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

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Abstract

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.

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Acknowledgments

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.

Funding

This study is partially funded by CIBER.

Conflicts of interest

There is no conflict of interests in our investigation.

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Authors and Affiliations

  1. Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Granada, Avenida de Madrid, 11, 18012, Granada, Spain

    Klejda Hudhra, Marta García-Caballos, Elena Espigares-Rodriguez & Aurora Bueno-Cavanillas

  2. Faculty of Pharmacy, University of Medicine of Tirana, Tirana, Albania

    Klejda Hudhra & Besnik Jucja

  3. Primary Care Health Center “Algarinejo”, Andalusian Health Service, Granada, Spain

    Marta García-Caballos

  4. Service of Documentation, University Hospital San Cecilio, Granada, Spain

    Eloisa Casado-Fernández

  5. CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain

    Elena Espigares-Rodriguez & Aurora Bueno-Cavanillas

  6. Service of Preventive Medicine, University Hospital San Cecilio, Granada, Spain

    Aurora Bueno-Cavanillas

Authors
  1. Klejda Hudhra
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  2. Marta García-Caballos
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  3. Besnik Jucja
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  4. Eloisa Casado-Fernández
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  5. Elena Espigares-Rodriguez
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  6. Aurora Bueno-Cavanillas
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Corresponding author

Correspondence to Aurora Bueno-Cavanillas.

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Hudhra, K., García-Caballos, M., Jucja, B. et al. Frequency of potentially inappropriate prescriptions in older people at discharge according to Beers and STOPP criteria. Int J Clin Pharm 36, 596–603 (2014). https://doi.org/10.1007/s11096-014-9943-8

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  • DOI: https://doi.org/10.1007/s11096-014-9943-8

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