TY - JOUR T1 - Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish LongituDinal Study on Ageing study (TILDA) JF - European Journal of Clinical Pharmacology Y1 - 2014 A1 - Galvin, R A1 - Moriarty, F A1 - Cousins, G A1 - Cahir, C A1 - Motterlini, N A1 - Bradley, MC A1 - Hughes, CM A1 - Bennett, K A1 - Smith, SM A1 - Fahey, T A1 - Kenny, RA KW - older people KW - Potential prescribing omissions KW - potentially inappropriate prescribing KW - START KW - STOPP AB - Abstract Purpose We sought to estimate the prevalence of potentially inappropriate prescriptions (PIP) and potential prescribing omissions (PPOs) using a subset of the STOPP/START criteria in a population based sample of Irish adults aged ≥65 years using data from The Irish LongituDinal Study on Ageing (TILDA). Methods A subset of 26 PIP indicators and 10 PPO indicators from the STOPP/START criteria were applied to the TILDA dataset. PIP/PPO prevalence according to individual STOPP/START criteria and the overall prevalence of PIP/PPO were estimated. The relationship between PIP and PPOs and polypharmacy, age, gender and multimorbidity was examined using logistic regression. Results The overall prevalence of PIP in the study population (n = 3,454) was 14.6 %. The most common examples of PIP identified were NSAID with moderate-severe hypertension (200 participants; 5.8 %) and aspirin with no history of coronary, cerebral, or peripheral vascular symptoms or occlusive event (112 participants; 3.2 %). The overall prevalence of PPOs was 30 % (n = 1,035). The most frequent PPO was antihypertensive therapy where systolic blood pressure consistently >160 mmHg (n = 341, 9.9 %), There was a significant association between PIP and PPO and polypharmacy when adjusting for age, sex and multimorbidity (adjusted OR 2.62, 95 % CI 2.05–3.33 for PIP and adjusted OR 1.46, 95 % CI 1.23–1.75 for prescribing omissions). Conclusion Our findings indicate prescribing omissions are twice as prevalent as PIP in the elderly using a subset of the STOPP/START criteria as an explicit process measure of potentially inappropriate prescribing and prescribing omissions. Polypharmacy was independently associated with both PPO and PIP. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, healthcare utilisation and cost. UR - http://link.springer.com/article/10.1007/s00228-014-1651-8# ER - TY - JOUR T1 - Potentially inappropriate prescribing according to STOPP and START and adverse outcomes in community-dwelling older people: a prospective cohort study JF - British Journal of Clinical Pharmacology Y1 - 2016 A1 - Moriarty, F A1 - Bennett, K A1 - Cahir, C A1 - Kenny, RA A1 - Fahey, T VL - 82(3) UR - http://epubs.rcsi.ie/gpart/102/ ER - TY - JOUR T1 - Potential for alcohol and drug interactions in older adults: evidence from the Irish longitudinal study on ageing JF - BMC Geriatics Y1 - 2014 A1 - Cousins, G A1 - Galvin, R A1 - Flood, Michelle A1 - Kennedy, Marie Claire A1 - Motterlini, N A1 - Henman, M A1 - Kenny, RA A1 - Fahey, T KW - Aged KW - Alcohol drinking/epidemiology KW - Alcohol interactive medications KW - Drug interactions AB - Abstract (provisional) Background Older adults are susceptible to adverse effects from the concomitant use of prescription medications and alcohol. This study estimates the prevalence of exposure to alcohol interactive (AI) medications and concomitant alcohol use by therapeutic class in a large, nationally representative sample of older adults. Methods Cross-sectional analysis of a population based sample of older Irish adults aged ?60?years using data from The Irish Longitudinal Study on Ageing (TILDA) (N?=?3,815). AI medications were identified using Stockley?s Drug Interactions, the British National Formulary and the Irish Medicines Formulary. An in-home inventory of medications was used to characterise AI drug exposure by therapeutic class. Self-reported alcohol use was classified as non-drinker, light/moderate and heavy drinking. Comorbidities known to be exacerbated by alcohol were also recorded (diabetes mellitus, hypertension, peptic ulcer disease, liver disease, depression, gout or breast cancer), as well as sociodemographic and health factors. Results Seventy-two per cent of participants were exposed to AI medications, with greatest exposure to cardiovascular and CNS agents. Overall, 60% of participants exposed to AI medications reported concomitant alcohol use, compared with 69.5% of non-AI exposed people (p?