title: A comparison of beers and STOPP criteria in assessing potentially inappropriate medications in nursing home residents attending the emergency department.
abstract: OBJECTIVE
  The Beers (2012) criteria and the screening tool of older persons' potentially inappropriate prescriptions (STOPP) criteria are often used to identify potentially inappropriate medication (PIM) use in elderly patients. The aim of this study is to determine the prevalence of PIM use in nursing home residents (NHRs) aged ≥65 years presenting to the Emergency Department (ED); to compare the Beers and STOPP criteria and to identify the potential role of PIMs in ED attendances.
  
  
  METHODS
  The ED of an urban tertiary referral hospital.
  
  
  METHODS
  Acutely unwell long-term care NHRs seeking medical assistance at the ED.
  
  
  METHODS
  This is a retrospective cohort study. Demographic and clinical data were retrieved from the ED electronic record system, from the clinical records, and transfer letters for all NHRs who attended the ED in 2011. Beers 2012 and STOPP criteria were used to identify PIMs.
  
  
  RESULTS
  Of 195 NHRs identified, 165 were included. The mean age (±standard deviation) was 82.5 (±7.7) years; 110 (66.7%) were female and 157 (95.2%) were prescribed at least 1 PIM by either criterion. One hundred forty patients (84.8%) received a PIM according to STOPP criteria and 147 (89.1%) according to the Beers criteria. In the majority of patients (148; 89.7%), there was a difference in the medications Beers and STOPP identified as inappropriate. Fifty patients (30.3%) were considered to have a link between their attendance at ED and the PIM prescribed when assessed subjectively. Objective assessment using the WHO-UMC criteria found 7 (4.2%) had a 'probable' link and 45 (27.3%) a 'possible' link.
  
  
  CONCLUSIONS
  These results show a high rate of PIM prescribing in this cohort. The use of criteria such as Beers and STOPP may be a useful guide for physicians coordinating the long-term care of NHRs and may have the potential to reduce attendances at ED.
authors.affiliation: TCD/HSE Specialist Training in General Practice, Dublin, Ireland. Electronic address: argrace@gmail.com.
authors.forename: Anne R
authors.initials: AR
authors.lastname: Grace
authors.affiliation: Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland.
authors.forename: Robert
authors.initials: R
authors.lastname: Briggs
authors.affiliation: School of Medicine, Trinity College, Dublin, Ireland.
authors.forename: Ruth E
authors.initials: RE
authors.lastname: Kieran
authors.affiliation: School of Medicine, Trinity College, Dublin, Ireland.
authors.forename: Roisin M
authors.initials: RM
authors.lastname: Corcoran
authors.affiliation: Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland.
authors.forename: Roman
authors.initials: R
authors.lastname: Romero-Ortuno
authors.affiliation: Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland.
authors.forename: Tara L
authors.initials: TL
authors.lastname: Coughlan
authors.affiliation: Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland.
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
authors.affiliation: Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland.
authors.forename: Rónán
authors.initials: R
authors.lastname: Collins
authors.affiliation: Department of Age Related Healthcare, Tallaght Hospital, Dublin, Ireland; Department of Medical Gerontology, Trinity College Dublin School of Medicine, Dublin, Ireland. Electronic address: sean.kennelly@amnch.ie.
authors.forename: Sean P
authors.initials: SP
authors.lastname: Kennelly
mesh_terms: D000368:Aged; D057286:Electronic Health Records; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data; D008297:Male; D009735:Nursing Homes; D010360:Patient Transfer; D012189:Retrospective Studies; D018570:Risk Assessment / Q000592:standards
keywords: Beers criteria; Potentially inappropriate medications; STOPP criteria; nursing homes