Title | Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients |
Publication Type | Published Journal Article |
2014 | |
Authors | Cahir C, Bennett K, Teljeur C, Fahey T |
Journal | Br J Clin Pharmacol |
Volume | 77 |
Issue | 1 |
Start Page | 201 |
Pagination | 201-210 |
Date Published | 01/2014 |
Keywords | adverse drug events, health care use, HRQOL, older populations, potentially inappropriate prescribing, STOPP |
Abstract | Abstract METHODS: A retrospective cohort study of 931 community dwelling patients aged ≥70 years in 15 general practices in Ireland in 2010. PIP was defined by the Screening Tool of Older Person's Prescriptions (STOPP). ADEs were measured by patient self-report and medical record for the previous 6 months and reviewed by two independent clinicians. HRQOL was measured by the EQ-5D. A&E visits were measured by patients' medical records and self-report. Multilevel logistic, linear and Poisson regression examined how ADEs, HRQOL and A&E visits varied by PIP after adjusting for patient and practice level covariates: socioeconomic status, co-morbidity, number of drug classes and adherence. RESULTS: The overall prevalence of PIP was 42% (n = 377). Patients with ≥2 PIP indicators were twice as likely to have an ADE (adjusted OR 2.21; 95% CI 1.02, 4.83, P < 0.05), have a significantly lower mean HRQOL utility (adjusted coefficient -0.09, SE 0.02, P < 0.001) and nearly a two-fold increased risk in the expected rate of A&E visits (adjusted IRR 1.85; 95% CI 1.32, 2.58, P < 0.001). The number of drug classes and adherence were also significantly associated with these same adverse health outcomes. CONCLUSIONS: Reducing PIP in primary care may help lower the burden of ADEs, its associated health care use and costs and enhance quality of life in older patients. |
URL | http://onlinelibrary.wiley.com/doi/10.1111/bcp.12161/abstract |
DOI | 10.1111/bcp.12161 |