title: Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review.
abstract: BACKGROUND
  Potentially inappropriate prescribing (PIP) is one of the main risk factors for adverse drug events (ADEs) in older people.
  
  
  OBJECTIVE
  This systematic literature review aims to determine prevalence and type of PIP in community-dwelling older people across Europe, as well as identifying risk factors for PIP.
  
  
  METHODS
  The PubMed and Web of Science database were searched systematically for relevant manuscripts (January 1, 2000-December 31, 2014). Manuscripts were included if the study design was observational, the study participants were community-dwelling older patients in Europe, and if a published screening method for PIP was used. Studies that focused on specific pathologies or that focused on merely one inappropriate prescribing issue were excluded. Data analysis was performed using R statistics.
  
  
  RESULTS
  Fifty-two manuscripts were included, describing 82 different sample screenings with an estimated overall PIP prevalence of 22.6 % (CI 19.2-26.7 %; range 0.0-98.0 %). Ten of the sample screenings were based on the Beers 1997 criteria, 19 on the Beers 2003 criteria, 14 on STOPP criteria (2008 version), 8 on START-criteria (2008 version), and 7 on the PRISCUS list. The 24 remaining sample screenings were carried out using compilations of screening methods or used country-specific lists such as the Laroche criteria. It appears that only PIP prevalence calculated from insurance data significantly differs from the other data collection method categories. Furthermore, risk factors most often positively associated with PIP prevalence were polypharmacy, poor functional status, and depression. Drug groups most often involved in PIP were anxiolytics (ATC-code: N05B), antidepressants (N06A), and nonsteroidal anti-inflammatory and anti-rheumatic products (M01A).
  
  
  CONCLUSIONS
  PIP prevalence in European community-dwelling older adults is high and depends partially on the data collection method used. Polypharmacy, poor functional status, and depression were identified as the most common risk factors for PIP.
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium. Eline.Tommelein@UGent.be.
authors.forename: Eline
authors.initials: E
authors.lastname: Tommelein
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
authors.forename: Els
authors.initials: E
authors.lastname: Mehuys
authors.affiliation: Department of Internal medicine, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Mirko
authors.initials: M
authors.lastname: Petrovic
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.|Department of Pharmacy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium.
authors.forename: Annemie
authors.initials: A
authors.lastname: Somers
authors.affiliation: Laboratory of Medical Biochemistry and Clinical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium.|Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Colin
authors.affiliation: Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium.
authors.forename: Koen
authors.initials: K
authors.lastname: Boussery
mesh_terms: D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D005060:Europe / Q000453:epidemiology; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D019338:Polypharmacy; D010818:Practice Patterns, Physicians' / Q000592:standards / Q000706:statistics & numerical data*; D015995:Prevalence; D012307:Risk Factors
keywords: Aged; Community-dwelling; Inappropriate prescribing; Primary care