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Potentially inappropriate medication in acute hospitalized elderly patients with polypharmacy: an observational study comparing PRISCUS, STOPP, and Beers criteria

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

A Correction to this article was published on 04 February 2021

This article has been updated

Abstract

Purpose

To compare the prevalence of potentially inappropriate medication (PIM) in the elderly according to the PRISCUS list, STOPP criteria, and Beers criteria. Secondary, to describe the differences using the three criteria focused on the inappropriate prescription of psychotropic drugs in the elderly.

Methods

A retrospective study was performed at Severo Ochoa University Hospital. The study included 365 patients, aged 80 years and older, living in Madrid, Spain.

Results

93.42% of patients received at least one PIM during hospitalization. Using the PRISCUS list, this changed from 32.6 to 2.7% at discharge. Applying STOPP criteria lowered the percentage from 65.20 to 10.95%, and with Beers criteria from 80.27 to 10.13. Lower Barthel index at admission was associated with an increased relative risk for receiving at least one PIM (OR 1.79, 95% CI 1.15–2.80, p = 0.024) using PRISCUS list as a tool in conjunction with STOPP criteria (OR 1.44, 95% CI 0.89–2.33, p = 0.037). Polypharmacy at admission predicted the presence of PIMs with STOPP criteria (OR 1.74, 95% CI 1.07–2.84, p = 0.001). Regarding psychotropic medicines, 208 patients (56.98%) received at least one psychotropic medicine during hospitalization. A total of 26.30% of patients were treated with psychotropic medicines, detected by the PRISCUS list, and 53.97% and 29.85% with STOPP and Beers, respectively.

Conclusions

Explicit criteria are a useful tool for identifying during hospitalization of the elderly patients. As indicated by the results, new research is needed to carry out an adaptation in our country that includes an evaluation of the strengths of the three tools to decrease PIMs and improve prescription in the elderly.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Acknowledgments

We are indebted to Kelli White and Pilar Garcia del Vello for their expertise and invaluable advice in the English language.

Author information

Authors and Affiliations

  1. Servicio de Farmacia, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n., Leganés, Spain

    Lorena de Agustín Sierra & Benito García Díaz

  2. Servicio de Geriatría, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n, Leganés, Spain

    Jaime Rodríguez Salazar & María Jesús Molina Hernández

  3. Servicio de Medicina Preventiva, Hospital Universitario Severo Ochoa, Avenida de Orellana, s/n., Leganés, Spain

    Ana Belén Jiménez-Muñoz

  4. Facultad de Farmacia, Servicio de Farmacología y Farmacognosia, Spain, Universidad Complutense de Madrid, Avenida Plaza de Ramón y Cajal, s/n, 28040, Madrid, Spain

    Paloma Bermejo Bescós & Irene Iglesias Peinado

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  1. Lorena de Agustín Sierra
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Contributions

• Lorena de Agustín Sierra: Substantial contributions to the conception or design of the work, the acquisition, analysis, drafting the work or revising it critically for important intellectual content and interpretation of data for the work

• Jaime Rodríguez Salazar: Substantial contributions to the conception or design of the work, the acquisition, analysis, drafting the work or revising it critically for important intellectual content

• Ana Belén Jiménez-Muñoz: drafting the work or revising it critically for important intellectual content and final approval of the version to be published

• María Jesús Molina Hernández: drafting the work or revising it critically for important intellectual content and final approval of the version to be published

• Paloma Bermejo Bescós: Final approval of the version to be published

• Irene Iglesias Peinado: Final approval of the version to be published

• Benito García Díaz: Final approval of the version to be published

Corresponding author

Correspondence to Lorena de Agustín Sierra.

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The authors declare that they have no conflict of interest.

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The study has been approved by the Clinical Research Ethics Committee of Severo Ochoa University Hospital and is being conducted in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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de Agustín Sierra, L., Rodríguez Salazar, J., Jiménez-Muñoz, A.B. et al. Potentially inappropriate medication in acute hospitalized elderly patients with polypharmacy: an observational study comparing PRISCUS, STOPP, and Beers criteria. Eur J Clin Pharmacol 77, 757–766 (2021). https://doi.org/10.1007/s00228-020-03022-8

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