• BMJ open · Nov 2015

    Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan.

    • Chirn-Bin Chang, Shu-Yu Yang, Hsiu-Yun Lai, Ru-Shu Wu, Hsing-Cheng Liu, Hsiu-Ying Hsu, Shinn-Jang Hwang, and Ding-Cheng Chan.
    • Division of Internal Medicine, National Taiwan University Chu-Tung Branch, Hsinchu County, Taiwan Department of Geriatrics and Gerontology, National Taiwan University Hospital, Taipei, Taiwan.
    • BMJ Open. 2015 Nov 6; 5 (11): e008214.

    ObjectiveTo investigate the national prevalence of potentially inappropriate medications (PIMs) prescribed in ambulatory care clinics in Taiwan according to three different sets of regional criteria and the correlates of PIM use.DesignCross-sectional study.SettingThis analysis included older patients who visited ambulatory care clinics in 2009 and represented half of the older population included on the Taiwanese National Health Insurance Research Database.ParticipantsWe identified 1,164,701 subjects who visited ambulatory care clinics and were over 65 years old in 2009.Primary And Secondary Outcome MeasuresPIM prevalence according to the 2012 Beers criteria, the PIM-Taiwan criteria and the PRISCUS criteria was estimated separately, and characteristics of PIM users were explored. Multivariate logistic regression analysis was used to determine patient factors associated with the use of at least one PIM. Leading PIMs for each set of criteria were also listed.ResultsThe prevalence of having at least one PIM at the patient level was highest with the Beers criteria (86.2%), followed by the PIM-Taiwan criteria (73.3%) and the PRISCUS criteria (66.9%). Polypharmacy and younger age were associated with PIM use for all three sets of criteria. The leading PIMs detected by the PIM-Taiwan and PRISCUS criteria were all included in the 2012 Beers criteria. Non-COX-selective non-steroidal anti-inflammatory drugs in the Beers criteria and benzodiazepines in the PIM-Taiwan and PRISCUS criteria accounted for most leading PIMs.ConclusionsThe prevalence of PIMs was high among older Taiwanese patients receiving ambulatory care visits. The prevalence of PIM and its associated factors varied according to three sets of criteria at the population level.Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

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