Association between potentially inappropriate medication and adverse drug reactions in hospitalized elderly patients

Abstract

What is known and objective The Beers, European Union (EU) and Screening Tool of Older Persons’ potentially inappropriate Prescription (STOPP) criteria were developed to improve the safe use of medicines in the elderly. However, the predictive validity of existing criteria to detect adverse drug reactions (ADRs) remains unexplored. The objective of the current study was to determine whether the 2019 Beers, 2015 STOPP or 2015 EU potentially inappropriate medicine (PIM) criteria were associated with ADRs. Methods A retrospective, cross‐sectional investigation was conducted among older persons (≥60 years of age) admitted to a tertiary hospital in China between April 2019 and December 2019. PIMs were identified as per the Beers, EU and STOPP criteria definitions. ADRs were retrospectively evaluated by two clinical pharmacists using the Naranjo algorithm. Multivariate logistic regression was used to evaluate the factors associated with ADRs in the hospitalized patients. Results and discussion The study participants included 560 hospitalized patients (mean age 72.05 ± 8.15). The prevalence of patients receiving at least one PIM was 52.1%, 37.0% and 42.9% according to the Beers, EU and STOPP criteria, respectively. Univariate analysis showed that ADRs were associated with PIMs listed in the Beers criteria (OR: 2.093, 95% CI: 1.028–4.263, 0.042), but not with the STOPP‐listed (OR: 0.536, 95% CI: 0.255–1.123, 0.098) and EU‐listed PIMs (OR: 0.258, 95% CI: 0.118–0.563, 0.001). What is new and conclusion In contrast to the STOPP and EU criteria on PIMs, the Beers criteria were significantly associated with avoidable ADRs in hospitalized older persons.

Relation between adverse drugs reactions with potentially inappropriate prescription in hospitalized older adults

“…In this study, it was shown that there is a relationship between PIP using explicit prescription tools, Beers criteria and STOPP/START criteria, and the development of in-hospital complications related to ADR. A high prevalence of PIP was found, like that reported in the literature in hospitalized older adult patients 16,17 . With respect to ADR, a higher prevalence was found than that reported in the literature in community dwelling, a study carried out in a hospital reported a similar prevalence 18 .…”

Medication management for patients with hip fracture at a regional hospital and associated primary care units in Norway: a descriptive study based on a survey of clinicians’ experience and a review of patient records

“…In our retrospective patient records review, we found that almost none contained a medication review, although it would be clearly beneficial for a majority of these multimorbid and polypharmacy patients 7 8 25 52. To illustrate, doctors’ medication review may reduce PIMs,53 which, if not stopped, may lead to ADRs,54 55 hospitalisation,56 57 increased mortality,58 and new falls and fractures 8. A majority of doctors considered PIMs when they performed a medication review, but needed more time to be able to complete medication reviews for more of their patients.…”

Opportunities and challenges of pharmacovigilance in special populations: a narrative review of the literature

“…99 Common tools for identifying PIMs include the Medication Appropriateness Index (MAI), HEDIS DAE, Beer's criteria, STOPP/ START criteria and EU-7-PIM list [Figure 3(c)]. [106][107][108][109] Wang et al 110 used Beer's criteria, STOPP/START criteria, and the EU-7-PIM list to evaluate the use of drugs in 560 elderly inpatients and found that Beer's criteria best predicted avoidable ADRs. However, for the elderly in Africa (Nigeria and South Africa), PIMs identified using Beer's criteria did not correlate to ADRs in hospitalized patients.…”