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

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dc.contributor.authorO'Riordan, David
dc.contributor.authorAubert, Carole E.
dc.contributor.authorWalsh, Kieran A.
dc.contributor.authorVan Dorland, Anette
dc.contributor.authorRodondi, Nicolas
dc.contributor.authorDu Puy, Robert S.
dc.contributor.authorPoortvliet, Rosalinde K. E.
dc.contributor.authorGussekloo, Jacobijn
dc.contributor.authorSinnott, Carol
dc.contributor.authorByrne, Stephen
dc.contributor.authorGalvin, Rose
dc.contributor.authorJukema, J Wouter
dc.contributor.authorMooijaart, Simon P.
dc.contributor.authorBaumgartner, Christine
dc.contributor.authorMcCarthy, Vera J. C.
dc.contributor.authorWalsh, Elaine K.
dc.contributor.authorCollet, Tinh-Hai
dc.contributor.authorDekkers, Olaf M.
dc.contributor.authorBlum, Manuel R.
dc.contributor.authorKearney, Patricia M.
dc.contributor.funderHealth Research Board
dc.contributor.funderSeventh Framework Programme
dc.contributor.funderSchweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
dc.contributor.funderHorizon 2020
dc.contributor.funderStaatssekretariat für Bildung, Forschung und Innovation
dc.contributor.funderMinisterie van Volksgezondheid, Welzijn en Sport
dc.contributor.funderZonMw
dc.date.accessioned2018-05-02T10:16:29Z
dc.date.available2018-05-02T10:16:29Z
dc.date.issued2018
dc.description.abstractObjectives: 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.sponsorshipHealth 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.description.statusPeer revieweden
dc.description.versionPublished Versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.articleide019003
dc.identifier.citationO 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-2017-019003en
dc.identifier.doi10.1136/bmjopen-2017-019003
dc.identifier.endpage10
dc.identifier.issn2044-6055
dc.identifier.issued3
dc.identifier.journaltitleBMJ Openen
dc.identifier.startpage1
dc.identifier.urihttps://hdl.handle.net/10468/5961
dc.identifier.volume8
dc.language.isoenen
dc.publisherBMJ Publishing Group:en
dc.relation.projectinfo:eu-repo/grantAgreement/EC/H2020::RIA/634238/EU/OPtimising thERapy to prevent Avoidable hospital admissions in the Multimorbid elderly/OPERAM
dc.relation.projectinfo: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
dc.relation.urihttp://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.urihttp://creativecommons.org/licenses/by-nc/4.0/
dc.subjectOlder peopleen
dc.subjectPotential prescribing omissionsen
dc.subjectHypnotic Z-drugsen
dc.subjectDutchen
dc.subjectIrishen
dc.subjectHypothyroidismen
dc.subjectSwissen
dc.titlePrevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional studyen
dc.typeArticle (peer-reviewed)en
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