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Longitudinal patterns of potentially inappropriate prescribing in early old-aged people

  • Pharmacoepidemiology and Prescription
  • Published:
European Journal of Clinical Pharmacology Aims and scope Submit manuscript

Abstract

Purpose

It is contentious whether potentially inappropriate prescribing (PIP) is predominantly a phenomenon of late life or whether it has its origins in early old age. This study examined the pattern of PIP in an early old-aged population over 5 years.

Methods

Secondary data analysis of a population-based primary care cohort, of patients aged 60–74 years. Medication data were extracted from electronic patient records in addition to information on comorbidities and demographics. Explicit START criteria (PPOs) and STOPP criteria (PIMs) were used to identify PIP. Generalised estimating equations were used to describe trends in PIP over time and adjusted for age, gender and number of medicines.

Results

A total of 978 participants (47.8%) aged 60–74 years were included from the cohort. At baseline, PPOs were detected in 31.2% of patients and PIMs were identified in 35.6% at baseline. Prevalence of PPOs and PIMs increased significantly over time (OR 1.08, 95% CI 1.07; 1.09 and OR 1.04, 95% CI 1.0; 1.06, respectively). A higher number of medicines and new diagnoses were associated with the increasing trend in both PPO and PIM prevalence observed over time, independent of PPOs and PIMs triggered by drug combinations.

Conclusions

Potentially inappropriate prescribing is highly prevalent among early old-aged people in primary care and increases as they progress to more advanced old age, suggesting that routine application of STOPP/START criteria in this population would significantly improve medication appropriateness.

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Acknowledgements

The authors wish to acknowledge the participants in the study and all staff at the Livinghealth Clinic as well as study nurses and administrators.

Funding

The Mitchelstown study is funded by a research grant from the Health Research Board Ireland (reference HRC/2007/13) [29]. Christina Raae-Hansen received funding from the EU Framework Programme for Research and Innovation for her work in the OPERAM project: Optimising thERapy to prevent Avoidable hospital admission in the Multi-morbid elderly, supported by the European Commission (EC) HORIZON 2020, proposal 634238 and by the Swiss State Secretariat for Education, Research and Innovation under contract number 15.0137. The opinions expressed and arguments employed herein are those of the authors and do not necessarily reflect the official views of the EC and the Swiss government.

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Authors and Affiliations

  1. Pharmaceutical Care Research Group, School of Pharmacy, University College Cork, Cavanagh Pharmacy Building, College Road, Cork, Ireland

    Christina Raae Hansen, Stephen Byrne & Laura J. Sahm

  2. School of Pharmacy, Royal College of Surgeons of Ireland, 123 St. Stephen’s Green, Dublin 2, Ireland

    Shane Cullinan

  3. Department of Medicine, University College Cork, Brookfield Health Sciences Complex, College Road, Cork, Ireland

    Denis O’Mahony

  4. Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland

    Denis O’Mahony

  5. Pharmacy Department, Mercy University Hospital, Greenville Place, Cork, Ireland

    Laura J. Sahm

  6. Department of Epidemiology and Public Health, University College Cork, Western Gateway Building, Western Road, Cork, Ireland

    Patricia M. Kearney

Authors
  1. Christina Raae Hansen
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  2. Stephen Byrne
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  3. Shane Cullinan
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  4. Denis O’Mahony
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  5. Laura J. Sahm
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  6. Patricia M. Kearney
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Contributions

P.M. Kearney provided access to the cohort data. C.R. Hansen extracted the data from the electronic patient records, performed the statistical analyses and drafted the manuscripts. S. Byrne, S. Cullinan, D. O’Mahony, L.J. Sahm and P.M. Kearney revised the manuscript and approved the final version for submission.

Corresponding author

Correspondence to Christina Raae Hansen.

Ethics declarations

Local ethical approval was obtained to analyse the data and the original study was approved by the Clinical Research Ethics Committee of the Cork Teaching Hospitals.

Conflict of interest

The authors declare that they have no conflicts of interest.

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Hansen, C.R., Byrne, S., Cullinan, S. et al. Longitudinal patterns of potentially inappropriate prescribing in early old-aged people. Eur J Clin Pharmacol 74, 307–313 (2018). https://doi.org/10.1007/s00228-017-2364-6

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  • DOI: https://doi.org/10.1007/s00228-017-2364-6

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