title: Inappropriate prescribing in hospitalised Australian elderly as determined by the STOPP criteria.
abstract: BACKGROUND
  The elderly population is increasing worldwide. Due to age-related physiological changes that affect the pharmacokinetics and pharmacodynamics of drugs, the elderly are predisposed to adverse drug reactions. Prescribing of potentially inappropriate medications (PIMs) has been found to be prevalent among the elderly and PIM use has been associated with hospitalisations and mortality.
  
  
  OBJECTIVE
  This study aims to identify the prevalence and nature of pre-admission inappropriate prescribing by using the STOPP (screening tool of older people's prescriptions) criteria amongst a sample of hospitalised elderly inpatients in South Australia.
  
  
  METHODS
  Medical, surgical and rehabilitation wards of a public teaching hospital in Adelaide, South Australia.
  
  
  METHODS
  Pre-admission prevalence of PIM.
  
  
  METHODS
  Medication management plans of 100 patients of ≥65 years old were prospectively studied to determine the prevalence of pre-admission PIM use. Sixty-five criteria of STOPP were applied to identify PIMs.
  
  
  RESULTS
  The total number of pre-admission medications screened during the study period was 949; the median number of medicines per patient was nine (range 2-28). Overall the STOPP criteria identified 138 PIMs in 60 % of patients. The most frequently encountered PIM was opiates prescribed in patients with recurrent falls (12.3 %), followed by benzodiazepines in fallers (10.1 %) and proton pump inhibitors when prescribed for peptic ulcer disease for long-term at maximum doses (9.4 %). The number of medications were found to have a positive correlation with pre-admission PIM use (r(s) = 0.49, P < 0.01).
  
  
  CONCLUSIONS
  Pre-admission PIM use is highly prevalent among the studied population. Strategies to reduce PIM use should be undertaken by physicians and pharmacists. The use of the STOPP criteria in clinical practice to reduce prescriptions of inappropriate medications requires further investigation.
authors.affiliation: Faculty of Pharmacy, Universiti Teknologi MARA, Puncak Alam, Malaysia. mohdsh2790@puncakalam.uitm.edu.my
authors.forename: Mohd Shahezwan Abd
authors.initials: MS
authors.lastname: Wahab
authors.forename: Karin
authors.initials: K
authors.lastname: Nyfort-Hansen
authors.forename: Stefan R
authors.initials: SR
authors.lastname: Kowalski
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004347:Drug Interactions; D011307:Drug Prescriptions; D005260:Female; D006299:Health Services for the Aged; D006779:Hospitals, Public; D006784:Hospitals, Teaching; D006801:Humans; D057970:Inappropriate Prescribing / Q000517:prevention & control; D007297:Inpatients; D008297:Male; D059065:Medication Reconciliation; D019338:Polypharmacy; D011446:Prospective Studies; D013021:South Australia