title: Concordance with a STOPP (Screening Tool of Older Persons' Potentially Inappropriate Prescriptions) Criterion in Nova Scotia, Canada: Benzodiazepine and Zoplicone Prescription Claims by Older Adults with Fall-related Hospitalizaions.
abstract: BACKGROUND
  Optimization of prescribing in older adults is needed. The STOPP criteria provide a systematic way of identifying potentially inappropriate prescribing in this population. Previous research indicates poor concordance between benzodiazepine prescribing and STOPP.
  
  
  OBJECTIVE
  To determine the extent and predictors of benzodiazepine and zopiclone (BZD-Z) pharmacy dispensations in older adults with a history of a recent fall, in concordance with STOPP.
  
  
  METHODS
  Prescription claims data from the Nova Scotia Seniors' Phamacare Program were linked with fall-related injury data from the CIHI Discharge Abstract Database. Adults aged ≥ 66 years making a claim for a BZD-Z in the 100 days prior to fall-related hospitalization were identified. Their BZD-Z claims in the 100 days following discharge were also identified. Descriptive statistics, trend tests and logistical regression modelling were performed to examine predictors for continued use of BZD-Z post-fall.
  
  
  RESULTS
  Over 5 years, from a pool of 8,271 older adults discharged following a fall-related hospitalization, 1,789 (21.6%) had made a claim for a BZD-Z in the 100 days prior to admission. Of these, 82% were women. Younger age and female sex were predictors of continuing BZD-Z dispensations post-fall. In the 100 days following discharge, 74.2% (n=1327) made a claim for at least one BZD-Z.
  
  
  CONCLUSIONS
  BZD-Z use continued in 74% of patients following discharge from a fall-related hospitalization, representing limited concordance with the STOPP criterion. Such hospitalizations and follow-up care present an opportunity to address an ongoing modifiable risk factor.
authors.forename: B
authors.initials: B
authors.lastname: Hill-Taylor
authors.forename: I S
authors.initials: IS
authors.lastname: Sketris
authors.forename: D M
authors.initials: DM
authors.lastname: Gardner
authors.forename: K
authors.initials: K
authors.lastname: Thompson
mesh_terms: D000058:Accidental Falls / Q000517:prevention & control; D000368:Aged; D000369:Aged, 80 and over; D053961:Azabicyclo Compounds / Q000009:adverse effects*; D001569:Benzodiazepines / Q000009:adverse effects*; D011307:Drug Prescriptions; D005260:Female; D006760:Hospitalization / Q000639:trends*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000009:adverse effects; D057970:Inappropriate Prescribing / Q000517:prevention & control / Q000639:trends*; D008297:Male; D009674:Nova Scotia / Q000453:epidemiology; D010879:Piperazines / Q000009:adverse effects*; D000067561:Potentially Inappropriate Medication List / Q000639:trends*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D053961:Azabicyclo Compounds; D006993:Hypnotics and Sedatives; D010879:Piperazines; C515050:zopiclone; D001569:Benzodiazepines