title: Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan.
abstract: OBJECTIVE
  To investigate the national prevalence of potentially inappropriate medications (PIMs) prescribed in ambulatory care clinics in Taiwan according to three different sets of regional criteria and the correlates of PIM use.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  This analysis included older patients who visited ambulatory care clinics in 2009 and represented half of the older population included on the Taiwanese National Health Insurance Research Database.
  
  
  METHODS
  We identified 1,164,701 subjects who visited ambulatory care clinics and were over 65 years old in 2009.
  
  
  METHODS
  PIM prevalence according to the 2012 Beers criteria, the PIM-Taiwan criteria and the PRISCUS criteria was estimated separately, and characteristics of PIM users were explored. Multivariate logistic regression analysis was used to determine patient factors associated with the use of at least one PIM. Leading PIMs for each set of criteria were also listed.
  
  
  RESULTS
  The prevalence of having at least one PIM at the patient level was highest with the Beers criteria (86.2%), followed by the PIM-Taiwan criteria (73.3%) and the PRISCUS criteria (66.9%). Polypharmacy and younger age were associated with PIM use for all three sets of criteria. The leading PIMs detected by the PIM-Taiwan and PRISCUS criteria were all included in the 2012 Beers criteria. Non-COX-selective non-steroidal anti-inflammatory drugs in the Beers criteria and benzodiazepines in the PIM-Taiwan and PRISCUS criteria accounted for most leading PIMs.
  
  
  CONCLUSIONS
  The prevalence of PIMs was high among older Taiwanese patients receiving ambulatory care visits. The prevalence of PIM and its associated factors varied according to three sets of criteria at the population level.
authors.affiliation: Division of Internal Medicine, National Taiwan University Chu-Tung Branch, Hsinchu County, Taiwan Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Chirn-Bin
authors.initials: CB
authors.lastname: Chang
authors.affiliation: College of Pharmacy, Kaohsiung Medical University, Kaohsiung, Taiwan Taipei City Psychiatry Center, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Shu-Yu
authors.initials: SY
authors.lastname: Yang
authors.affiliation: Department of Family Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu City, Taiwan.
authors.forename: Hsiu-Yun
authors.initials: HY
authors.lastname: Lai
authors.affiliation: Taipei City Psychiatry Center, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Ru-Shu
authors.initials: RS
authors.lastname: Wu
authors.affiliation: Taipei City Psychiatry Center, Taipei City Hospital, Taipei, Taiwan Department of Psychiatry, School of Medicine, Taipei Medical University, Taipei, Taiwan.
authors.forename: Hsing-Cheng
authors.initials: HC
authors.lastname: Liu
authors.affiliation: Taipei City Psychiatry Center, Taipei City Hospital, Taipei, Taiwan.
authors.forename: Hsiu-Ying
authors.initials: HY
authors.lastname: Hsu
authors.affiliation: Department of Family Medicine, Taipei Veteran General Hospital, Taipei, Taiwan National Yang-Ming University, School of Medicine, Taipei, Taiwan.
authors.forename: Shinn-Jang
authors.initials: SJ
authors.lastname: Hwang
authors.affiliation: Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan Superintedent Office, National Taiwan University Hospital Chu-Tung Branch, Hsinchu County, Taiwan.
authors.forename: Ding-Cheng
authors.initials: DC
authors.lastname: Chan
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000592:standards*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D005260:Female; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009313:National Health Programs; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List; D012307:Risk Factors; D013624:Taiwan
keywords: Ambulatory care; Beers criteria; PIM-Taiwan criteria; PRISCUS criteria; potentially inappropriate medications