Hou Kaixuan, Xing Xiaoxuan, Yan Suying
ObjectiveTo evaluate and compare the condition of potentially inappropriate medications (PIM) in elderly inpatients in our hospital by the new edition of Beers and the STOPP criteria.MethodsThe patients who were ≥65 years old and discharged from the internal medicine ward of Xuanwu Hospital, Capital Medical University in March 2017 were enrolled into the study. The patients′ basic information (gender, age), coexistence diseases, Chalson Comorbidity Index (CCI) scores, types of drug used during hospitalization, expenses for medicine, and total hospitalization expenses were collected. The Beers criteria (2015) and the STOPP criteria (2014) were used respectively to evaluate the PIM in inpatients and logistic regression analysis was used to analyze related factors of PIM occurrence.ResultsA total of 453 patients were enrolled into the study, including 247 males and 206 females, aged 65-97 years with the mean age of (74±7) years. The hospitalization time was 2 to 57 days, the median hospitalization time was 10 (7, 13) days; the number of coexistence diseases was 1 to 42, the median number of coexistence diseases was 8 (5, 12); the number of drug types during hospitalization was 1 to 57, the median number of drug types was 12 (8, 17); CCI scores were 0 to 7 points, the median CCI score was 1 (1, 2). Two hundred and ninety patients (290/453, 64.0%) were prescribed at least 1 PIM by the Beers criteria, mainly including vasodilators (131/709, 18.48%), diuretics (123/709, 17.35%), and benzodiazepines (107/709, 15.09%). One hundred and eighty-nine patients (189/453, 41.7%) were prescribed at least 1 PIM by the STOPP criteria, mainly including benzodiazepines (101/283, 35.69%), first generation antihistamines (49/283, 17.31%), and repeated use of the same kind of drugs (30/283, 10.60%). The difference in PIM incidence assessed by the Beers and STOPP criteria among the patients with different gender was not statistically significant (P=0.161, P=0.438). The differences in PIM incidences assessed by the Beers and STOPP criteria at different ages, different hospitalization time, kinds of coexistence diseases, types of drug use, and CCI scores were all statistically significant (Beers criteria: P values were <0.001, <0.001, <0.001, <0.001, and 0.003, respectively; STOPP criteria: P values were <0.001, <0.001, <0.001, <0.001, and 0.010, respectively). The mortality and total hospitalization expenses in patients with PIM use identified by the Beers and STOPP criteria were higher than those in patients without PIM use (Beers criteria: P values were 0.001 and <0.001, respectively; STOPP criteria: P values were 0.001 and 0.006, respectively). The result of Kappa consistency test reviewed that the 2 criteria had general consistency. Aged 75-84 years, hospitalization time≥15 days, 6-10 and≥16 kinds of coexistence diseases, and ≥10 drugs types were risk factors of PIM occurrence in patients.ConclusionsMore PIM users could be determined by the Beers criteria. The PIM evaluated by STOPP criteria in elderly patients was more beneficial to clinical diagnosis and treatment. More PIM in elderly patients could be found by combining the results of the 2 criteria.
