Inappropriate Medicines Tied to Serious Avoidable Adverse Events

Potentially and actually inappropriate medications are often prescribed in the ICU

WEDNESDAY, June 15 (HealthDay News) -- Use of the Screening Tool of Older Persons' potentially inappropriate prescriptions (STOPP) criteria has identified an association between potentially inappropriate medicine (PIM) prescriptions and the likelihood of a serious adverse drug event (ADE) in older people; and, when hospitalized, older people are at risk of being prescribed PIMs and actually inappropriate medicines (AIMs), especially in intensive care units (ICUs), according to a study and research letter published in the June 13 issue of the Archives of Internal Medicine.

Hilary Hamilton, M.B., M.R.C.P.I., from the University College Cork in Ireland, and colleagues investigated whether PIMs defined by STOPP and Beers criteria were significantly associated with ADEs in 600 older people (age 65 years or older) admitted with acute illness. They identified 329 ADEs, 219 of which contributed to admission. After adjusting for all variables, PIMs defined by STOPP criteria significantly increased the likelihood of a serious avoidable ADE (odds ratio, 1.847; P < 0.001), while PIMs defined by Beers criteria did not (odds ratio, 1.276; P = 0.11).

Alessandro Morandi, M.D., from the Vanderbilt University School of Medicine in Nashville, Tenn., and colleagues used Beers criteria to identify PIMs and AIMs in 120 patients, aged 60 years and older, admitted to the ICU. Per patient, the number of PIM prescriptions at hospital discharge was significantly higher than before admission. Half of the PIMs and 59 percent of the AIMs detected at hospital discharge were originally prescribed in the ICU.

"Our study highlights the importance of performing an evaluation of medication appropriateness during reconciliation of medications at hospital admission, ICU discharge, and hospital discharge," Morandi and colleagues write.

Two of the authors from the Morandi and colleagues study disclosed financial relationships with the pharmaceutical industry.

Abstract - Hamilton
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Abstract - Morandi
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