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"Potentially Inappropriate Medications"

Review Article

Global Mapping of Potentially Inappropriate Prescribing for Older Adults in Community Settings: An Umbrella Review
Nafiseh Ghassab-Abdollahi, Haidar Nadrian, Fatemeh Saadati, Fariba ashazadeh, Elnaz Shaseb, Mina Hashemiparast, Hamid Allahverdipour
Korean J Fam Med 2023;44(4):189-204.   Published online July 18, 2023
DOI: https://doi.org/10.4082/kjfm.23.0032
Potentially inappropriate prescribing (PIP) is a major public health concern with several undesirable health consequences for older adults. In this overview, we aimed to map and gather information from existing literature to provide a better insight into the prevalence of PIP among community dwellers. Electronic databases were searched from their inception to April 2022. The quality of the included systematic reviews (SRs) was assessed using the assessment of multiple systematic reviews checklist. The degree of overlap within the SRs was also evaluated (2% overlap). All SRs on the prevalence of PIP in older individuals in community settings were included, and a narrative approach was used to synthesize data. Nineteen SRs comprising 548 primary studies met the inclusion criteria, and the average quality of the included SRs was moderate. More than half (50.5%) of the primary studies were conducted in Europe, followed by the United States (22.8%), and Asia (18.9%). Thirty different criteria were used in the primary studies to estimate the prevalence of PIP. The most widely used criteria were those presented in Beers (41.8%) and STOPP (Screening Tool of Older Persons’ Prescriptions)/START (Screening Tool to Alert to Right Treatment) (21.8%) criteria. Benzodiazepines, nonsteroidal anti-inflammatory drugs, and antidepressants were the most frequently reported PIPs. A considerable variation in the prevalence of PIP ranging from 0% to 98% was reported by SRs. However, there is a high degree of uncertainty regarding the extent of PIP in community settings. To identify knowledge-to-action gaps, SR authors should consider the differences in prevalence of PIP according to settings, applied tools, data sources, geographical areas, and specific pathologies. There is also a need for primary and SR studies from low- and middle-income countries regarding the prevalence of PIP.
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Original Article
Survey of Potentially Inappropriate Prescription Using STOPP/START Criteria in Inha University Hospital
Sang-Jin Lee, Se-Wook Cho, Yeon Ji Lee, Ji-Ho Choi, Hyuk Ga, You-Hoi Kim, So-Yun Woo, Woo-Suc Jung, Dong-Yop Han
Korean J Fam Med 2013;34(5):319-326.   Published online September 26, 2013
DOI: https://doi.org/10.4082/kjfm.2013.34.5.319
Background

Prescribing potentially harmful drugs and omitting essential drugs to older patients is a common problem because they take so many medications. In this study, our goal was to identify potentially inappropriate medications (PIMs) and potential prescribing omissions (PPOs) using Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to the Right Treatment (START) criteria to improve proper prescription and reduce improper prescription.

Methods

Enrolled in this study were 117 patients older than 65 years old who were hospitalized at Inha University Hospital in Incheon due to pneumonia from January 2012 to March 2012. Patient data, including medical histories, current diagnoses, current medications, and biochemical data were recorded from electronic records. STOPP and START were applied to their clinical datasheets.

Results

STOPP criteria identified 24 patients who had 29 PIMs. Most potential inappropriate prescribing was of cardiovascular medications, followed by drugs whose primary effect is on the urogenital system and gastrointestinal system. START criteria identified 31 patients who had 46 PPOs. The cardiovascular system drugs comprised most of the PPOs. No PPOs were identified under the central nervous system criteria.

Conclusion

Given the current Korean medical system conditions and considering the many clinically important situations when prescribing drugs, STOPP/START criteria are not absolute criteria to prevent improper prescription, but sagacious usage of these standards can help physicians to prescribe properly in clinical practice.

Citations

Citations to this article as recorded by  
  • The impact of a multifaceted intervention to reduce potentially inappropriate prescribing among discharged older adults: a before-and-after study
    Muhammad Eid Akkawi, Mohamad Haniki Nik Mohamed, Mohd Aznan Md Aris
    Journal of Pharmaceutical Policy and Practice.2020;[Epub]     CrossRef
  • Evaluation of potentially inappropriate medication utilization in elderly patients with cancer at outpatient oncology unit
    Ceylan Paksoy, Öznur Özkan, Bala BÖ Ustaalioğlu, Mesut Sancar, Refik Demirtunç, Fikret V Izzettin, Betul Okuyan
    Journal of Oncology Pharmacy Practice.2019; 25(6): 1321.     CrossRef
  • Usefulness of STOPP/START criteria to assess appropriateness of medicines prescribed to older adults in a resource-limited setting
    U. G. S. Siripala, S. P. K. Premadasa, N. R. Samaranayake, C. A. Wanigatunge
    International Journal of Clinical Pharmacy.2019; 41(2): 525.     CrossRef
  • Potentially inappropriate prescribing and associated factors in elderly patients at hospital discharge in Brazil: a cross-sectional study
    Ana Luiza Pereira Moreira Mori, Renata Cunha Carvalho, Patricia Melo Aguiar, Maria Goretti Farias de Lima, Magali da Silva Pacheco Nobre Rossi, José Fernando Salvador Carrillo, Egídio Lima Dórea, Sílvia Storpirtis
    International Journal of Clinical Pharmacy.2017; 39(2): 386.     CrossRef
  • Examining potentially inappropriate prescribing in residential care using the STOPP/START criteria
    N.J. Ailabouni, P.S. Nishtala, J.M. Tordoff
    European Geriatric Medicine.2016; 7(1): 40.     CrossRef
  • Prevalence of inappropriate medication prescription in the elderly in Nigeria: A comparison of Beers and STOPP criteria
    Joseph O. Fadare, Olufemi O. Desalu, Abimbola M. Obimakinde, Adekunle O. Adeoti, Segun M. Agboola, Felix O. Aina
    International Journal of Risk & Safety in Medicine.2015; 27(4): 177.     CrossRef
  • Difficulty in managing polypharmacy in the elderly: Case report and review of the literature
    Rhita Bennis Nechba, Moncif El M'barki Kadiri, Mounia Bennani-Ziatni, Amine Ali Zeggwagh, Abdelhalim Mesfioui
    Journal of Clinical Gerontology and Geriatrics.2015; 6(1): 30.     CrossRef
  • Consensus Validated List of Potentially Inappropriate Medication for the Elderly and Their Prevalence in South Korea
    Seong-Ok Kim, Sunmee Jang, Chul-Min Kim, Yu-Ri Kim, Hyun Soon Sohn
    International Journal of Gerontology.2015; 9(3): 136.     CrossRef
  • 4,006 View
  • 30 Download
  • 8 Crossref
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