admitted to psychiatric hospital. International Journal of Geriatric Psychiatry, 31(2), 137-45. https://doi.org/10.1002/gps.4302
Rongen S, et al. Potentially Inappropriate Prescribing in Older Patients Admitted to Psychiatric Hospital. Int J Geriatr Psychiatry. 2016;31(2):137-45. PubMed PMID: 26032252.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Potentially inappropriate prescribing in older patients admitted to psychiatric hospital. AU - Rongen,Sara, AU - Kramers,Cornelis, AU - O'Mahony,Denis, AU - Feuth,Ton B, AU - Olde Rikkert,Marcel G M, AU - Ahmed,Amir I A, Y1 - 2015/05/31/ PY - 2014/12/14/received PY - 2015/04/13/revised PY - 2015/04/15/accepted PY - 2015/6/3/entrez PY - 2015/6/3/pubmed PY - 2016/10/13/medline KW - Beers criteria KW - Older patients KW - STOPP/START criteria KW - potentially inappropriate prescribing KW - psychiatric hospital SP - 137 EP - 45 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 31 IS - 2 N2 - OBJECTIVES: The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness. METHODS: This was a cross-sectional study of older patients hospitalized in a psychiatric hospital (n = 164; mean age 74.9 ± 7.3 years; 62% female). The primary endpoint was the prevalence of participants receiving PIMs and PPOs, which was assessed by using the Beers criteria 2012 and the screening tool of older person's potentially inappropriate prescriptions (STOPP) and screening tool of alert doctors to the right treatment (START) criteria. Univariate and multivariate logistic regression was used to assess significant risk factors for PIMs in this population. RESULTS: A total of 1269 drugs were prescribed to included patients (range: 0-19 drugs/day). PIMs were identified in 47% and 79% of participants, based on the Beers 2012 and STOPP criteria, respectively. Most PIMs (70%) concerned psychotropic drugs. The STOPP criteria identified more PIMs (331) than the Beers criteria 2012 (199). According to the START criteria, 59% of participants had PPOs. The number of prescribed medications was significantly associated with the occurrence of PIMs according to the Beers 2012 [OR 1.2 (95% CI 1.1-1.3)] and STOPP [OR 1.5 (95% CI 1.3-1.8)] criteria. CONCLUSION: Potentially inappropriate prescribing, as identified by the Beers and STOPP/START criteria, is highly prevalent among older patients hospitalized with major psychiatric illness. However, the focus on psychotropic drugs prescription without taking into account the benefit of these drugs to individual patients may limit the application of the Beers and STOPP criteria in psychiatric hospitals. SN - 1099-1166 UR - https://www.unboundmedicine.com/medline/citation/26032252/Potentially_inappropriate_prescribing_in_older_patients_admitted_to_psychiatric_hospital_ L2 - https://doi.org/10.1002/gps.4302 DB - PRIME DP - Unbound Medicine ER -