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Age and Ageing Advance Access originally published online on October 11, 2007
Age and Ageing 2008 37(1):96-101; doi:10.1093/ageing/afm116
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Copyright © The Author 2007. Published by Oxford University Press on behalf of the British Geriatrics Society.

Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria

Paul F. Gallagher1,, Pat J. Barry1, Cristin Ryan2, Irene Hartigan3 and Denis O'Mahony4

1 Specialist Registrar, Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland
2 School of Pharmacy, University College, Cork, Ireland
3 School of Nursing, Brookfield Health Sciences Complex, University College, Cork, Ireland
4 Consultant Physician in Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland

Address correspondence to: Paul F. Gallagher. Tel: 00353 21 4922396; Fax: 00353 21 4922829. Email: pfgallagher77{at}eircom.net

Introduction: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation.

Methods: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers' Criteria applied.

Results: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0–13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking ≤5 medications (OR 3.34: 95%, CI 2.37–4.79; P<0.001). Forty-nine per cent of patients with inappropriate prescriptions were admitted with adverse effects of the inappropriate medications. Sixteen per cent of all admissions were associated with such adverse effects.

Conclusion: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.

Keywords: Beers Criteria, inappropriate prescribing, elderly

Received 1 May 2007; accepted in revised form 8 August 2007.


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