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