Potentially Inappropriate Medication Prescribing Detected by Computer Algorithm among Older Patients: Results from the MAPT Study

Abstract

(1) Background: Some medications may be dangerous for older patients. Potentially inappropriate medication prescribing (PIP) among older patients represents a significant cause of morbidity. The aim of this study was to create an algorithm to detect PIP in a geriatric database (Multidomain Alzheimer Preventive Trial (MAPT) study), and then to assess the algorithm construct validity by comparing the prevalence of PIP and associated factors with literature data. (2) Methods: An algorithm was constructed to detect PIP and was based on different explicit criteria among which the European list of potentially inappropriate medications (EU(7)-PIM), the STOPP and START version 2 tools. For construct validity assessment, logistic mixed-effects model repeated measures analyses were used to identify factors associated with PIP. (3) Results: Prevalence of PIP was 59.0% with the EU(7)-PIM list criteria, 43.2% with the STOPP criteria and 51.3% with the START criteria. Age, polypharmacy, and higher Charlson comorbidity index were associated with PIP. (4) Conclusions: Prevalence of PIP and associated factors are consistent with literature data, supporting the construct validity of our algorithm. This algorithm opens up interesting perspectives both in terms of analysis of very large databases and integration into e-prescribing or pharmaceutical validation software.

Medication Safety in Municipal Health and Care Services

“…St. 28) and the START and STOPP criteria (O'Mahony et al, 2015) have been given most attention, the NORGEP-NH criteria seem to be a more appropriate choice for Norwegian nursing home residents, especially as these validated criteria are based on nationally available medications (Nyborg et al, 2015). A few pharmacist-led studies have electronically identified the prevalence of inappropriate prescribing in nursing homes residents and older adults (Pagès et al, 2021). The findings of these studies are comparable to clinical studies, which also state that the use of inappropriate medications by these residents is highly prevalent.…”

Impact of low‐value medications on quality of life, hospitalization and costs – A longitudinal analysis of patients living with dementia

“…Previous cross-sectional studies have already revealed that receiving Lvm in dementia was associated with lower HRQoL and an increased risk for hospitalization and greater health care expenditures. 15,16,20,21 However, the longitudinal effects of Lvm on patient-relevant outcomes have been rarely reported. Therefore, the objective of the present analysis was to examine the effects of receiving Lvm on HRQoL, hospitalization and health care expenditures for PwD over 24 months.…”

“…Previous cross‐sectional studies have already revealed that receiving Lvm in dementia was associated with lower HRQoL and an increased risk for hospitalization and greater health care expenditures 15,16,20,21 . However, the longitudinal effects of Lvm on patient‐relevant outcomes have been rarely reported.…”