title: Polypharmacy and potentially inappropriate prescriptions identified by Beers and STOPP criteria in co-morbid older patients at hospital discharge.
abstract: OBJECTIVE
  The objective of this study was to evaluate the prevalence of potentially inappropriate prescriptions (PIP) and the association with polypharmacy (more than six drugs prescribed) in co-morbid older patients in a critical moment of care transition such as hospital discharge by means of two explicit criteria (Beers 2012 and STOPP 2008).
  
  
  METHODS
  Cross-sectional study carried out in an older patients' population (≥65 years old) discharged from a university hospital in Spain. We recorded patients' information regarding demographics, diagnosis, drugs prescribed and associated pathological conditions and calculated the Charlson co-morbidity index. Data were obtained from the electronic medical records of hospital discharge. Beers (2012) and STOPP criteria (2008) were applied for PIP detection. The strength of association between polypharmacy and the presence of PIP was assessed by calculating the crude and adjusted odds ratio and its 95% confidence interval.
  
  
  RESULTS
  From 1004 patients of a 15% random sample, just 624 that fulfilled the inclusion criteria were included in the study. The number of prescribed drugs was a risk factor for PIP according to both criteria, even after adjusting for confounding variables. PIP frequency was higher in patients who received more than 12 medications (Beers: 34.8%, STOPP: 54.4%). Each additional medication increased the risk of PIP by 14 or 15% (Beers or STOPP).
  
  
  CONCLUSIONS
  Our results suggest that the strategies used for PIP reduction in co-morbid older patients should focus on the management of polypharmacy. Medication review at hospital discharge is highly recommended for patients taking more than six drugs.
authors.affiliation: Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Granada, Granada, Spain.|Faculty of Pharmacy, University of Medicine, Tirana, Albania.
authors.forename: Klejda
authors.initials: K
authors.lastname: Hudhra
authors.affiliation: Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Granada, Granada, Spain.|Primary Care Health Center 'Peligros', Andalusian Health Service, Granada, Spain.
authors.forename: Marta
authors.initials: M
authors.lastname: García-Caballos
authors.affiliation: Service of Documentation, University Hospital San Cecilio, Granada, Spain.
authors.forename: Eloisa
authors.initials: E
authors.lastname: Casado-Fernandez
authors.affiliation: Faculty of Pharmacy, University of Medicine, Tirana, Albania.
authors.forename: Besnik
authors.initials: B
authors.lastname: Jucja
authors.affiliation: Faculty of Pharmacy, University of Medicine, Tirana, Albania.|Department of Pharmacy, Faculty of Medicine, University of Pristine, Pristina, Kosovo.
authors.forename: Driton
authors.initials: D
authors.lastname: Shabani
authors.affiliation: Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Granada, Granada, Spain.|CIBER Epidemiology and Public Health (CIBERESP), Spain.|Service of Preventive Medicine, University Hospital San Cecilio, Granada, Spain.
authors.forename: Aurora
authors.initials: A
authors.lastname: Bueno-Cavanillas
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015897:Comorbidity; D003430:Cross-Sectional Studies; D057286:Electronic Health Records / Q000706:statistics & numerical data; D005260:Female; D006785:Hospitals, University / Q000706:statistics & numerical data; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008297:Male; D010351:Patient Discharge; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List / Q000706:statistics & numerical data*; D012307:Risk Factors; D012959:Socioeconomic Factors; D013030:Spain
keywords: Beers 2012; STOPP 2008; hospital discharge; older people; polypharmacy; potentially inappropriate prescriptions