Prevalence of potentially inappropriate medications at hospital discharge in older adults: comparative study using STOPP version 3, Beers 2023 and PRISCUS 2.0 Criteria.

内容摘要

Potentially inappropriate medications (PIMs) are common in older adults and increase the risk of adverse outcomes, particularly at transitions of care such as hospital discharge. The aims of this study were to estimate the prevalence of PIMs at hospital discharge in older patients using STOPP version 3, the 2023 AGS Beers Criteria and PRISCUS 2.0; to describe the most frequently involved therapeutic groups; and to compare the ability of these tools to detect PIMs. We conducted a single-centre retrospective study in a tertiary university hospital in Barcelona including patients aged 70 years and older who were admitted to hospital. Sociodemographic, clinical and pharmacological variables were collected. Prevalence of PIMs was calculated separately for each set of criteria and comparative analysis was performed across the three tools. We included 638 patients (mean age 86.1 years; 58.3% women). Overall, 75.2% had at least one PIM at discharge. Polypharmacy was highly prevalent (>90%). The most frequent PIMs belonged to Anatomical Therapeutic Chemical (ATC) group N (45.0%; anxiolytics, antipsychotics, hypnotics and sedatives, and opioid analgesics), followed by ATC group C (18.3%; mainly cardiac therapy agents, loop and thiazide diuretics, and lipid-lowering agents) and ATC group A (16.4%; proton pump inhibitors). PIMs prevalence varied by criteria: 73% (95% CI 69.6% to 76.4%) with STOPP, 56.6% (95% CI 52.7% to 60.4%) with AGS Beers and 55.6% (95% CI 51.8% to 59.5%) with PRISCUS. PIMs at hospital discharge are highly prevalent among older patients. Systematic medication review and deprescribing, supported by explicit criteria, are needed to improve prescribing quality and potentially reduce adverse outcomes. Across tools, the STOPP criteria appeared to be the tool that detected more PIMs in this population.