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The impact of PIPs on mortality and readmissions in older adults: a retrospective cohort study

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

Abstract

Purpose

Our aim was to determine the impact of potentially inappropriate prescriptions (PIP), according to “Screening Tool of Older Persons’ Prescriptions” criteria version 2 (STOPP-2), on mortality and hospital admissions.

Methods

Monocentric retrospective cohort study. Patients over 65 years of age and who were consecutively discharged from internal medicine at a Spanish university hospital in 2016 were included. The mortality and hospital admissions of the cohort of patients were analysed using their electronic health records within two years from the time of discharge. Analysis was done based on the type and number of STOPP-2 criteria as well as taking into account the total number of medications. The subdistribution hazard ratios (SHR) were estimated through a competing proportional hazards model.

Results

A total of 270 patients with a median age of 82 years (interquartile range/IQR 76–86 years), and 152 (56.3%) women were studied. It was found out that 28.3% of patients with PIP died compared to 17.2% of patients without it. Digoxin (B1 STOPP-2 criterion) with a subdistribution hazard ratio (SHR) 2.40 (95% CI 0.63–9.18), selective serotonin re-uptake inhibitors/SSRIs (D4) with a SHR 1.76 (95% CI 0.52–5.96) and neuroleptic drugs (K2) with a SHR 2.01 (95% CI 0.82–4.95) non-significantly increased the risk of death. Dementia (SHR 5.45; 95% CI 2.76–10.78) was then the only statistically significant risk factor for death. Sixty percent of patients with a PIP had shown at least one hospital admission compared to 51% of patients without it. The number of drugs at discharge (SHR 1.03; 95% CI 1.01–1.05) and having 1–2 STOPP-2 criteria (SHR 1.17; 95% CI 1.02–1.35) significantly increased the risk of hospital admission.

Conclusion

The number of drugs at discharge and having any STOPP criteria significantly increased the risk of hospital admission in this cohort. PIP, only according to some specific STOPP-2 criteria involving digoxin, neuroleptics and SSRIs, might associate with a statistically non-significantly higher risk on mortality.

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Availability of data and material

The datasets generated during and/or analysed during the study are available from the corresponding author subject to a reasonable request.

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Acknowledgements

The authors thank Shari Meyan Fae Barro for improving the English style.

Author information

Authors and Affiliations

  1. Department of Internal Medicine, Hospital Universitario San Cecilio, Granada, Spain

    Alfredo Jose Pardo-Cabello

  2. Department of Internal Medicine, Hospital Universitario Virgen de Las Nieves, Granada, Spain

    Victoria Manzano-Gamero

  3. Department of Biostatistics, School of Medicine, University of Granada, Granada, Spain

    Juan de Dios Luna

Authors
  1. Alfredo Jose Pardo-Cabello
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  2. Victoria Manzano-Gamero
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  3. Juan de Dios Luna
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Contributions

AJPC and JDL contributed to the conception or design of the work and/or to the acquisition of data. JDL, AJPC and VMG contributed to the analysis and/or interpretation of results. AJPC and VMG drafted the manuscript. AJPC and VMG carefully revised the manuscript. All authors gave final approval and agree to be accountable for all aspects of the work ensuring integrity and accuracy.

Corresponding author

Correspondence to Alfredo Jose Pardo-Cabello.

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Ethics approval

Given the observational and retrospective nature of the study, and the anonymity of all patients whom clinical data were used, approval by the ethics committee was not requested.

Research involving human participants and/or animals

This observational study was conducted retrospectively from electronic data exclusively obtained for clinical purposes.

Informed consent

Informed consent is not required because of the retrospective and observational nature of study, because the information is anonymized, and the submission does not include data or images that may identify the people.

Conflict of interest

The authors declare no competing interests.

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Pardo-Cabello, A.J., Manzano-Gamero, V. & Luna, J.d. The impact of PIPs on mortality and readmissions in older adults: a retrospective cohort study. Eur J Clin Pharmacol 78, 139–145 (2022). https://doi.org/10.1007/s00228-021-03217-7

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  • DOI: https://doi.org/10.1007/s00228-021-03217-7

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