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A comparison of beers and STOPP criteria in assessing potentially inappropriate medications in nursing home residents attending the emergency department.

Abstract：

OBJECTIVES:The Beers (2012) criteria and the screening tool of older persons' potentially inappropriate prescriptions (STOPP) criteria are often used to identify potentially inappropriate medication (PIM) use in elderly patients. The aim of this study is to determine the prevalence of PIM use in nursing home residents (NHRs) aged ≥65 years presenting to the Emergency Department (ED); to compare the Beers and STOPP criteria and to identify the potential role of PIMs in ED attendances. SETTING:The ED of an urban tertiary referral hospital. PARTICIPANTS:Acutely unwell long-term care NHRs seeking medical assistance at the ED. DESIGN AND MEASUREMENTS:This is a retrospective cohort study. Demographic and clinical data were retrieved from the ED electronic record system, from the clinical records, and transfer letters for all NHRs who attended the ED in 2011. Beers 2012 and STOPP criteria were used to identify PIMs. RESULTS:Of 195 NHRs identified, 165 were included. The mean age (±standard deviation) was 82.5 (±7.7) years; 110 (66.7%) were female and 157 (95.2%) were prescribed at least 1 PIM by either criterion. One hundred forty patients (84.8%) received a PIM according to STOPP criteria and 147 (89.1%) according to the Beers criteria. In the majority of patients (148; 89.7%), there was a difference in the medications Beers and STOPP identified as inappropriate. Fifty patients (30.3%) were considered to have a link between their attendance at ED and the PIM prescribed when assessed subjectively. Objective assessment using the WHO-UMC criteria found 7 (4.2%) had a 'probable' link and 45 (27.3%) a 'possible' link. CONCLUSIONS:These results show a high rate of PIM prescribing in this cohort. The use of criteria such as Beers and STOPP may be a useful guide for physicians coordinating the long-term care of NHRs and may have the potential to reduce attendances at ED.

journal_name

J Am Med Dir Assoc

journal_title

Journal of the American Medical Directors Association

authors

Grace AR,Briggs R,Kieran RE,Corcoran RM,Romero-Ortuno R,Coughlan TL,O'Neill D,Collins R,Kennelly SP

doi

10.1016/j.jamda.2014.08.008

subject

Has Abstract

pub_date

2014-01-01 00:00:00

pages

830-4

issue

eissn

1525-8610

issn

1538-9375

pii

S1525-8610(14)00541-6

journal_volume

pub_type

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A comparison of beers and STOPP criteria in assessing potentially inappropriate medications in nursing home residents attending the emergency department.