title: Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals.
abstract: OBJECTIVE
  Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe.
  
  
  METHODS
  Prospective data were collected from 900 consecutive older patients admitted to six university teaching hospitals (150 patients per centre) in Geneva (Switzerland), Madrid (Spain), Oostende (Belgium), Perugia (Italy), Prague (Czech Republic) and Cork (Ireland). Age, gender, comorbidity, cognitive status, prescription medicines taken before admission and baseline haematological, biochemical and electrocardiographic data were recorded. STOPP and Beers' criteria were applied to detect potentially inappropriate medicines (PIMs). START criteria were applied to detect potentially inappropriate prescribing omissions (PPOs).
  
  
  RESULTS
  The overall PIM prevalence rate was 51.3% using STOPP criteria, varying from 34.7% in Prague to 77.3% in Geneva, and 30.4% using Beer's criteria, varying from 22.7% in Prague to 43.3% in Geneva. Using START criteria, the overall PPO prevalence rate was 59.4%, ranging from 51.3% in Cork to 72.7% in Perugia. Polypharmacy predicted the presence of PIMs using STOPP criteria [with >10 medications: odds ratio (OR)  7.22, 95% confidence interval (CI) 4.30-12.12, p < 0.001] and Beers' criteria (with >10 medications: OR 4.87, 95% CI 3.00-7.90, p < 0.001). Increasing co-morbidity (Charlson Index ≥2) and age ≥85 years significantly predicted PPOs.
  
  
  CONCLUSIONS
  Potentially inappropriate drug prescribing and the omission of beneficial drugs are highly prevalent in acutely ill hospitalized older people in six European centres.
authors.affiliation: Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland. pfgallagher77@eircom.net
authors.forename: Paul
authors.initials: P
authors.lastname: Gallagher
authors.forename: Pierre Olivier
authors.initials: PO
authors.lastname: Lang
authors.forename: Antonio
authors.initials: A
authors.lastname: Cherubini
authors.forename: Eva
authors.initials: E
authors.lastname: Topinková
authors.forename: Alfonso
authors.initials: A
authors.lastname: Cruz-Jentoft
authors.forename: Beatriz
authors.initials: B
authors.lastname: Montero Errasquín
authors.forename: Pavla
authors.initials: P
authors.lastname: Mádlová
authors.forename: Beatrice
authors.initials: B
authors.lastname: Gasperini
authors.forename: Hilde
authors.initials: H
authors.lastname: Baeyens
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Baeyens
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Michel
authors.forename: Denis
authors.initials: D
authors.lastname: O'Mahony
mesh_terms: D000208:Acute Disease / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D017723:Drug Utilization Review / Q000706:statistics & numerical data / Q000639:trends*; D005060:Europe; D005260:Female; D006299:Health Services for the Aged / Q000592:standards / Q000706:statistics & numerical data*; D006785:Hospitals, University / Q000592:standards* / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data / Q000639:trends*; D008297:Male; D055553:Prescription Drugs / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D055553:Prescription Drugs