Inappropriate prescribing in an acutely ill population of elderly patients as determined by Beers' Criteria

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Abstract
Introduction: Adverse drug events (ADEs) are associated with inappropriate prescribing (IP) and result in increased morbidity, mortality and resource utilisation. We used Beers' Criteria to determine the three-month prevalence of IP in a non-selected community-dwelling population of acutely ill older people requiring hospitalisation. Methods: A prospective, observational study of 597 consecutive acute admissions was performed. Diagnoses and concurrent medications were recorded before hospital physician intervention, and Beers' Criteria applied. Results: Mean patient age (SD) was 77 (7) years. Median number of medications was 5, range 0–13. IP occurred in 32% of patients (n = 191), with 24%, 6% and 2% taking 1, 2 and 3 inappropriate medications respectively. Patients taking >5 medications were 3.3 times more likely to receive an inappropriate medication than those taking ≤5 medications (OR 3.34: 95%, CI 2.37–4.79; PConclusion: IP is highly prevalent in acutely ill older patients and is associated with polypharmacy and hospitalisation. However, Beers' Criteria cannot be used as a gold standard as they do not comprehensively address all aspects of IP in older people.