Older individuals generally suffer from multiple co-morbidities and this makes this
patient group particularly vulnerable to inappropriate prescribing (IP). IP has been
reported to be a substantial cause of morbidity and mortality and has been identified
as a major contributing factor to increased healthcare utilisation. One method of
evaluating or identifying inappropriate or sub-optimal prescribing practice is to use
validated evidence-based explicit criteria to define instances of potential IP. Two
sets of criteria have gained international recognition, i.e. Beers¿ criteria and
¿Screening Tool of Older Peoples Prescriptions (STOPP)¿.
The aim of this study was to determine the prevalence of potential IP in older nursing
home residents on the island of Ireland.
A total of 315 residents ≥65 years were randomly selected from fourteen nursing
homes from County Cork, Ireland and were age and gender matched with 315
residents from a Northern Irish nursing home dataset. Exclusion criteria included
terminally ill or respite patients. Both the Beers¿ and STOPP criteria were applied to
the patient profiles of the 630 residents in both Northern Ireland (NI) and the
Republic of Ireland (RoI).
Of the residents reviewed (n=630), 472 (74.9%) were female; the median age was
84 (IQR: 78-89) of the entire dataset. The total number of medicines prescribed for
the RoI dataset was 3,730 (median 11, IQR 9-13) and for the NI population was
3,394 (median 10, IQR 7-13). In the RoI dataset, 73.0% of residents had at least one
potentially inappropriate medication (PIM) identified by STOPP criteria and 54.3%
had at least one PIM identified by the Beers¿ criteria. In the NI dataset 67.0% of
residents had at least one PIM identified by STOPP criteria and 56.8% of residents
had at least one PIM identified by the Beers¿ criteria.
Potential IP is a major area of concern and has been implicated throughout the
literature as a substantial burden to health services internationally. In this study
STOPP criteria demonstrated superior capability over the Beers¿ criteria in the
identification of instances of potential inappropriate prescribing (PIP) in these nursing
home / long term care facility residents.