000150339 001__ 150339
000150339 005__ 20251017144646.0
000150339 0247_ $$2doi$$a10.1371/journal.pone.0237186
000150339 0248_ $$2sideral$$a142515
000150339 037__ $$aART-2020-142515
000150339 041__ $$aeng
000150339 100__ $$aLopez-Rodriguez, Juan A.
000150339 245__ $$aPotentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study
000150339 260__ $$c2020
000150339 5060_ $$aAccess copy available to the general public$$fUnrestricted
000150339 5203_ $$aBackground
Multimorbidity is a global health challenge that is associated with polypharmacy, increasing the risk of potentially inappropriate prescribing (PIP). There are tools to improve prescription, such as implicit and explicit criteria.
Objective
To estimate the prevalence of PIP in a population aged 65 to 74 years with multimorbidity and polypharmacy, according to American Geriatrics Society Beers Criteria® (2015, 2019), the Screening Tool of Older Person’s Prescription -STOPP- criteria (2008, 2014), and the Medication Appropriateness Index -MAI- criteria in primary care.
Methods
This was an observational, descriptive, cross-sectional study. The sample included 593 community-dwelling elderly aged 65 to 74 years, with multimorbidity and polypharmacy, who participated in the MULTIPAP trial. Socio-demographic, clinical, professional, and pharmacological-treatment variables were recorded. Potentially inappropriate prescribing was detected by computerized prescription assistance system, and family doctors evaluated the MAI. The MAI-associated factors were analysed using a logistic regression model.
Results
A total of 4,386 prescriptions were evaluated. The mean number of drugs was 7.4 (2.4 SD). A total of 94.1% of the patients in the study had at least one criterion for drug inappropriateness according to the MAI. Potentially inappropriate prescribing was detected in 57.7%, 43.6%, 68.8% and 71% of 50 patients according to the explicit criteria STOPP 2014, STOPP 2008, Beers 2019 and Beers 2015 respectively. For every new drug taken by a patient, the MAI score increased by 2.41 (95% CI 1.46; 3.35) points. Diabetes, ischaemic heart disease and asthma were independently associated with lower summated MAI scores.
Conclusions
The prevalence of potentially inappropriate prescribing detected in the sample was high and in agreement with previous literature for populations with multimorbidity and polypharmacy. The MAI criteria detected greater inappropriateness than did the explicit criteria, but their application was more complex and difficult to automate.
Figures
000150339 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII-FEDER/RD16-0001-0004$$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI15-00276$$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI15-00572$$9info:eu-repo/grantAgreement/ES/ISCIII/FIS/PI15-00996$$9info:eu-repo/grantAgreement/ES/ISCIII/RD16-0001-0005$$9info:eu-repo/grantAgreement/ES/ISCIII/RD16-0001-0006
000150339 540__ $$9info:eu-repo/semantics/openAccess$$aby$$uhttps://creativecommons.org/licenses/by/4.0/deed.es
000150339 590__ $$a3.24$$b2020
000150339 591__ $$aMULTIDISCIPLINARY SCIENCES$$b25 / 71 = 0.352$$c2020$$dQ2$$eT2
000150339 592__ $$a0.99$$b2020
000150339 593__ $$aMultidisciplinary$$c2020$$dQ1
000150339 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion
000150339 700__ $$aRogero-Blanco, Eloísa
000150339 700__ $$aAza-Pascual-Salcedo, Mercedes
000150339 700__ $$aLopez-Verde, Fernando
000150339 700__ $$aPico-Soler, Victoria
000150339 700__ $$aLeiva-Fernandez, Francisca
000150339 700__ $$aPrados-Torres, J. Daniel
000150339 700__ $$aPrados-Torres, Alexandra
000150339 700__ $$aCura-González, Isabel
000150339 700__ $$0(orcid)0000-0003-2928-6623$$aGimeno Feliu Luis$$uUniversidad de Zaragoza
000150339 700__ $$aon behalf MULTIPAP group
000150339 7102_ $$11007$$2610$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Medicina
000150339 773__ $$g15, 8 (2020), e0237186 [20 pp.]$$pPLoS One$$tPLoS ONE$$x1932-6203
000150339 8564_ $$s914877$$uhttps://zaguan.unizar.es/record/150339/files/texto_completo.pdf$$yVersión publicada
000150339 8564_ $$s2182287$$uhttps://zaguan.unizar.es/record/150339/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada
000150339 909CO $$ooai:zaguan.unizar.es:150339$$particulos$$pdriver
000150339 951__ $$a2025-10-17-14:34:07
000150339 980__ $$aARTICLE