Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’
Abstract Background Potentially inappropriate prescribing (PIP) is associated with negative health outcomes, including hospitalisation and mortality. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ) is a longitudinal study of Māori (the indigenous population of New Zealand)...
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| Format: | Article |
| Language: | English |
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BMC
2020-01-01
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| Series: | BMC Geriatrics |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12877-020-1432-4 |
| _version_ | 1818930733926842368 |
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| author | Karen Cardwell Ngaire Kerse Carmel M. Hughes Ruth Teh Simon A. Moyes Oliver Menzies Anna Rolleston Joanna B. Broad Cristín Ryan |
| author_facet | Karen Cardwell Ngaire Kerse Carmel M. Hughes Ruth Teh Simon A. Moyes Oliver Menzies Anna Rolleston Joanna B. Broad Cristín Ryan |
| author_sort | Karen Cardwell |
| collection | DOAJ |
| description | Abstract Background Potentially inappropriate prescribing (PIP) is associated with negative health outcomes, including hospitalisation and mortality. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ) is a longitudinal study of Māori (the indigenous population of New Zealand) and non-Māori octogenarians. Health disparities between indigenous and non-indigenous populations are prevalent internationally and engagement of indigenous populations in health research is necessary to understand and address these disparities. Using LiLACS NZ data, this study reports the association of PIP with hospitalisations and mortality prospectively over 36-months follow-up. Methods PIP, from pharmacist applied criteria, was reported as potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). The association between PIP and hospitalisations (all-cause, cardiovascular disease-specific and ambulatory-sensitive) and mortality was determined throughout a series of 12-month follow-ups using binary logistic (hospitalisations) and Cox (mortality) regression analysis, reported as odds ratios (ORs) and hazard ratios (HRs), respectively, and the corresponding confidence intervals (CIs). Results Full demographic data were obtained for 267 Māori and 404 non-Māori at baseline, 178 Māori and 332 non-Māori at 12-months, and 122 Māori and 281 non-Māori at 24-months. The prevalence of any PIP (i.e. ≥1 PIM and/or PPO) was 66, 75 and 72% for Māori at baseline, 12-months and 24-months, respectively. In non-Māori, the prevalence of any PIP was 62, 71 and 73% at baseline, 12-months and 24-months, respectively. At each time-point, there were more PPOs than PIMs; at baseline Māori were exposed to a significantly greater proportion of PPOs compared to non-Māori (p = 0.02). In Māori: PPOs were associated with a 1.5-fold increase in hospitalisations and mortality. In non-Māori, PIMs were associated with a double risk of mortality. Conclusions PIP was associated with an increased risk of hospitalisation and mortality in this cohort. Omissions appear more important for Māori in predicting hospitalisations, and PIMs were more important in non-Māori in predicting mortality. These results suggest understanding prescribing outcomes across and between population groups is needed and emphasises prescribing quality assessment is useful. |
| first_indexed | 2024-12-20T04:05:24Z |
| format | Article |
| id | doaj.art-03bbc6aaf8264d8e980f39ded5166b9b |
| institution | Directory Open Access Journal |
| issn | 1471-2318 |
| language | English |
| last_indexed | 2024-12-20T04:05:24Z |
| publishDate | 2020-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Geriatrics |
| spelling | doaj.art-03bbc6aaf8264d8e980f39ded5166b9b2022-12-21T19:54:03ZengBMCBMC Geriatrics1471-23182020-01-012011910.1186/s12877-020-1432-4Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’Karen Cardwell0Ngaire Kerse1Carmel M. Hughes2Ruth Teh3Simon A. Moyes4Oliver Menzies5Anna Rolleston6Joanna B. Broad7Cristín Ryan8School of Pharmacy, Queen’s University BelfastDepartment of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences University of AucklandSchool of Pharmacy, Queen’s University BelfastDepartment of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences University of AucklandDepartment of General Practice and Primary Health Care, School of Population Health, Faculty of Medical and Health Sciences University of AucklandOlder People’s Health, Auckland District Health BoardThe Centre for HealthDepartment of Geriatric Medicine, Faculty of Medical and Health Sciences University of AucklandSchool of Pharmacy & Pharmaceutical Science, Trinity College Dublin, The University of DublinAbstract Background Potentially inappropriate prescribing (PIP) is associated with negative health outcomes, including hospitalisation and mortality. Life and Living in Advanced Age: a Cohort Study in New Zealand (LiLACS NZ) is a longitudinal study of Māori (the indigenous population of New Zealand) and non-Māori octogenarians. Health disparities between indigenous and non-indigenous populations are prevalent internationally and engagement of indigenous populations in health research is necessary to understand and address these disparities. Using LiLACS NZ data, this study reports the association of PIP with hospitalisations and mortality prospectively over 36-months follow-up. Methods PIP, from pharmacist applied criteria, was reported as potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs). The association between PIP and hospitalisations (all-cause, cardiovascular disease-specific and ambulatory-sensitive) and mortality was determined throughout a series of 12-month follow-ups using binary logistic (hospitalisations) and Cox (mortality) regression analysis, reported as odds ratios (ORs) and hazard ratios (HRs), respectively, and the corresponding confidence intervals (CIs). Results Full demographic data were obtained for 267 Māori and 404 non-Māori at baseline, 178 Māori and 332 non-Māori at 12-months, and 122 Māori and 281 non-Māori at 24-months. The prevalence of any PIP (i.e. ≥1 PIM and/or PPO) was 66, 75 and 72% for Māori at baseline, 12-months and 24-months, respectively. In non-Māori, the prevalence of any PIP was 62, 71 and 73% at baseline, 12-months and 24-months, respectively. At each time-point, there were more PPOs than PIMs; at baseline Māori were exposed to a significantly greater proportion of PPOs compared to non-Māori (p = 0.02). In Māori: PPOs were associated with a 1.5-fold increase in hospitalisations and mortality. In non-Māori, PIMs were associated with a double risk of mortality. Conclusions PIP was associated with an increased risk of hospitalisation and mortality in this cohort. Omissions appear more important for Māori in predicting hospitalisations, and PIMs were more important in non-Māori in predicting mortality. These results suggest understanding prescribing outcomes across and between population groups is needed and emphasises prescribing quality assessment is useful.https://doi.org/10.1186/s12877-020-1432-4Potentially inappropriate prescribingAdults aged ≥80 yearsSTOPP/START criteriaLongitudinal studyHealth outcomes |
| spellingShingle | Karen Cardwell Ngaire Kerse Carmel M. Hughes Ruth Teh Simon A. Moyes Oliver Menzies Anna Rolleston Joanna B. Broad Cristín Ryan Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’ BMC Geriatrics Potentially inappropriate prescribing Adults aged ≥80 years STOPP/START criteria Longitudinal study Health outcomes |
| title | Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’ |
| title_full | Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’ |
| title_fullStr | Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’ |
| title_full_unstemmed | Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’ |
| title_short | Does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality? A longitudinal study of the ‘oldest old’ |
| title_sort | does potentially inappropriate prescribing predict an increased risk of admission to hospital and mortality a longitudinal study of the oldest old |
| topic | Potentially inappropriate prescribing Adults aged ≥80 years STOPP/START criteria Longitudinal study Health outcomes |
| url | https://doi.org/10.1186/s12877-020-1432-4 |
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