Prevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional study

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dc.contributor.author O'Riordan, David
dc.contributor.author Aubert, Carole E.
dc.contributor.author Walsh, Kieran A.
dc.contributor.author Van Dorland, Anette
dc.contributor.author Rodondi, Nicolas
dc.contributor.author Du Puy, Robert S.
dc.contributor.author Poortvliet, Rosalinde K. E.
dc.contributor.author Gussekloo, Jacobijn
dc.contributor.author Sinnott, Carol
dc.contributor.author Byrne, Stephen
dc.contributor.author Galvin, Rose
dc.contributor.author Jukema, J Wouter
dc.contributor.author Mooijaart, Simon P.
dc.contributor.author Baumgartner, Christine
dc.contributor.author McCarthy, Vera J. C.
dc.contributor.author Walsh, Elaine K.
dc.contributor.author Collet, Tinh-Hai
dc.contributor.author Dekkers, Olaf M.
dc.contributor.author Blum, Manuel R.
dc.contributor.author Kearney, Patricia M.
dc.date.accessioned 2018-05-02T10:16:29Z
dc.date.available 2018-05-02T10:16:29Z
dc.date.issued 2018
dc.identifier.citation O Riordan, D., Aubert, C. E., Walsh, K. A., Van Dorland, A., Rodondi, N., Du Puy, R. S., Poortvliet, R. K. E., Gussekloo, J., Sinnott, C., Byrne, S., Galvin, R., Jukema, J. W., Mooijaart, S. P., Baumgartner, C., McCarthy, V., Walsh, E. K., Collet, T.-H., Dekkers, O. M., Blum, M. R. and Kearney, P. M. (2018) 'Prevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional study', BMJ Open, 8(3), e019003 (10pp). doi: 10.1136/bmjopen-2017-019003 en
dc.identifier.volume 8
dc.identifier.issued 3
dc.identifier.startpage 1
dc.identifier.endpage 10
dc.identifier.issn 2044-6055
dc.identifier.uri http://hdl.handle.net/10468/5961
dc.identifier.doi 10.1136/bmjopen-2017-019003
dc.description.abstract Objectives: To estimate and compare the prevalence and type of potentially inappropriate prescribing (PIP) and potential prescribing omissions (PPOs) among community-dwelling older adults (≥65 years) enrolled to a clinical trial in three European countries. Design: A secondary analysis of the Thyroid Hormone Replacement for Subclinical Hypothyroidism Trial dataset. Participants: A subset of 48/80 PIP and 22/34 PPOs indicators from the Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) V2 criteria were applied to prescribed medication data for 532/737 trial participants in Ireland, Switzerland and the Netherlands. Results: The overall prevalence of PIP was lower in the Irish participants (8.7%) compared with the Swiss (16.7%) and Dutch (12.5%) participants (P=0.15) and was not statistically significant. The overall prevalence of PPOs was approximately one-quarter in the Swiss (25.3%) and Dutch (24%) participants and lower in the Irish (14%) participants (P=0.04) and the difference was statistically significant. The hypnotic Z-drugs were the most frequent PIP in Irish participants, (3.5%, n=4), while it was non-steroidal anti-inflammatory drug and oral anticoagulant combination, sulfonylureas with a long duration of action, and benzodiazepines (all 4.3%, n=7) in Swiss, and benzodiazepines (7.1%, n=18) in Dutch participants. The most frequent PPOs in Irish participants were vitamin D and calcium in osteoporosis (3.5%, n=4). In the Swiss and Dutch participants, they were bone antiresorptive/anabolic therapy in osteoporosis (9.9%, n=16, 8.6%, n=22) respectively. The odds of any PIP after adjusting for age, sex, multimorbidity and polypharmacy were (adjusted OR (aOR)) 3.04 (95% CI 1.33 to 6.95, P<0.01) for Swiss participants and aOR 1.74 (95% CI 0.79 to 3.85, P=0.17) for Dutch participants compared with Irish participants. The odds of any PPOs were aOR 2.48 (95% CI 1.27 to 4.85, P<0.01) for Swiss participants and aOR 2.10 (95% CI 1.11 to 3.96, P=0.02) for Dutch participants compared with Irish participants. Conclusions: This study has estimated and compared the prevalence and type of PIP and PPOs among this cohort of community-dwelling older people. It demonstrated a significant difference in the prevalence of PPOs between the three populations. Further research is urgently needed into the impact of system level factors as this has important implications for patient safety, healthcare provision and economic costs. en
dc.description.sponsorship Health Research Board (SPHeRE/2013/1); Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung (SNSF 320030-150025; SNSF P2BEP3_165409; PZ00P3-167826; SNSF P2BEP3_175289); Staatssekretariat für Bildung, Forschung und Innovation (15.0137); ZonMw (project number 62700.3002) en
dc.format.mimetype application/pdf en
dc.language.iso en en
dc.publisher BMJ Publishing Group: en
dc.relation.uri http://bmjopen.bmj.com/content/8/3/e019003
dc.rights © 2018, article authors. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ en
dc.rights.uri http://creativecommons.org/licenses/by-nc/4.0/
dc.subject Older people en
dc.subject Potential prescribing omissions en
dc.subject Hypnotic Z-drugs en
dc.subject Dutch en
dc.subject Irish en
dc.subject Hypothyroidism en
dc.subject Swiss en
dc.title Prevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional study en
dc.type Article (peer-reviewed) en
dc.internal.authorcontactother David O'Riordan, Pharmacy, University College Cork, Cork, Ireland. +353-21-490-3000 Email: davidoriordan@ucc.ie en
dc.internal.availability Full text available en
dc.description.version Published Version en
dc.contributor.funder Health Research Board
dc.contributor.funder Seventh Framework Programme
dc.contributor.funder Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
dc.contributor.funder Horizon 2020
dc.contributor.funder Staatssekretariat für Bildung, Forschung und Innovation
dc.contributor.funder Ministerie van Volksgezondheid, Welzijn en Sport
dc.contributor.funder ZonMw
dc.description.status Peer reviewed en
dc.identifier.journaltitle BMJ Open en
dc.internal.IRISemailaddress davidoriordan@ucc.ie en
dc.identifier.articleid e019003
dc.relation.project info:eu-repo/grantAgreement/EC/H2020::RIA/634238/EU/OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly/OPERAM
dc.relation.project info:eu-repo/grantAgreement/EC/FP7::SP1::HEALTH/278148/EU/Multi-modal effects of thyroid hormone replacement for untreated older adults with subclinical hypothyroidism; a randomised placebo-controlled trial/TRUST


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© 2018, article authors. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ Except where otherwise noted, this item's license is described as © 2018, article authors. All rights reserved. No commercial use is permitted unless otherwise expressly granted. This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
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