TY  - JOUR
PY  - 2016//
TI  - Impact of potentially inappropriate prescribing on adverse drug events, health related quality of life and emergency hospital attendance in older people attending general practice: a prospective cohort study
JO  - Journals of gerontology. Series A: Biological sciences and medical sciences
A1  - Wallace, Emma
A1  - McDowell, Ronald
A1  - Bennett, Kathleen
A1  - Fahey, Tom
A1  - Smith, Susan M.
SP  - 271
EP  - 277
VL  - 72
IS  - 2
N2  - BACKGROUND: Potentially inappropriate prescribing (PIP) describes medications where risk generally outweighs benefit for older people. Cross-sectional studies suggest an association between PIP and poorer health outcomes but there is a paucity of prospective cohort studies. This study investigates the longitudinal association of PIP with adverse drug events (ADEs), health related quality of life, and accident & emergency visits. <br><br>METHODS: Study design: Two-year (2010-2012) prospective cohort study (n = 904, ≥70 years, community-dwelling) with linked pharmacy dispensing data. EXPOSURE: Baseline PIP: Screening Tool for Older Persons potentially Inappropriate Prescriptions (STOPP) and Beers 2012 applied 12 months prior. STUDY OUTCOMES: ADEs (patient interview), health related quality of life (EQ-5D-3L: patient questionnaire), and accident & emergency visits (general practice medical record review). STATISTICAL ANALYSIS: Descriptive statistics: Poisson (incidence rate ratio [95% confidence interval [CI]], linear regression models [regression coefficient [95% CI]], and logistic [odds ratio [OR] [95% CI]). <br><br>RESULTS: Of 791 participants eligible for follow-up, 673 (85%) returned a questionnaire and 605 (77%) also completed an ADE interview. Baseline STOPP PIP prevalence was 40% and 445 (74%) patients reported ≥1 ADE at follow-up. In multivariable analysis, ≥2 STOPP PIP was associated with ADEs (adjusted incidence rate ratio: 1.29 [95% CI 1.03, 1.85; p =.03]; poorer health related quality of life [adjusted regression coefficient: -0.11 [95% CI -0.16, -0.06; p <.001]]; and, ≥1 accident & emergency visit [adjusted OR: 1.85 [95% CI 1.06, 3.24; p =.03]]). Baseline Beers 2012 prevalence was 26% and there was no association with adverse health outcomes in multivariable analysis. <br><br>CONCLUSIONS: Older community-dwelling people, prescribed ≥2 STOPP PIP are more likely to report ADEs, poorer health related quality of life and attend the accident & emergency department over 2-year follow-up.<br><br>© The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America.<p />  <p>Language: en</p>
LA  - en
SN  - 1079-5006
UR  - http://dx.doi.org/10.1093/gerona/glw140
ID  - ref1
ER  -