International Journal of Clinical Pharmacy

, Volume 36, Issue 3, pp 596–603 | Cite as

Frequency of potentially inappropriate prescriptions in older people at discharge according to Beers and STOPP criteria

  • Klejda Hudhra
  • Marta García-Caballos
  • Besnik Jucja
  • Eloisa Casado-Fernández
  • Elena Espigares-Rodriguez
  • Aurora Bueno-CavanillasEmail author
Research Article


Background Potentially inappropriate prescriptions (PIP) are frequent, generate negative outcomes, and are to a great extent avoidable. Although there is general agreement about the definition of PIP, how to measure them is a matter of debate. Objective Our aim was to measure the frequency of PIP in older people at hospital discharge using two sets of criteria—Beers (2012 update) and STOPP. Setting A University Hospital in southern Spain. Method This cross sectional study involved a random sample of patients 65 years or more discharged from the University Hospital San Cecilio (Granada, Spain), from July 1, 2011 to June 30, 2012. Age, gender, length of hospital stay, type of hospital service, drugs prescribed and pathologies were obtained from discharge reports. Main outcome measure The main outcome measures were: (1) the prevalence of PIP according to each set of criteria (Beers and STOPP) and its 95 % confidence interval, globally and stratified for different categories of the study variables; (2) the degree of agreement between the two criteria using Kappa statistics; and (3) the drugs most commonly involved in PIP according to both criteria. Results There were 624 patients (median age 78) included in our study. According to Beers criteria, 22.9 % (19.6–26.2 %) of the patients had at least one PIP. This figure was 38.4 % (34.6–42.2 %) for STOPP criteria. Just 13.6 % of the patients had prescriptions simultaneously inappropriate for both criteria. Higher PIP frequency was observed in patients discharged from internal medicine. PIP increased with the Charlson Index and with the number of drugs prescribed, but not with gender, age or length of hospital stay. Conclusion A very high frequency of PIP at discharge was observed. By intervening in five drug groups, about 80 % of PIP might be avoided according to either of the two criteria.


Beers criteria Elderly Patient discharge Potentially inappropriate prescription Spain STOPP criteria 



The authors wish to acknowledge Jean Sanders for improving the use of English in the manuscript. We also thank the Erasmus Mundus JoinEU-SEE project for the mobility scholarship given to K. Hudhra. The results are part of the doctorate thesis of K. Hudhra.


This study is partially funded by CIBER.

Conflicts of interest

There is no conflict of interests in our investigation.

Supplementary material

11096_2014_9943_MOESM1_ESM.doc (163 kb)
Supplementary material 1 (DOC 163 kb)


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Copyright information

© Koninklijke Nederlandse Maatschappij ter bevordering der Pharmacie 2014

Authors and Affiliations

  • Klejda Hudhra
    • 1
    • 2
  • Marta García-Caballos
    • 1
    • 3
  • Besnik Jucja
    • 2
  • Eloisa Casado-Fernández
    • 4
  • Elena Espigares-Rodriguez
    • 1
    • 5
  • Aurora Bueno-Cavanillas
    • 1
    • 5
    • 6
    Email author
  1. 1.Department of Public Health and Preventive Medicine, Faculty of MedicineUniversity of GranadaGranadaSpain
  2. 2.Faculty of PharmacyUniversity of Medicine of TiranaTiranaAlbania
  3. 3.Primary Care Health Center “Algarinejo”Andalusian Health ServiceGranadaSpain
  4. 4.Service of DocumentationUniversity Hospital San CecilioGranadaSpain
  5. 5.CIBER Epidemiology and Public Health (CIBERESP)MadridSpain
  6. 6.Service of Preventive MedicineUniversity Hospital San CecilioGranadaSpain

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