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Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review

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Abstract

Background

Potentially inappropriate prescribing (PIP) is one of the main risk factors for adverse drug events (ADEs) in older people.

Purpose

This systematic literature review aims to determine prevalence and type of PIP in community-dwelling older people across Europe, as well as identifying risk factors for PIP.

Methods

The PubMed and Web of Science database were searched systematically for relevant manuscripts (January 1, 2000–December 31, 2014). Manuscripts were included if the study design was observational, the study participants were community-dwelling older patients in Europe, and if a published screening method for PIP was used. Studies that focused on specific pathologies or that focused on merely one inappropriate prescribing issue were excluded. Data analysis was performed using R statistics.

Results

Fifty-two manuscripts were included, describing 82 different sample screenings with an estimated overall PIP prevalence of 22.6 % (CI 19.2–26.7 %; range 0.0–98.0 %). Ten of the sample screenings were based on the Beers 1997 criteria, 19 on the Beers 2003 criteria, 14 on STOPP criteria (2008 version), 8 on START-criteria (2008 version), and 7 on the PRISCUS list. The 24 remaining sample screenings were carried out using compilations of screening methods or used country-specific lists such as the Laroche criteria. It appears that only PIP prevalence calculated from insurance data significantly differs from the other data collection method categories. Furthermore, risk factors most often positively associated with PIP prevalence were polypharmacy, poor functional status, and depression. Drug groups most often involved in PIP were anxiolytics (ATC-code: N05B), antidepressants (N06A), and nonsteroidal anti-inflammatory and anti-rheumatic products (M01A).

Conclusion

PIP prevalence in European community-dwelling older adults is high and depends partially on the data collection method used. Polypharmacy, poor functional status, and depression were identified as the most common risk factors for PIP.

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Authors and Affiliations

  1. Pharmaceutical Care Unit, Faculty of Pharmaceutical Sciences, Ghent University, Ottergemsesteenweg 460, 9000, Ghent, Belgium

    Eline Tommelein, Els Mehuys, Annemie Somers & Koen Boussery

  2. Department of Internal medicine, Faculty of Medicine and Health Sciences, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium

    Mirko Petrovic

  3. Department of Pharmacy, Ghent University Hospital, De Pintelaan 185, 9000, Ghent, Belgium

    Annemie Somers

  4. Laboratory of Medical Biochemistry and Clinical Analysis, Faculty of Pharmaceutical Sciences, Ghent University, Ghent, Belgium

    Pieter Colin

  5. Department of Anesthesiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands

    Pieter Colin

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  1. Eline Tommelein
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Tommelein, E., Mehuys, E., Petrovic, M. et al. Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review. Eur J Clin Pharmacol 71, 1415–1427 (2015). https://doi.org/10.1007/s00228-015-1954-4

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