Inappropriate Prescribing in Older Hospitalized Adults: A Comparison of Medical Specialties

Inappropriate Prescribing in Older Hospitalized Adults: A Comparison of Medical Specialties

Objectives To evaluate the prevalence and number of potentially inappropriate medications (PIMs) in hospitalized older adults, comparing prescription patterns of medical specialties. Design Retrospective cohort study. Setting Tertiary general hospital. Participants All older adults hospitalized from...

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Bibliographic Details
Published in:Journal of the American Geriatrics Society (JAGS) Vol. 66; no. 2; pp. 383 - 388
Main Authors: Juliano, Ana Carmen dos Santos Ribeiro Simoes, Lucchetti, Alessandra Lamas Granero, Silva, Jéssica Teixeira Santos da, Santos, Letícia Gomes, Nunes, Jéssica Borges Taranto, Fernandes, Guilherme Cortes, Lucchetti, Giancarlo
Format: Journal Article
Language:English
Published: United States Wiley Subscription Services, Inc 01-02-2018
Subjects:
Acetylsalicylic acid
Aged
Aged, 80 and over
Brazil
Cardiology
Clonazepam
Female
Gastroenterology
geriatrics
Hospitalization
Humans
Inappropriate Prescribing - statistics & numerical data
Infectious diseases
Insulin
Male
medical specialties
Medicine - statistics & numerical data
Neurology
Older people
Potentially Inappropriate Medication List
potentially inappropriate medications
prescription
Prevalence
Retrospective Studies
Brazil
geriatrics
medical specialties
potentially inappropriate medications
prescription
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Summary:Objectives To evaluate the prevalence and number of potentially inappropriate medications (PIMs) in hospitalized older adults, comparing prescription patterns of medical specialties. Design Retrospective cohort study. Setting Tertiary general hospital. Participants All older adults hospitalized from January through May 2015 (N = 1,900). Measurements Information on medications prescribed during the first and last days of hospitalization was collected and evaluated regarding PIMs using Beers and Screening Tool of Older People's Prescriptions (STOPP) criteria. Medical specialties (internal medicine, cardiology, gastroenterology, infectious disease, nephrology, neurology, pneumology) were compared regarding the prevalence of PIMs and the increase in the number of PIMs during hospitalization. Results The number of individuals with PIMs increased significantly according to both criteria (62.3% to 66.6% according to Beers criteria, 43.4% to 50.0% according to STOPP criteria). The most common PIMs were sliding‐scale insulin (26.9%), clonazepam (9.5%), and periciazine (6.4%) using Beers criteria and spironolactone (10.3%), acetylsalicylic acid (9.8%), and periciazine (8.7%) using STOPP criteria. Neurology, infectious disease, and pneumology had the highest numbers of PIMs, and neurology, pneumology, and cardiology had a greater increase in PIMs during hospitalization than the other specialties. Conclusion This study demonstrates the high and growing prevalence of PIMs in the hospital environment, according to Beers and STOPP criteria. Educational measures and specific pharmaceutical interventions for each specialty are needed to change this situation.
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ISSN:0002-8614
1532-5415
DOI:10.1111/jgs.15138