Evaluating potentially inappropriate medications in the elderly with seven different screening tools

Abstract

Introduction: We aimed to determine the rates of potentially inappropriate medications using various screening tools and also the affecting factors in elderly patients.Materials and Method: In this prospective cross-sectional study, we recorded in detail the concomitant chronic diseases, geriatric syndromes, and drugs used in elderly patients admitted to a university hospital and then assessed potentially inappropriate medications using seven different screening tools.Results: The study included 315 patients (190 female; 125 male). We evaluated potentially inappropriate medication use with the PRISCUS, EU(7), Beers 2019, STOPP v2, and TIME-to-STOP criteria and evaluated potential prescription omissions with the START v2 and TIME-to-START criteria; the resulting identified rates of PIMs were 15.9%, 45.1%, 48.9%, 44.8%, 48.3%, 73.9%, and 97.5%, respectively. The lowest value was found with PRISCUS, as it uses fewer criteria than the others. The EU(7), Beers 2019, STOPP v2, and TIME-to -STOP results were similar to one another. START v2 and TIME-to-START yielded higher outcomes than the others due to the omission of vaccines in patients. The highest outcome was found with TIME-to-START due to the omission of the herpes zoster vaccine (97.5%), which appears only in that screening tool. Potentially inappropriate medication rates increased with the number of drugs used and with the number of concomitant chronic diseases.Conclusion: This study detected potentially inappropriate medication use in approximately half of the patients with the EU(7), Beers 2019, STOPP v2, and TIME-to-STOP screening tools. There was a positive correlation between potentially inappropriate medications and polypharmacy and increased disease burden.