Application of STOPP Criteria and Beers Criteria in an inpatient psychiatric facility and impact on utilization of potentially inappropriate medications and adverse outcomes

2014 ◽  
Vol 4 (4) ◽  
pp. 201-206 ◽  
Author(s):  
Morgan C. Snyder ◽  
Lisa M. Mican ◽  
Tawny Smith ◽  
Jamie Barner
Keyword(s):  
Geriatric Patients ◽  
Adverse Drug Events ◽  
Adverse Outcomes ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Psychiatric Facility ◽  
Stopp Criteria ◽  
Secondary Outcomes ◽  
Inappropriate Medications ◽  
Inpatient Psychiatric Facility

Background: The Beers Criteria and STOPP Criteria were developed to identify potentially inappropriate medications (PIMs) in the geriatric population. Utilization of STOPP Criteria PIMs have shown a significant association with presence of avoidable adverse drug events (ADEs) as compared to utilization of Beers Criteria PIMs. Objectives: The purpose of this study was to utilize STOPP and Beers Criteria to identify PIMs in geriatric patients at an inpatient psychiatric facility, with the goal of implementing a formal process for assessing medication regimens. This process would be expected to decrease adverse outcomes. Methods: Both criteria were used by the pharmacist to identify PIMs and recommendations were made to address the PIMs. A retrospective chart review evaluated whether utilization of the two criteria led to a significant change in number of PIMs and associated adverse outcomes. The primary outcome was the change in number of PIMs for the Beers Criteria versus the STOPP Criteria. Secondary outcomes included the change in number of PIMs, falls, required referrals/transfers, and medication-specific ADEs for each set of criteria assessed separately. Results: Twenty-nine patients met inclusion criteria, and 76 treatment recommendations were made. More PIMs per patient were identified at baseline utilizing STOPP (mean±SD,3.9±2.3) versus Beers Criteria (mean±SD, 2.2±1.3) (p<0.001). The number of PIMs decreased using STOPP (from 112 to 66; mean decrease per patient −1.6±1.5, p<0.0001) and Beers Criteria (from 63 to 23; mean decrease per patient −1.4±1.1, p<0.0001), although the change was not significant for STOPP vs. Beers (p=0.375). All secondary outcomes decreased using both criteria. Conclusions: Utilization of each set of criteria by the pharmacist led to a significant decrease in PIMs and adverse outcomes decreased at follow-up using both criteria. Implementation of a process for assessing medication regimens of geriatric patients utilizing the Beers and/or STOPP Criteria would likely be beneficial to this institution.

scholarly journals Potentially inappropriate medications use and its associated factors among geriatric patients: a cross-sectional study based on 2019 Beers Criteria

Pharmacia ◽  
2021 ◽  
Vol 68 (4) ◽  
pp. 789-795
Author(s):  
Heba Khader ◽  
Luai Z. Hasoun ◽  
Ahmad Alsayed ◽  
Mahmoud Abu-Samak
Keyword(s):  
Geriatric Patients ◽  
Adverse Drug Events ◽  
Cross Sectional Study ◽  
Community Dwelling ◽  
Sample Population ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Sectional Study ◽  
Cross Sectional ◽  
Inappropriate Medications

The aims of this study were to estimate the prevalence of potentially inappropriate medications (PIMs) in a community-dwelling Jordanian population of geriatrics according to the 2019 American Geriatrics Society Beers Criteria, to identify the most used PIMs and factors independently associated with PIMs use. This was an observational, descriptive, cross-sectional study. The sample population included 386 participants. Data were collected by face-to-face interviews. A total of 2894 medications were evaluated. The prevalence of patients using at least one PIM was 49.2%. The most used PIMs were proton pump inhibitors (24.6%) and long-acting sulfonylurea (20.5%). Participants who had diabetes mellitus, peptic ulcer, or irritable bowel syndrome had significantly higher numbers of PIMs. The use of PIMs was high in Jordanian geriatric patients. The results of this study might help healthcare providers to detect high-risk patients and reconsider the necessity of using PIMs to decrease the risk of adverse drug events.

