Author/Authors :
Yang, Po-Jen Chung Shan Medical University - School of Medicine, Institute of Medicine, Center for Education and Research on Geriatrics and Gerontology, Taiwan , Lee, Yuan-Ti Chung Shan Medical University - Institute of Medicine - Department of Internal Medicine, Taiwan , Tzeng, Shu-Ling Chung Shan Medical University - School of Medicine, Institute of Medicine - Department of Pharmacy, Taiwan , Lee, Huei-Chao Chung Shan Medical University - School of Medicine, Institute of Medicine - department of Pharmacy, Taiwan , Tsai, Chin-Feng Chung Shan Medical University - School of Medicine, Institute of Medicine - Department of Internal Medicine, Taiwan , Chen, Chun-Chieh Chung Shan Medical University - Center for Education and Research on Geriatrics and Gerontology - Departments of d Family and Community Medicine, Taiwan , Chen, Shiuan-Chih Chung Shan Medical University - Institute of Medicine, Taiwan , Chen, Shiuan-Chih Chung Shan Medical University - School of Medicine, Taiwan , Chen, Shiuan-Chih Ministry of Health and Welfare - Taichung Hospital - Department of Family Medicine, Taiwan , Lee, Meng-Chih Chung Shan Medical University - Institute of Medicine, Taiwan , Lee, Meng-Chih Ministry of Health and Welfare - Taichung Hospital - Department of Family Medicine, Taiwan
Abstract :
Objective: To evaluate the prescription of potentially inappropriate medications (PIM), using the Screening Tool of Older Persons’ potentially inappropriate Prescriptions (STOPP) and Beers criteria, to disabled older people. Subjects and Methods: One hundred and forty-one patients aged ≥ 65 years with Barthel scale scores ≤ 60 and a regular intake of medication for chronic diseases at Chung Shan Medical University Hospital from July to December 2012 were included, and their medical records were reviewed. Comprehensive patient information was extracted from the patients’ medical notes. The STOPP and Beers 2012 criteria were used separately to identify PIM, and logistic regression analyses were performed to identify risk factors for PIM. The optimal cutoff for the number of medications prescribed for predicting PIM was estimated using the Youden index. Results: Of the 141 patients, 94 (66.7%) and 94 (66.7%) had at least one PIM identified by the STOPP and Beers criteria, respectively. In multivariate analysis, PIM identified by the Beers criteria were associated with the prescription of multiple medications (p = 0.013) and the presence of psychiatric diseases (p 0.001), whereas PIM identified by the STOPP criteria were only associated with the prescription of multiple medications (p = 0.008). The optimal cutoff for the number of medications prescribed for predicting PIM by using the STOPP or Beers criteria was 6. After adjustment for covariates, patients prescribed ≥ 6 medications had a significantly higher risk of PIM, identified using the STOPP or Beers criteria, compared to patients prescribed 6 medications (both p 0.05). Conclusion: This study revealed a high frequency of PIM in disabled older patients with chronic diseases, particularly those prescribed ≥ 6 medications.