title: Prevalence of inappropriate medication use in residential long-term care facilities for the elderly: A systematic review.
abstract: BACKGROUND
  Multi-morbidity and polypharmacy of the elderly population enhances the probability of elderly in residential long-term care facilities experiencing inappropriate medication use.
  
  
  OBJECTIVE
  The aim is to systematically review literature to assess the prevalence of inappropriate medication use in residential long-term care facilities for the elderly.
  
  
  METHODS
  Databases (MEDLINE, EMBASE) were searched for literature from 2004 to 2016 to identify studies examining inappropriate medication use in residential long-term care facilities for the elderly. Studies were eligible when relying on Beers criteria, STOPP, START, PRISCUS list, ACOVE, BEDNURS or MAI instruments. Inappropriate medication use was defined by the criteria of these seven instruments.
  
  
  RESULTS
  Twenty-one studies met inclusion criteria. Seventeen studies relied on a version of Beers criteria with prevalence ranging between 18.5% and 82.6% (median 46.5%) residents experiencing inappropriate medication use. A smaller range, from 21.3% to 63.0% (median 35.1%), was reported when considering solely the 10 studies that used Beers criteria updated in 2003. Prevalence varied from 23.7% to 79.8% (median 61.1%) in seven studies relying on STOPP. START and ACOVE were relied on in respectively four (prevalence: 30.5-74.0%) and two studies (prevalence: 28.9-58.0%); PRISCUS, BEDNURS and MAI were all used in one study each.
  
  
  CONCLUSIONS
  Beers criteria of 2003 and STOPP were most frequently used to determine inappropriate medication use in residential long-term care facilities. Prevalence of inappropriate medication use strongly varied, despite similarities in research design and assessment with identical instrument(s).
authors.affiliation: a Faculty of Medicine and Life Sciences , Hasselt University , Hasselt , Belgium.
authors.forename: Hannelore
authors.initials: H
authors.lastname: Storms
authors.affiliation: a Faculty of Medicine and Life Sciences , Hasselt University , Hasselt , Belgium.|b Quality and Safety Department , Jessa Hospital , Hasselt , Belgium.
authors.forename: Kristel
authors.initials: K
authors.lastname: Marquet
authors.affiliation: c Department of Public Health and Primary Care , Academic Centre for General Practice, KU Leuven; Centre for EBM-CEBAM , Leuven , Belgium.
authors.forename: Bert
authors.initials: B
authors.lastname: Aertgeerts
authors.affiliation: a Faculty of Medicine and Life Sciences , Hasselt University , Hasselt , Belgium.|d Antwerp Management School, Faculty Leadership, Health Care Management , Antwerp , Belgium.
authors.forename: Neree
authors.initials: N
authors.lastname: Claes
mesh_terms: D000368:Aged; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D006707:Homes for the Aged; D006801:Humans; D057970:Inappropriate Prescribing / Q000706:statistics & numerical data*; D008134:Long-Term Care; D009735:Nursing Homes; D019338:Polypharmacy; D000067561:Potentially Inappropriate Medication List; D015995:Prevalence
keywords: General practice/family medicine; general; geriatrics; methodology; multimorbidity; pharmacotherapy; quality of care; research; systematic reviews and meta-analyses