Associations Between Potentially Inappropriate Medications and Adverse Health Outcomes in the Elderly: A Systematic Review and Meta-analysis

2019 ◽  
Vol 53 (10) ◽  
pp. 1005-1019 ◽  
Author(s):  
Xiao Xuan Xing ◽  
Chen Zhu ◽  
Hua Yu Liang ◽  
Ke Wang ◽  
Yan Qi Chu ◽  
...  
Keyword(s):  
Health Outcomes ◽  
Adverse Drug Events ◽  
The Elderly ◽  
Adverse Outcomes ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inclusion Criteria ◽  
Adverse Health ◽  
Adverse Health Outcomes ◽  
Inappropriate Medications

Background: Adverse drug outcomes in the elderly have led to the development of lists of potentially inappropriate medications (PIMs), such as the Beers criteria, and these PIMs have been studied widely; however, it is still unclear whether PIM use is predictive of adverse outcomes in older people. Objective: To qualitatively examine the associations between exposure to PIMs from the general Beers criteria and the Screening Tool of Older Persons’ Prescriptions list and adverse outcomes, such as adverse drug reactions (ADRs)/adverse drug events (ADEs), hospitalization, and mortality. Methods: Specified databases were searched from inception to February 1, 2018. Two reviewers independently selected studies that met the inclusion criteria, assessed study quality, and extracted data. Data were pooled using Stata 12.0. The outcomes were ADRs/ADEs, hospitalization, and mortality. Results: A total of 33 studies met the inclusion criteria. The combined analysis revealed a statistically significant association between ADRs/hospitalizations and PIMs (odds ratio [OR] = 1.44, 95% CI = 1.33-1.56; OR = 1.27, 95% CI = 1.20-1.35), but no statistically significant association was found between mortality and PIMs (OR = 1.04; 95% CI = 0.75-1.45). It is interesting to note that the results changed when different continents/criteria were used for the analysis. Compared with the elderly individuals exposed to 1 PIM, the risk of adverse health outcomes was much higher for those who took ≥2 PIMs. Conclusion and Relevance: We recommend that clinicians avoid prescribing PIMs for older adults whenever feasible. In addition, the observed associations should be generalized to other countries with different PIM criteria with caution.

scholarly journals Adherence to Beers Criteria in Geriatrics: A Retrospective Study in a Saudi Teaching Hospital

Geriatrics ◽  
2020 ◽  
Vol 5 (4) ◽  
pp. 97
Author(s):  
Samah Alshehri ◽  
Mohannad Alshibani ◽  
Ghaydaa Magboul ◽  
Albandari Albandar ◽  
Roaa Nasser ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Older Patients ◽  
Adverse Drug Events ◽  
Healthcare Providers ◽  
Tertiary Hospital ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inflammatory Drugs ◽  
The Mean ◽  
Inappropriate Medications

Background: The aging process makes geriatric populations more prone to various chronic diseases. Such diseases require older patients to be on more medications than any other age group and make them more susceptible to adverse drug events related to potentially inappropriate medications (PIMs). Aim: To identify the prevalence of potentially inappropriate medications among older people and explore the most commonly prescribed PIMs in hospitalized patients. Design and Setting: A retrospective study conducted in a large tertiary hospital among patients hospitalized in a 4 year period from January 2015 to December 2018. Methods: The 2019 Beers Criteria were used to assess PIMs in all inpatient prescribed medications focusing on the first class (i.e., drug/drug class to be avoided in older adults). Results: The mean age was 75.17 ± 7.66 years. A total of 684 (80.6%) patients were prescribed at least one medication listed in the first-class category of the 2019 Beers Criteria. Top five drugs were proton pump inhibitors (40.3%), nonsteroidal anti-inflammatory drugs (10.2%), metoclopramide (9.3%), benzodiazepines (8.4%), and insulin (5.4%). Conclusions: The prevalence of PIMs is high among older patients admitted to the hospital. More efforts are needed to investigate the potential reasons and develop action plans to improve concordance to Beers Criteria among healthcare providers.

Potentially inappropriate medications in older adults: A review of the 2012 Beers Criteria and the implications in persons with dementia

2014 ◽  
Vol 4 (4) ◽  
pp. 166-169 ◽  
Author(s):  
Nicole J. Brandt ◽  
Traci Turner
Keyword(s):  
Older Adults ◽  
Adverse Drug Events ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Clinical Tool ◽  
Drug Classes ◽  
Information Set ◽  
Sliding Scale ◽  
Institutionalized Patients ◽  
Inappropriate Medications

