Prevalence and predictors of inappropriate prescribing according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version?2 criteria in older patients discharged from geriatric and internal medicine wards: A prospective observational multicenter study

摘要

Aim To evaluate the prevalence and predictors of potentially inappropriate medications (PIM) and potential prescribing omissions (PPO) in hospital‐discharged older patients, according to the recently updated Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version?2 criteria. Methods This was a multicenter prospective observational study of patients aged ≥65?years consecutively discharged from geriatric and internal medicine wards. Each patient underwent a comprehensive geriatric assessment, and PIM and PPO at discharge were determined according to the Screening Tool of Older People's Prescriptions and Screening Tool to Alert to Right Treatment version?2 criteria. A multivariate logistic regression was carried out to identify variables independently associated with PIM and PPO. Results Among 726 participants (mean age 81.5?years, 47.8% women), the prevalence of PIM and PPO were 54.4% and 44.5%, respectively. Benzodiazepines and proton‐pump inhibitors were the drugs most frequently involved with PIM, whereas PPO were often related to 5‐alpha reductase inhibitors, angiotensin‐converting enzyme inhibitors, statins and drugs for osteoporosis. The number of medications (OR 1.22, 95% CI 1.15–1.28) and discharge from geriatric units (OR 0.55, 95% CI 0.40–0.75) were associated with PIM, whereas PPO were independently associated with discharge from geriatric wards (OR 0.44, 95% CI 0.31–0.62), age (OR 1.04, 95% CI 1.02–1.07), comorbidities (OR 1.17, 95% CI 1.04–1.30) and the number of drugs (OR 1.12, 95% CI 1.05–1.18). Conclusions Inappropriate prescribing is highly prevalent among hospital‐discharged older patients, and is associated with polypharmacy and discharge from internal medicine departments. Geriatr Gerontol Int 2019; 19: 5–11 .