alexa Factors associated with an increased risk of potentially inappropriate prescriptions at hospital discharge in comorbid older patients

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Research Article

Factors associated with an increased risk of potentially inappropriate prescriptions at hospital discharge in comorbid older patients

Klejda Hudhra1,2, Aurora Bueno-Cavanillas1,3,4*

Department of Public Health and Preventive Medicine, Faculty of Medicine, University of Granada, Spain

Faculty of Pharmacy, University of Medicine, Tirana, Albania

CIBER Epidemiology and Public Health (CIBERESP), Spain

Service of Preventive Medicine. University Hospital San Cecilio, Granada, Spain

*Corresponding Author:
Aurora Bueno-Cavanillas
Department of Public Health and Preventive Medicine
Faculty of Medicine, Avenida de Madrid
1118012, Granada, Spain
Tel: 34 958 248 855
E-mail: [email protected]

Received: 27/11/2015 Accepted: 29/11/2015 Published: 30/11/2015

 

Abstract

Objective: The objective of this study was to identify clinical or demographic variables associated with potentially inappropriate prescriptions (PIP) at hospital discharge in older patients. Method: A single-center, cross-sectional study was performed on patients aged ≥ 65 years who had been discharged from a university hospital. Data on the patients’ demographics, primary diagnosis, prescribed medications, and related pathologies were collected, and each patient’s Charlson co-morbidity index was calculated. The Beers (2012) and STOPP (2008) criteria were used to define PIP, and the strength of the association between each variable and the presence of PIP was estimated. Results: Six hundred twenty-four persons were included in the study. The frequency of PIP was not associated with the patients’ sex, age, or length of hospital stay. However, it was associated with the number of medications prescribed and was higher for patients discharged from the internal medicine service (Beers: cOR 2.39, 95% CI 1.47-3.90; STOPP: cOR 2.21, 95% CI 1.44-3.38). Besides these factors, when the Beers criteria were used to define PIP, several comorbid conditions were associated with a significantly higher frequency of PIP. For STOPP criteria, only the presence of hypertension or chronic obstructive pulmonary disease acted as independent risk factors. Ischemic heart disease and cerebrovascular disease acted as protective factors in both criteria. Conclusion: The risk factors for PIP differed depending on the type of criteria used to define PIP. However, the results of this study highlight the importance of hypertension management on the prevention of PIP.

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