Alarming Rates of Potentially Inappropriate Prescriptions For Seniors

HealthDay News – More than half of older adults are prescribed at least one potentially inappropriate prescription (PIP) at the time of hospital discharge, according to a cross-sectional study published in the Journal of Evaluation in Clinical Practice. These exceptionally high rates of PIPs dispensed to older adults should prompt immediate clinical action to reduce them.

Using the STOPP (Screening Tool of Older Person’s Prescriptions) and Beers Criteria for Potentially Inappropriate Medication Use in Older Adults, Klejda Hudhra PhD., from University of Medicine Tirana in Albania, and colleagues retrospectively identified PIPs among 319 patients (aged ≥60 years) discharged from cardiology and internal medicine departments during 2013.

The researchers found that the median number of drugs prescribed was 7.8. Using both criteria (STOPP version 1), PIPs prevalence at hospital discharge was 34.5%. Use of STOPP version 2 found 63.0% of patients had at least one PIP (total of 312 PIPs). 

Aspirin, spironolactone, benzodiazepines, digoxin, and methyldopa were the drugs most frequently involved in PIPs. There was a significant positive correlation between the number of prescribed drugs and PIP occurrence. Patients discharged from internal medicine had higher odds of PIP (P <.005).

Summary and Clinical Applicability 

The use of medication that can potentially introduce increased risks of adverse drug-related events should be avoided when safer alternatives exist.  This is especially true in elderly adults who may have decreased kidney function and may be taking multiple medications, making them at a higher risk of effects due to polypharmacy.

“The high frequency of PIPs suggests the urgent need for interventions to reduce them,” the authors write.

Reference

Hudhra K, Beçi E, Petrela E, Xhafaj D, García-caballos M, Bueno-cavanillas A. Prevalence and factors associated with potentially inappropriate prescriptions among older patients at hospital discharge. J Eval Clin Pract. 2016; Epub Ahead of Print March 27, 2016. DOI: 10.1111/1756-185X.12845