Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria.
BACKGROUND
Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation.


METHODS
A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers' Criteria applied.


RESULTS
Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0-13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking < or =5 medications (OR 3.34: 95%, CI 2.37-4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects.


CONCLUSIONS
IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.
Gallagher
Paul F
PF
Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland. pfgallagher77@eircom.net
Barry
Pat J
PJ
Ryan
Cristin
C
Hartigan
Irene
I
O'Mahony
Denis
D
D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000009:adverse effects; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D011307:Drug Prescriptions / Q000592:standards*; D004359:Drug Therapy, Combination; D064420:Drug-Related Side Effects and Adverse Reactions; D005260:Female; D006801:Humans; D007494:Ireland; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D011446:Prospective Studies; D011619:Psychotropic Drugs / Q000009:adverse effects; D012307:Risk Factors
D000894:Anti-Inflammatory Agents, Non-Steroidal; D002317:Cardiovascular Agents; D011619:Psychotropic Drugs