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. 2004 Oct 15:4:9.
doi: 10.1186/1471-2318-4-9.

Potentially inappropriate prescriptions for older patients in long-term care

Carol Rancourt  1 , Jocelyne Moisan, Lucie Baillargeon, René Verreault, Danielle Laurin, Jean-Pierre Grégoire
Affiliations

Potentially inappropriate prescriptions for older patients in long-term care

Carol Rancourt et al. BMC Geriatr. .

Abstract

Background: Inappropriate medication use is a major healthcare issue for the elderly population. This study explored the prevalence of potentially inappropriate prescriptions (PIPs) in long-term care in metropolitan Quebec.

Methods: A cross sectional chart review of 2,633 long-term care older patients of the Quebec City area was performed. An explicit criteria list for PIPs was developed based on the literature and validated by a modified Delphi method. Medication orders were reviewed to describe prescribing patterns and to determine the prevalence of PIPs. A multivariate analysis was performed to identify predictors of PIPs.

Results: Almost all residents (94.0%) were receiving one or more prescribed medication; on average patients had 4.8 prescribed medications. A majority (54.7%) of treated patients had a potentially inappropriate prescription (PIP). Most common PIPs were drug interactions (33.9% of treated patients), followed by potentially inappropriate duration (23.6%), potentially inappropriate medication (14.7%) and potentially inappropriate dosage (9.6%). PIPs were most frequent for medications of the central nervous system (10.8% of prescribed medication). The likelihood of PIP increased significantly as the number of drugs prescribed increased (odds ratio [OR]: 1.38, 95% confidence interval [CI]: 1.33-1.43) and with the length of stay (OR: 1.78, CI: 1.43-2.20). On the other hand, the risk of receiving a PIP decreased with age.

Conclusion: Potentially inappropriate prescribing is a serious problem in the highly medicated long-term care population in metropolitan Quebec. Use of explicit criteria lists may help identify the most critical issues and prioritize interventions to improve quality of care and patient safety.

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Figures

Figure 1
Figure 1
Potentially inappropriate prescribing including inappropriate medication, dosage, duration and potential drug-drug interaction among three age-groupsof long-term care elderly (N = 2,481) ♂ = male ♀ = female
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