Potentially inappropriate medication use in Indian elderly: Comparison of Beers' criteria and Screening Tool of Older Persons' potentially inappropriate Prescriptions

摘要

Aim: To compare Beers' criteria (BC) and Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) for prevalence, specificity, sensitivity and predictors for potentially inappropriate medication (PIM) use. Methods: Patients aged ≥60years from medicine wards of a tertiary care hospital were included. Comparisons between BC and STOPP were made using Pearson's χ 2-test for categorical variables and Mann-Whitney U-test for continuous variables. Specificity and sensitivity were assessed by using 2×2 contingency table. Bivariate analysis and subsequent multivariate logistic regression was used to identify the predictors of PIM use. Results: In the 540 patients included, prevalence of PIM use as per BC and STOPP was 24.6% and 13.3%, respectively. Sensitivity and specificity of BC in detecting PIM was 0.65 and 0.53, respectively. Considering the diagnoses/conditions, sensitivity and specificity of BC was 0.12 and 0.48, respectively, whereas independent of diagnoses/conditions, corresponding values were 0.75 and 0.54. PIM as per BC and STOPP accounted for 11 and 6 adverse drug reactions (ADR), respectively. Medications not listed in BC or STOPP were more likely to be associated with ADR. Multiple diseases (≥4) and use of more drugs during hospital stay (10-14) predicted PIM use as per BC, whereas age (60-74years) predicted PIM use as per STOPP. Conclusion: Overall, BC is useful in the detection of PIM use independent of diagnoses/conditions, whereas STOPP is useful in detection of PIM use considering the diagnoses/conditions. There is a need for consensus on using the tool for detection of PIM use in Indian elderly.