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.
Keywords
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Article info
Publication history
Published online: October 07, 2014
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
