Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients

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dc.contributor.author Hamilton, Hilary J.
dc.contributor.author Gallagher, Paul F.
dc.contributor.author Ryan, Cristin
dc.contributor.author Byrne, Stephen
dc.contributor.author O'Mahony, Denis
dc.date.accessioned 2017-04-10T09:25:02Z
dc.date.available 2017-04-10T09:25:02Z
dc.date.issued 2011-06
dc.identifier.citation Hamilton, H., Gallagher, P., Ryan, C., Byrne, S. and O’Mahony, D. (2011) 'Potentially inappropriate medications defined by stopp criteria and the risk of adverse drug events in older hospitalized patients', Archives of Internal Medicine, 171(11), pp. 1013-1019. doi:10.1001/archinternmed.2011.215 en
dc.identifier.volume 171 en
dc.identifier.issued 11 en
dc.identifier.startpage 1013 en
dc.identifier.endpage 1019 en
dc.identifier.issn 0003-9926
dc.identifier.uri http://hdl.handle.net/10468/3863
dc.identifier.doi 10.1001/archinternmed.2011.215
dc.description.abstract Background: Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness. Methods: We prospectively studied 600 consecutive patients 65 years or older who were admitted with acute illness to a university teaching hospital over a 4-month interval. Potentially inappropriate medicines were defined by both Beers and STOPP criteria. Adverse drug events were defined by World Health Organization- Uppsala Monitoring Centre criteria and verified by a local expert consensus panel, which also assessed whether ADEs were causal or contributory to current hospitalization. Hallas criteria defined ADE avoidability. We compared the proportions of patients taking Beers criteria PIMs and STOPP criteria PIMs with avoidable ADEs that were causal or contributory to admission. Results: A total of 329 ADEs were detected in 158 of 600 patients (26.3%); 219 of 329 ADEs (66.6%) were considered causal or contributory to admission. Of the 219 ADEs, 151(68.9%) considered causal or contributory to admission were avoidable or potentially avoidable. After adjusting for age, sex, comorbidity, dementia, baseline activities of daily living function, and number of medications, the likelihood of a serious avoidable ADE increased significantly when STOPP PIMs were prescribed (odds ratio, 1.847; 95% confidence interval [CI], 1.506-2.264;P<.001);prescription of Beers criteria PIMs did not significantly increase ADE risk (odds ratio, 1.276; 95% CI, 0.945-1.722; P=.11). Conclusion: STOPP criteria PIMs, unlike Beers criteria PIMs, are significantly associated with avoidable ADEs in older people that cause or contribute to urgent hospitalization. en
dc.description.sponsorship Health Research Board (research fellowship); Enterprise Ireland (research funding) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher American Medical Association (AMA) en
dc.rights © 2011 American Medical Association. All rights reserved en
dc.subject Adverse drug reaction reporting systems en
dc.subject Chi-square distribution en
dc.subject Comorbidity en
dc.subject Drug toxicity en
dc.subject Inappropriate prescribing en
dc.subject Inpatients en
dc.subject Ireland en
dc.subject Medication errors en
dc.subject Pharmaceutical preparations en
dc.subject Polypharmacy en
dc.subject Regression analysis en
dc.subject Risk en
dc.subject Beers criteria en
dc.title Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother Denis O'Mahony, Medicine Department, University College Cork, Cork, Ireland. +353-21-490-3000 Email: denis.omahony@ucc.ie en
dc.internal.availability Full text available en
dc.date.updated 2017-04-10T09:18:54Z
dc.description.version Published Version en
dc.internal.rssid 90194231
dc.internal.wokid 000291544400011
dc.contributor.funder Health Research Board en
dc.contributor.funder Enterprise Ireland en
dc.description.status Peer reviewed en
dc.identifier.journaltitle Archives of Internal Medicine en
dc.internal.copyrightchecked No !!CORA!! en
dc.internal.licenseacceptance Yes en
dc.internal.IRISemailaddress denis.omahony@ucc.ie en

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