In 2012, the American Geriatrics Society (AGS), along with a panel of 11 experts, updated the Beers Criteria which has evolved significantly since its inception in 1991. The Beers Criteria, in general, classifies medications/medication classes as: (1) potentially inappropriate for use in all older adults, (2) potentially inappropriate for older adults with certain diseases or symptoms and (3) requiring extra caution when used in older adults. Although each patient must be evaluated individually, the Beers Criteria is a useful clinical tool that can be used when initiating pharmacologic agents in both ambulatory and institutionalized patients. The concept behind use of the Beers Criteria is that it allows prescribers to readily identify, and avoid, medications associated with negative outcomes in older adults therefore decreasing the risk of adverse drug events (ADEs). Within this review article, there will be a highlight of potentially inappropriate medications (PIMs) commonly seen in clinical practice settings such as antipsychotics, benzodiazepines, non-benzodiazepine sedative-hypnotics, anticholinergics and sliding scale insulin. The focus will be to outline the risk-benefits of these drug classes within the context of persons with dementia. Furthermore, the use of PIMs has both clinical and financial implications in Medicare Star ratings and Healthcare Effectiveness Data and Information Set (HEDIS) measures.

Identification and evaluation of potentially inappropriate medications (PIMs) in hospitalized geriatric patients using Beers criteria

2015 ◽  
Vol 26 (4) ◽  
Author(s):  
Pattani Danisha ◽  
Chandrasekhar Dilip ◽  
Panakkal Linu Mohan ◽  
Cholamugath Shinu ◽  
Jaffer Chalil Parambil ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Geriatric Patients ◽  
Adverse Drug Events ◽  
Inappropriate Medication ◽  
Drug Event ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Close Monitoring ◽  
Entire Study ◽  
Hospitalized Elderly

AbstractThe aim of the study was to identify and evaluate potentially inappropriate medication (PIM) in geriatric patients using Beers criteria and also to identify adverse drug events (ADEs) due to PIMs and various drug-drug interactions.The medications in the prescriptions of patients above 60 years of age, their dosage regimen respective of their diagnosis were analyzed. Each medication was then checked with Beers list tables, and any medication if mentioned in the Beers list, was noted along with its strength of recommendation and quality of evidence. Any adverse drug event (ADE) due to PIM was identified. Causality of the events was assessed by Naranjo’s Scale. The number of drug-drug interactions per prescription and the severity of each interaction were also analyzed. The collected data from 200 subjects were subjected to statistical treatments using Statistical Package for Social Sciences (SPSS) software version 16.0 for WINDOWS.Based on the Beers criteria 2012, 106 out of 200 (53%) prescriptions had at least one PIM prescribed. A sum of 1690 medications was prescribed as a whole for the entire study subjects. Among which, 134 PIMs were identified. Most commonly prescribed PIMs were benzodiazepines (39, 19.5%), followed by sliding scale use of insulin (31, 15.5%), and prazosin at a rate of 11.5% (23). A total of 10 ADEs were identified during the study. The average number of drug interactions observed among total samples was found to be 3.0±6.0 with 0±5.0 serious interactions, 2±4.0 significant interactions requiring close monitoring, and 0±6.0 minor interactions.The study shows high prevalence of prescribing PIMs in hospitalized elderly patients; PIM also caused incidence of ADEs; and serious drug-drug interactions were scarce among the patients.

scholarly journals Potentially inappropriate prescribing in elderly: a comparison of Beers and STOPP criteria in tertiary care

2018 ◽  
Vol 8 (1) ◽  
pp. 95
Author(s):  
Akanksha Mathur ◽  
Prashant C. Shah
Keyword(s):  
Tertiary Care ◽  
Inappropriate Prescribing ◽  
Relevant Information ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Age Related ◽  
Stopp Criteria ◽  
Sliding Scale ◽  
Long Acting ◽  
Inappropriate Medications

Background: Prescribing in elderly is a challenging task as they have age related physiological changes, various co-morbidities, altered pharmacological properties and higher propensity for adverse events. They are often prescribed medications which are potentially inappropriate for them, sometimes may even be unnecessary. The medicines are considered as inappropriate if the risk associated with them outweighs benefits. The objective of this study is to assess the prevalence of potentially inappropriate medications (PIM) at a tertiary care teaching hospital according to the Beers updated 2015 criteria and STOPP criteria and to compare the two criteria in detection of PIMs.Methods: A prospective observational study involving 228 elderly patients (>65years) of medicine wards was conducted from October 2015 to March 2016. Relevant information was recorded in a predesigned proforma. The use of potentially inappropriate medications is assessed using Beers updated 2015 criteria and STOPP criteria using descriptive statistics.Results: The prevalence of PIM use in the sample was 26.31% according to the 2015 Beers criteria and 14.03% using the STOPP criteria. The most prevalent PIM according to the Beers criteria were sliding scale insulin (17.54%) and long acting benzodiazepines (5.26%); according to the STOPP criteria, they were aspirin in heart failure (5.26%) and chlorpheniramine (3.07%).Conclusions: The prevalence of PIM varied when different criteria were applied. The 2015 Beers criteria identified more PIM than the STOPP criteria.

