title: Potentially inappropriate prescribing in older patients admitted to psychiatric hospital.
abstract: OBJECTIVE
  The objectives of this study are to determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs) and to assess related risk factors in older people with major psychiatric illness.
  
  
  METHODS
  This was a cross-sectional study of older patients hospitalized in a psychiatric hospital (n = 164; mean age 74.9 ± 7.3 years; 62% female). The primary endpoint was the prevalence of participants receiving PIMs and PPOs, which was assessed by using the Beers criteria 2012 and the screening tool of older person's potentially inappropriate prescriptions (STOPP) and screening tool of alert doctors to the right treatment (START) criteria. Univariate and multivariate logistic regression was used to assess significant risk factors for PIMs in this population.
  
  
  RESULTS
  A total of 1269 drugs were prescribed to included patients (range: 0-19 drugs/day). PIMs were identified in 47% and 79% of participants, based on the Beers 2012 and STOPP criteria, respectively. Most PIMs (70%) concerned psychotropic drugs. The STOPP criteria identified more PIMs (331) than the Beers criteria 2012 (199). According to the START criteria, 59% of participants had PPOs. The number of prescribed medications was significantly associated with the occurrence of PIMs according to the Beers 2012 [OR 1.2 (95% CI 1.1-1.3)] and STOPP [OR 1.5 (95% CI 1.3-1.8)] criteria.
  
  
  CONCLUSIONS
  Potentially inappropriate prescribing, as identified by the Beers and STOPP/START criteria, is highly prevalent among older patients hospitalized with major psychiatric illness. However, the focus on psychotropic drugs prescription without taking into account the benefit of these drugs to individual patients may limit the application of the Beers and STOPP criteria in psychiatric hospitals.
authors.affiliation: Department of Psychogeriatric Medicine, Vincent van Gogh Institute, Venray, The Netherlands.|Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Sara
authors.initials: S
authors.lastname: Rongen
authors.affiliation: Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Pharmacy, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands.|Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Cornelis
authors.initials: C
authors.lastname: Kramers
authors.affiliation: Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland.|School of Medicine, University College Cork, Cork, Ireland.
authors.forename: Denis
authors.initials: D
authors.lastname: O'Mahony
authors.affiliation: Department of Epidemiology, Biostatistics and Health Technology Assessment, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Ton B
authors.initials: TB
authors.lastname: Feuth
authors.affiliation: Department of Geriatric Medicine, Radboud Alzheimer Centre and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.|Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Marcel G M
authors.initials: MG
authors.lastname: Olde Rikkert
authors.affiliation: Department of Psychogeriatric Medicine, Vincent van Gogh Institute, Venray, The Netherlands.|Department of Pharmacology and Toxicology, Radboud University Medical Center, Nijmegen, The Netherlands.|Department of Geriatric Medicine, Radboud Alzheimer Centre and Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.
authors.forename: Amir I A
authors.initials: AI
authors.lastname: Ahmed
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions / Q000592:standards*; D005260:Female; D006778:Hospitals, Psychiatric / Q000706:statistics & numerical data*; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D009426:Netherlands; D012307:Risk Factors
keywords: Beers criteria; Older patients; STOPP/START criteria; potentially inappropriate prescribing; psychiatric hospital