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Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review

Eline Tommelein (UGent) , Els Mehuys (UGent) , Mirko Petrovic (UGent) , Annemie Somers (UGent) , Pieter Colin (UGent) and Koen Boussery (UGent)
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Organization
Abstract
Background: Potentially inappropriate prescribing (PIP) is one of the main risk factors for adverse drug events (ADEs) in older people. Purpose: 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 onSTART-criteria (2008 version), and 7 on thePRISCUS 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). Conclusion: 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.
Keywords
Community-dwelling, Aged, Primary care, BEERS CRITERIA, EXPLICIT CRITERIA, STOPP/START CRITERIA, DISEASE INTERACTIONS, MEDICATION USE, ELDERLY-PATIENTS, PRIMARY-CARE PATIENTS, NURSING-HOME RESIDENTS, POPULATION-BASED COHORT, ADVERSE DRUG EVENTS, Inappropriate prescribing

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Chicago
Tommelein, Eline, Els Mehuys, Mirko Petrovic, Annemie Somers, Pieter Colin, and Koen Boussery. 2015. “Potentially Inappropriate Prescribing in Community-dwelling Older People Across Europe: a Systematic Literature Review.” European Journal of Clinical Pharmacology 71 (12): 1415–1427.
APA
Tommelein, E., Mehuys, E., Petrovic, M., Somers, A., Colin, P., & Boussery, K. (2015). Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY, 71(12), 1415–1427.
Vancouver
1.
Tommelein E, Mehuys E, Petrovic M, Somers A, Colin P, Boussery K. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY. 2015;71(12):1415–27.
MLA
Tommelein, Eline et al. “Potentially Inappropriate Prescribing in Community-dwelling Older People Across Europe: a Systematic Literature Review.” EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY 71.12 (2015): 1415–1427. Print.
@article{6941254,
  abstract     = {Background: Potentially inappropriate prescribing (PIP) is one of the main risk factors for adverse drug events (ADEs) in older people.
Purpose: 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 onSTART-criteria (2008 version), and 7 on thePRISCUS 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).
Conclusion: 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.},
  author       = {Tommelein, Eline and Mehuys, Els and Petrovic, Mirko and Somers, Annemie and Colin, Pieter and Boussery, Koen},
  issn         = {0031-6970},
  journal      = {EUROPEAN JOURNAL OF CLINICAL PHARMACOLOGY},
  keywords     = {Community-dwelling,Aged,Primary care,BEERS CRITERIA,EXPLICIT CRITERIA,STOPP/START CRITERIA,DISEASE INTERACTIONS,MEDICATION USE,ELDERLY-PATIENTS,PRIMARY-CARE PATIENTS,NURSING-HOME RESIDENTS,POPULATION-BASED COHORT,ADVERSE DRUG EVENTS,Inappropriate prescribing},
  language     = {eng},
  number       = {12},
  pages        = {1415--1427},
  title        = {Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review},
  url          = {http://dx.doi.org/10.1007/s00228-015-1954-4},
  volume       = {71},
  year         = {2015},
}

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