Potentially inappropriate prescriptions for older patients in long-term careReport as inadecuate

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BMC Geriatrics

, 4:9

First Online: 15 October 2004Received: 27 February 2004Accepted: 15 October 2004


BackgroundInappropriate 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.

MethodsA 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.

ResultsAlmost 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.

ConclusionPotentially 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.

Electronic supplementary materialThe online version of this article doi:10.1186-1471-2318-4-9 contains supplementary material, which is available to authorized users.

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Author: Carol Rancourt - Jocelyne Moisan - Lucie Baillargeon - René Verreault - Danielle Laurin - Jean-Pierre Grégoire

Source: https://link.springer.com/

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