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Potentially inappropriate prescribing among older people in the United Kingdom

机译:在英国老年人中可能不适当的处方

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Background Potentially inappropriate prescribing (PIP) in older people is associated with increases in morbidity, hospitalisation and mortality. The objective of this study was to estimate the prevalence of and factors associated with PIP, among those aged ≥70 years, in the United Kingdom, using a comprehensive set of prescribing indicators and comparing these to estimates obtained from a truncated set of the same indicators. Methods A retrospective cross-sectional study was carried out in the UK Clinical Practice Research Datalink (CPRD), in 2007. Participants included those aged?≥?70 years, in CPRD. Fifty-two PIP indicators from the Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) criteria were applied to data on prescribed drugs and clinical diagnoses. Overall prevalence of PIP and prevalence according to individual STOPP criteria were estimated. The relationship between PIP and polypharmacy (≥4 medications), comorbidity, age, and gender was examined. A truncated, subset of 28 STOPP criteria that were used in two previous studies, were further applied to the data to facilitate comparison. Results Using 52 indicators, the overall prevalence of PIP in the study population (n?=?1,019,491) was 29%. The most common examples of PIP were therapeutic duplication (11.9%), followed by use of aspirin with no indication (11.3%) and inappropriate use of proton pump inhibitors (PPIs) (3.7%). PIP was strongly associated with polypharmacy (Odds Ratio 18.2, 95% Confidence Intervals, 18.0-18.4, P??8 weeks, NSAIDs for?>?3 months, and use of long-term neuroleptics. Conclusions PIP was prevalent in the UK and increased with polypharmacy. Application of the comprehensive set of STOPP criteria allowed more accurate estimation of PIP compared to the subset of criteria used in previous studies. These findings may provide a focus for targeted interventions to reduce PIP.
机译:背景技术老年人中潜在的不适当处方(PIP)与发病率,住院和死亡率的增加有关。这项研究的目的是使用一套全面的处方指标,将英国≥70岁的人群中PIP的患病率和相关因素估算出来,并将其与从一组相同的截短指标中得出的估算值进行比较。方法2007年,在英国临床实践研究数据链(CPRD)中进行了回顾性横断面研究。参与者包括年龄≥70岁的CPRD。来自“老年人潜在不适当处方”(STOPP)筛选标准的52个PIP指标被用于处方药和临床诊断的数据。估计了总体PIP患病率和根据个体STOPP标准的患病率。检查了PIP和多药房(≥4种药物),合并症,年龄和性别之间的关系。在先前的两项研究中使用的28个STOPP标准的截断子集被进一步应用于数据,以方便比较。结果使用52个指标,研究人群中PIP的总体患病率(n = 1,019,491)为29%。 PIP最常见的例子是治疗性重复(11.9%),然后使用无指示的阿司匹林(11.3%)和不适当使用质子泵抑制剂(PPI)(3.7%)。 PIP与多药店密切相关(赔率比18.2、95%的置信区间,18.0-18.4,P ?? 8周,NSAIDs≥3个月以及使用长期抗精神病药。)结论PIP在英国和美国普遍存在。与先前研究中使用的标准子集相比,综合使用STOPP标准集可以更准确地估计PIP,这些发现可能为减少PIP的针对性干预措施提供了重点。

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