Home > Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission: longitudinal study.

Pérez, Teresa and Moriarty, Frank and Wallace, Emma and McDowell, Ronald and Redmond, Patrick and Fahey, Tom (2018) Prevalence of potentially inappropriate prescribing in older people in primary care and its association with hospital admission: longitudinal study. BMJ, 363, (k4524), doi: https://doi.org/10.1136/bmj.k4524.

Objective: To determine whether hospital admission is associated with potentially inappropriate prescribing among older primary care patients (aged ≥65 years) and whether such prescribing was more likely after hospital admission than before.

Design: Longitudinal study of retrospectively extracted data from 44 general practices in Ireland in 2012-15. Participants were adults aged 65 years or over attending participating practices.
Exposure: Admission to hospital (any hospital admission versus none, and post-admission versus pre-admission).

Main outcome measures: Prevalence of potentially inappropriate prescribing assessed using 45 criteria from the Screening Tool for Older Persons’ Prescription (STOPP) version 2, analysed both as rate of distinct potentially inappropriate prescribing criteria met (stratified Cox regression) and binary presence of potentially inappropriate prescribing (logistic regression) and adjusted for patients’ characteristics. A sensitivity analysis used matching with propensity scores based on patients’ characteristics and diagnoses.

Conclusion: Hospital admission was independently associated with potentially inappropriate prescribing. It is important to determine how hospital admission may affect appropriateness of prescribing for older people and how potential adverse consequences of admission can be minimised.


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