Potentially inappropriate prescribing and its associations with health‐related and system‐related outcomes in hospitalised older adults: A systematic review and meta‐analysis
Top Cited Papers
Open Access
- 18 May 2021
- journal article
- review article
- Published by Wiley in British Journal of Clinical Pharmacology
- Vol. 87 (11), 4150-4172
- https://doi.org/10.1111/bcp.14870
Abstract
Aims To synthesise associations of potentially inappropriate prescribing (PIP) with health-related and system-related outcomes in inpatient hospital settings. Methods Six electronic databases were searched: Medline Complete, EMBASE, CINAHL, PyscInfo, IPA and Cochrane library. Studies published between 1 January 1991 and 31 January 2021 investigating associations between PIP and health-related and system-related outcomes of older adults in hospital settings, were included. A random effects model was employed using the generic inverse variance method to pool risk estimates. Results Overall, 63 studies were included. Pooled risk estimates did not show a significant association with all-cause mortality (adjusted odds ratio [AOR] 1.10, 95% confidence interval [CI] 0.90–1.36; adjusted hazard ratio 1.02, 83% CI 0.90–1.16), and hospital readmission (AOR 1.11, 95% CI 0.76–1.63; adjusted hazard ratio 1.02, 95% CI 0.89–1.18). PIP was associated with 91%, 60% and 26% increased odds of adverse drug event-related hospital admissions (AOR 1.91, 95% CI 1.21–3.01), functional decline (AOR 1.60, 95% CI 1.28–2.01), and adverse drug reactions and adverse drug events (AOR 1.26, 95% CI 1.11–1.43), respectively. PIP was associated with falls (2/2 studies). The impact of PIP on emergency department visits, length of stay, and health-related quality of life was inconclusive. Economic cost of PIP reported in 3 studies, comprised various cost estimation methods. Conclusions PIP was significantly associated with a range of health-related and system-related outcomes. It is important to optimise older adults' prescriptions to facilitate improved outcomes of care.Keywords
Funding Information
- Deakin University
This publication has 107 references indexed in Scilit:
- Effects of Pharmacists' Interventions on Appropriateness of Prescribing and Evaluation of the Instruments' (MAI, STOPP and STARTs') Ability to Predict Hospitalization–Analyses from a Randomized Controlled TrialPLOS ONE, 2013
- Multimorbidity in Older AdultsEpidemiologic Reviews, 2013
- Medication quality and quality of life in the elderly, a cohort studyHealth and Quality of Life Outcomes, 2011
- Potentially inappropriate prescribing and cost outcomes for older people: a national population studyBritish Journal of Clinical Pharmacology, 2010
- STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions): application to acutely ill elderly patients and comparison with Beers' criteriaAge and Ageing, 2008
- Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' CriteriaAge and Ageing, 2007
- Is inappropriate medication use a major cause of adverse drug reactions in the elderly?British Journal of Clinical Pharmacology, 2006
- Impact of inappropriate drug use among hospitalized older adultsEuropean Journal of Clinical Pharmacology, 2005
- Adverse Drug Reactions in an Elderly Hospitalised PopulationDrugs & Aging, 2005