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Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities

Hasso, Yasmine
Drame, Moustapha
Prudent, Max
Published in Age and ageing. 2010, vol. 39, no. 3, p. 373-381
Collection Open Access - Licence nationale Oxford University Press
Abstract OBJECTIVE: the study aimed to determine the prevalence of and risk factors for inappropriate prescribing (IP) and prescribing omission (PO) in elderly with mental co-morbidities. PARTICIPANTS: One hundred fifty consecutive inpatients with mental co-morbidities hospitalised for acute medical illness (mean age 80 +/- 9, 70% of women) were considered for the study. MEASUREMENTS: IP and PO were prospectively identified according to STOPP/START criteria at hospital admission. RESULTS: over 95% were taking ≥ 1 medication (median = 7) which amounted to 1,137 prescriptions. The prevalence of IP was 77% and PO was 65%. The most frequent encountered IP concerned drugs adversely affecting fallers (25%) and antiaggregants therapy without atherosclerosis (14%). PO concerned antidepressants with moderate/severe depression (20%) and calcium-vitamin D supplementation (18%). Independent predictors for IP were increased number of concomitant drugs (odds ratio [OR] 1.54, 95% confidence interval [CI] 1.13-1.89), being cognitively impaired (OR 1.83, 95% CI 1.55-2.24), and having fallen in the preceding 3 months (OR 2.03, 95% CI 1.52-2.61) or hospitalised in the preceding year (OR 1.09, 95% CI 1.02-1.23). Concerning PO, psychiatric disorder (OR 1.64, 95% CI 1.42-2.01) and increase level of co-morbidities (OR 1.79, 95% CI 1.48-1.99) were identified. Living in an institutional setting was a predictive maker for both IP (OR 1.45, 95% CI 1.27-1.74) and PO (OR 1.67, 95% CI 1.32-1.91). CONCLUSION: IP and PO were highly prevalent raising the need of a greater health literacy concerning geriatric conditions in non-geriatrician practitioners who care elderly as well as in the community, in hospital and institutional settings for improving quality and safety in prescribing medication.
Keywords AgedAged, 80 and overComorbidityDrug Prescriptions/standards/*statistics & numerical dataFemaleHumansInpatientsMaleMedication Errors/*statistics & numerical dataMental Disorders/*drug therapyPhysician's Practice Patterns/standards/*statistics & numerical dataPrevalenceProspective StudiesPsychotropic Drugs/*therapeutic useRisk Factors
PMID: 20378571
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Research groups Démence du sujet âgé, troubles cognitifs, la symptomatologie cognitive (577)
Groupe Desmeules Jules (pharmacologie/toxicologie) (567)
(ISO format)
LANG, Pierre Olivier et al. Potentially inappropriate prescribing including under-use amongst older patients with cognitive or psychiatric co-morbidities. In: Age and ageing, 2010, vol. 39, n° 3, p. 373-381. doi: 10.1093/ageing/afq031 https://archive-ouverte.unige.ch/unige:21070

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Deposited on : 2012-05-23

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