Evaluation of potentially inappropriate medications for the elderly according to beers, STOPP, START, and Chinese criteria

Zhu, Xiaojuan; Zhang, Feng; Zhao, Yong; Zhang, Wen; Zhang, Yahui; Wang, Jianchun

doi:10.3389/fphar.2023.1265463

Front. Pharmacol.

2024

DOI: 10.3389/fphar.2023.1265463

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Evaluation of potentially inappropriate medications for the elderly according to beers, STOPP, START, and Chinese criteria

Xiaojuan Zhu,

Feng Zhang,

Yong Zhao

et al.

Abstract: Objective: Polypharmacy prevalence is increasing worldwide, and it is becoming more popular among the elderly. This study aimed to compare the prevalence of potentially inappropriate medications (PIMs) using the Beers criteria (2019 edition), criteria for potentially inappropriate medications for older adults in China (Chinese criteria), Screening Tool of Older Persons’ Prescriptions (STOPP), and Screening Tool to Alert to Right Treatment (START) criteria and to identify risk factors associated with PIM use.Me… Show more

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Cited by 2 publications

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Prevalence of Potentially Inappropriate Medications in Older Adults with Cognitive Impairment or Dementia Attending Memory Clinics: A Systematic Review and Meta-Analysis

Sharma,

Gill,

Chhabra

et al. 2024

JAD

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Background: Older adults with dementia who are on polypharmacy are more vulnerable to the use of potentially inappropriate medications (PIM), which can significantly increase the risk of adverse events and drug-related problems (DRPs). Objective: This systematic review and meta-analysis were conducted to map the prevalence of PIM use, polypharmacy, and hyper-polypharmacy among older adults with cognitive impairment or dementia attending memory clinics. Methods: Ovid MEDLINE, Ovid EMBASE, Scopus, Cochrane Library, EBSCOhost CINAHL, and Ovid International Pharmaceutical Abstracts (IPA) were systematically searched from inception to April 22, 2024. Observational studies assessing the PIMs use among older adults with CI or dementia were screened. A random- effects meta-analysis was conducted to pool the prevalence estimates. Results: Of 5,787 identified citations, 11 studies including 4,571 participants from 8 countries were included. Among all the included studies the pooled prevalence of PIM use was 38% (95% confidence interval (CIn): 27– 50%), highlighting a notable range from 20% to 78%. The analysis identified anticholinergics, benzodiazepines, and non-benzodiazepine sedatives as the most common PIMs. Subgroup analysis revealed a higher pooled prevalence of PIM in the USA (39%; 95% CIn: 10– 78, I2 (%) = 98, 3 studies) and Australia (36%, 95% CIn: 12– 70, I2 (%) = 96, 2 Studies). Additionally, pooled prevalence of polypharmacy and hyper-polypharmacy was reported as (60%; 95% CIn: 46– 73, I2 (%) = 95, 3 studies), and (The prevalence of hyper-polypharmacy was 17.6%; 1 study) respectively. Conclusions: The definition of PIMs significantly impacts study results, often more than geographical variations. The variability in criteria and tools like the Beers or Screening Tool of Older Persons’ Prescriptions (STOPP) criteria across studies and regions leads to differing prevalence rates.

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Prevalence of Potentially Inappropriate Medications in Older Adults with Cognitive Impairment or Dementia Attending Memory Clinics: A Systematic Review and Meta-Analysis

Sharma,

Gill,

Chhabra

et al. 2024

JAD

View full text Add to dashboard Cite

show abstract

Potentially inappropriate prescribing among older adults with hypertension in China: prevalence and related comorbidities across different outpatient settings

Chen,

Wang,

et al. 2024

Front. Pharmacol.

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PurposePotentially inappropriate prescribing (PIP) is commonly encountered in older adults; yet, there is limited information on the occurrence of PIP among older adults with hypertension. This study aims to determine and compare the prevalence of PIP and its association with comorbidities in older adult outpatients with hypertension across hospitals and community health centers (CHCs).MethodsThis 3-year (2015–2017) repeated cross-sectional study used electronic medical records from Shenzhen, China, involving 62 hospitals and 678 primary medical institutions. PIP was defined using the 2019 Beers Criteria. Older adults (≥65 years) with hypertension and at least one outpatient prescription were included. Modified Poisson regression analysis was used to assess the association between chronic comorbidities, healthcare settings, and PIP.ResultsThe prevalence of PIP in old adult outpatients with hypertension in 2015, 2016, and 2017 was 46.32%, 46.98%, and 46.58% in hospitals, with a sample size of 38,411, 46,235, and 50,495, respectively, and 29.14%, 26.66%, and 29.84% in CHCs, with a sample size of 26,876, 29,434, and 34,775 respectively. The top four most popular PIP in hospitals and CHCs was proton-pump inhibitors (PPIs), diuretics, benzodiazepines, and non-cyclooxygenase-selective non-steroidal anti-inflammatory drugs (NSAIDs), respectively. PIP was most associated with chronic gastrointestinal disease (adjusted prevalence ratio = 1.54, 95% confidence interval [CI] = 1.50–1.59) and mental and behavioral disorders (adjusted prevalence ratio = 1.49, 95% CI = 1.46–1.53) in hospitals and with mental and behavioral disorders (adjusted prevalence ratio = 1.99; 95% CI = 1.95–2.03) and musculoskeletal system and connective tissue disorders (adjusted prevalence ratio = 1.33; 95% CI = 1.31–1.36) in CHCs. The prevalence of PIP was significantly higher in hospital settings than in CHCs (adjusted prevalence ratio = 1.65; 95% CI = 1.63–1.66).ConclusionAmong older adult outpatients with hypertension in Shenzhen, PIP was more prevalent in hospitals than in CHCs. The comorbidities most strongly associated with PIP were chronic gastrointestinal disease and mental and behavioral disorders in hospitals and mental and behavioral disorders in CHCs. Clinical pharmacy integration needs to be considered to reduce inappropriate prescribing in this vulnerable population.

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Evaluation of potentially inappropriate medications for the elderly according to beers, STOPP, START, and Chinese criteria

Cited by 2 publications

References 34 publications

Prevalence of Potentially Inappropriate Medications in Older Adults with Cognitive Impairment or Dementia Attending Memory Clinics: A Systematic Review and Meta-Analysis

Prevalence of Potentially Inappropriate Medications in Older Adults with Cognitive Impairment or Dementia Attending Memory Clinics: A Systematic Review and Meta-Analysis

Potentially inappropriate prescribing among older adults with hypertension in China: prevalence and related comorbidities across different outpatient settings

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