title: Longitudinal prevalence of potentially inappropriate medicines and potential prescribing omissions in a cohort of community-dwelling older people.
abstract: OBJECTIVE
  This study aims to compare the prevalence of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) using several screening tools in an Irish community-dwelling older cohort, to assess if the prevalence changes over time and to determine factors associated with any change.
  
  
  METHODS
  This is a prospective cohort study of participants aged ≥65 years in The Irish Longitudinal Study on Ageing (TILDA) with linked pharmacy claims data (n = 2051). PIM and PPO prevalence was measured in the year preceding participants' TILDA baseline interviews and in the year preceding their follow-up interviews using the Screening Tool for Older Persons' Prescriptions (STOPP), Beers criteria (2012), Assessing Care of Vulnerable Elders (ACOVE) indicators and the Screening Tool to Alert doctors to Right Treatment (START). Generalised estimating equations were used to determine factors associated with change in prevalence over time.
  
  
  RESULTS
  Depending on the screening tool used, between 19.8% (ACOVE indicators) and 52.7% (STOPP) of participants received a PIM at baseline, and PPO prevalence ranged from 38.2% (START) to 44.8% (ACOVE indicators), while 36.7% of participants had both a PIM and PPO. Common criteria were aspirin for primary prevention (19.6%) and omission of calcium/vitamin D in osteoporosis (14.7%). Prevalence of PIMs and PPOs increased at follow-up (PIMs range 22-56.1%, PPOs range 40.5-49.3%), and this was associated with patient age, female sex, and numbers of medicines and chronic conditions.
  
  
  CONCLUSIONS
  Sub-optimal prescribing is common in older patients. Ongoing prescribing review to optimise care is important, particularly as patients get older, receive more medicines or develop more illnesses.
authors: HRB Centre for Primary Care Research, Department of General Practice, Royal College of Surgeons in Ireland, 123 St Stephens Green, Dublin 2, Ireland, frankmoriarty@rcsi.ie.
authors: Frank
authors: F
authors: Moriarty
authors: Kathleen
authors: K
authors: Bennett
authors: Tom
authors: T
authors: Fahey
authors: Rose Anne
authors: RA
authors: Kenny
authors: Caitriona
authors: C
authors: Cahir
mesh_terms: D000368:Aged; D011307:Drug Prescriptions / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008137:Longitudinal Studies; D008297:Male; D019300:Medical Errors / Q000706:statistics & numerical data*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D015995:Prevalence; D011446:Prospective Studies; D012111:Residence Characteristics / Q000706:statistics & numerical data*