scholarly journals The updated PIM-Taiwan criteria: a list of potentially inappropriate medications in older people

2019 ◽  
Vol 10 ◽  
pp. 204062231987960 ◽  
Author(s):  
Chirn-Bin Chang ◽  
Hsiu-Yun Lai ◽  
Shinn-Jang Hwang ◽  
Shu-Yu Yang ◽  
Ru-Shu Wu ◽  
...  
Keyword(s):  
Chronic Diseases ◽  
Delphi Method ◽  
Older Persons ◽  
Screening Tool ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Modified Delphi ◽  
Stopp Criteria ◽  
Explicit Criteria ◽  
Inappropriate Medications

Background: Explicit criteria for potentially inappropriate medications (PIMs) developed for other countries are difficult to apply to a specific territory. This study aimed to update the PIM-Taiwan criteria from a qualitative review of several published PIM criteria, followed by consensus among regional experts in Taiwan. Methods: After a review of the literature, we selected four sets of published PIM criteria to construct preliminary core PIMs. The Beers criteria, Fit fOR The Aged (FORTA), and Japan criteria were used for PIMs, without consideration of chronic diseases. The Beers criteria, Screening Tool of Older Persons’ Prescriptions (STOPP) criteria, and Japan criteria were used for PIMs with respect to chronic diseases. We asked experts ( n = 24) to rate their agreement with each statement, including in the final PIM criteria, after two rounds of modified Delphi methods. The intraclass coefficient (ICC) was used to examine the reliability of the modified Delphi method. Results: Overall, two categories of PIMs were established: 131 individual drugs and 9 drugs with combinations that should generally be avoided; and 9 chronic diseases with their corresponding PIMs that have drug–disease interactions. The ICC estimates for PIMs to be avoided generally were 0.634 and 0.557 (round 1 and 2) and those for PIMs with respect to chronic diseases were 0.866 and 0.775 (round 1 and 2) of the Delphi method, respectively. Conclusions: The 2018 version of PIM-Taiwan criteria was established and several modifications were made to keep the criteria updated and relevant. Clinicians can use them to reduce polypharmacy and PIMs among older patients.

scholarly journals The Effect of Beers Criteria-Based Training in General Practitioners on Prescribing Potentially Inappropriate Medications in Elderly Patients

2020 ◽  
Author(s):  
Hananeh Baradaran ◽  
Mohammad Nasirpur ◽  
Hadi Hamishehkar
Keyword(s):  
Elderly Patients ◽  
General Practitioners ◽  
Geriatric Patients ◽  
Drug Prescription ◽  
Inappropriate Medication ◽  
Inappropriate Drug ◽  
National Committee ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Inappropriate Medications

Background: Pharmacotherapy in elderly patients has become a major concern due to their physiological changes, pharmacokinetic and pharmacodynamics variations and poly-pharmacy. In considering the global trend in population aging, we aim to evaluate the effect of “Beers Criteria” education on prescribing medications for elderly patients by General Practitioners (GPs). Methods: Thirty GPs with the highest number of prescriptions were included in this pilot study. All prescriptions written over a three-month period were considered, then prescriptions for geriatric patients were selected and evaluated. The GPs were trained using pamphlets and booklets which were prepared based on Beers 2015 explicit criteria. In order to evaluate the effect of education, appropriateness of prescriptions was analyzed before and 1 month following training. Results: Of 15,447 prescriptions selected during the first step, 1,281 prescriptions were related to geriatric patients in which the prevalence of inappropriate drug prescriptions was 37.3%. The most inappropriate medications identified were Bisacodyl, Alprazolam, and Hyoscyamine. While in the second step 1,055 of 15,154 prescriptions concerned the elderly and inappropriate drug prescription rate was noted as 23.6%. The most common inappropriate medications included Alprazolam, Amitriptyline, and Hyoscyamine. Based on our results, the prevalence of prescribing potentially inappropriate medications (PIMs) for elderly patients is high among GPs and educational interventions that raise awareness about “Beers Criteria” significantly reduce the prescribing PIMs. Conclusion: Given the importance of GP training programs in reducing inappropriate prescription rates among geriatric patients, it will be necessary for the National Committee of Rational Use of Drugs (NCRUD) to consider undertaking comprehensive educational strategies for reducing the prevalence of inappropriate medication use in elderly people.

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