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Prevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional study

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dc.contributor.author O'Riordan, David
dc.contributor.author Elodie Aubert, Carole
dc.contributor.author Walsh, Kieran A.
dc.contributor.author Van Dorland, Anette
dc.contributor.author Rodondi, Nicolas
dc.contributor.author Du Puy, Robert S.
dc.contributor.author Poortvliet, Rosalinde K E.
dc.contributor.author Gussekloo, Jacobijn
dc.contributor.author Sinnott, Carol
dc.contributor.author Byrne, Stephen
dc.contributor.author Galvin, Rose
dc.contributor.author Jukema, J Wouter
dc.contributor.author Mooijaart, Simon P.
dc.contributor.author Baumgartner, Christine
dc.contributor.author McCarthy, Vera
dc.contributor.author Walsh, Elaine K.
dc.contributor.author Collet, Tinh-Hai
dc.contributor.author Dekkers, Olaf M.
dc.contributor.author Blum, Manuel R.
dc.contributor.author Kearney, Patricia M.
dc.date.accessioned 2018-04-03T11:27:30Z
dc.date.available 2018-04-03T11:27:30Z
dc.date.issued 2018
dc.identifier.uri http://hdl.handle.net/10344/6698
dc.description peer-reviewed en_US
dc.description.abstract Objectives To estimate and compare the prevalence and type of potentially inappropriate prescribing (PIP) and potential prescribing omissions (PPOs) among communitydwelling older adults (≥65 years) enrolled to a clinical trial in three European countries. Design A secondary analysis of the Thyroid Hormone Replacement for Subclinical Hypothyroidism Trial dataset. Participants A subset of 48/80 PIP and 22/34 PPOs indicators from the Screening Tool of Older Persons Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) V2 criteria were applied to prescribed medication data for 532/737 trial participants in Ireland, Switzerland and the Netherlands. Results The overall prevalence of PIP was lower in the Irish participants (8.7%) compared with the Swiss (16.7%) and Dutch (12.5%) participants (P=0.15) and was not statistically significant. The overall prevalence of PPOs was approximately one-quarter in the Swiss (25.3%) and Dutch (24%) participants and lower in the Irish (14%) participants (P=0.04) and the difference was statistically significant. The hypnotic Z-drugs were the most frequent PIP in Irish participants, (3.5%, n=4), while it was non-steroidal anti-inflammatory drug and oral anticoagulant combination, sulfonylureas with a long duration of action, and benzodiazepines (all 4.3%, n=7) in Swiss, and benzodiazepines (7.1%, n=18) in Dutch participants. The most frequent PPOs in Irish participants were vitamin D and calcium in osteoporosis (3.5%, n=4). In the Swiss and Dutch participants, they were bone antiresorptive/anabolic therapy in osteoporosis (9.9%, n=16, 8.6%, n=22) respectively. The odds of any PIP after adjusting for age, sex, multimorbidity and polypharmacy were (adjusted OR (aOR)) 3.04 (95% CI 1.33 to 6.95, P<0.01) for Swiss participants and aOR 1.74 (95% CI 0.79 to 3.85, P=0.17) for Dutch participants compared with Irish participants. The odds of any PPOs were aOR 2.48 (95% CI 1.27 to 4.85, P<0.01) for Swiss participants and aOR 2.10 (95% CI 1.11 to 3.96, P=0.02) for Dutch participants compared with Irish participants. Conclusions This study has estimated and compared the prevalence and type of PIP and PPOs among this cohort of community-dwelling older people. It demonstrated a significant difference in the prevalence of PPOs between the three populations. Further research is urgently needed into the impact of system level factors as this has important implications for patient safety, healthcare provision and economic costs. en_US
dc.language.iso eng en_US
dc.publisher BMJ Publishing Group en_US
dc.relation.ispartofseries BMJ Open;8:e019003
dc.relation.uri http://dx.doi.org/10.1136/bmjopen-2017-019003
dc.subject prevalence en_US
dc.subject potentially inappropriate prescribing en_US
dc.subject potential prescribing omissions en_US
dc.subject older en_US
dc.subject thyroid en_US
dc.title Prevalence of potentially inappropriate prescribing in a subpopulation of older European clinical trial participants: a cross-sectional study en_US
dc.type info:eu-repo/semantics/article en_US
dc.type.supercollection all_ul_research en_US
dc.type.supercollection ul_published_reviewed en_US
dc.identifier.doi 10.1136/bmjopen-2017-019003
dc.contributor.sponsor HRB en_US
dc.contributor.sponsor Swiss National Science Foundation en_US
dc.contributor.sponsor European Commission (EC) HORIZON 2020 en_US
dc.contributor.sponsor Swiss State Secretariat for Education, Research and Innovation en_US
dc.contributor.sponsor Swiss National Science Foundation en_US
dc.contributor.sponsor Dutch Ministry of Health and Welfare en_US
dc.relation.projectid SPHeRE/2013/1 en_US
dc.relation.projectid 278148 en_US
dc.relation.projectid SNSF 320030-150025 en_US
dc.relation.projectid 15.0137 en_US
dc.relation.projectid SNSF P2BEP3_165409 en_US
dc.relation.projectid PZ00P3-167826 en_US
dc.relation.projectid P2BEP3_175289 en_US
dc.relation.projectid 62700.3002 en_US
dc.rights.accessrights info:eu-repo/semantics/openAccess en_US


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