%0 Journal Article %J BMJ Open %D 2022 %T What is the impact of multimorbidity on out-of-pocket healthcare expenditure among community-dwelling older adults in Ireland? A cross-sectional study %A Larkin, J %A Walsh, B %A Moriarty, F %A Clyne, B %A Harrington, P %A Smith, SM %B BMJ Open %V 12:e060502 %8 09/2022 %G eng %R 10.1136/bmjopen-2021-060502 %0 Journal Article %J BMJ Open %D 2015 %T Trends and interaction of polypharmacy and potentially inappropriate prescribing in primary care over 15 years in Ireland: a repeated cross-sectional study %A Moriarty, F %A Hardy, C %A Bennett, K %A Smith, SM %A Fahey, T %X Objectives To examine: (1) changes in polypharmacy in 1997, 2002, 2007 and 2012 and; (2) changes in potentially inappropriate prescribing (PIP) prevalence and the relationship between PIP and polypharmacy in individuals aged ≥65 years over this period in Ireland. Methods This repeated cross-sectional study using pharmacy claims data included all individuals eligible for the General Medical Services scheme in the former Eastern Health Board region of Ireland in 1997, 2002, 2007 and 2012 (range 338 025–539 752 individuals). Outcomes evaluated were prevalence of polypharmacy (being prescribed ≥5 regular medicines) and excessive polypharmacy (≥10 regular medicines) in all individuals and PIP prevalence in those aged ≥65 years determined by 30 criteria from the Screening Tool for Older Persons’ Prescriptions. Results The prevalence of polypharmacy increased from 1997 to 2012, particularly among older individuals (from 17.8% to 60.4% in those aged ≥65 years). The adjusted incident rate ratio for polypharmacy in 2012 compared to 1997 was 4.16 (95% CI 3.23 to 5.36), and for excessive polypharmacy it was 10.53 (8.58 to 12.91). Prevalence of PIP rose from 32.6% in 1997 to 37.3% in 2012. High-dose aspirin and digoxin prescribing decreased over time, but long-term proton pump inhibitors at maximal dose increased substantially (from 0.8% to 23.8%). The odds of having any PIP in 2012 were lower compared to 1997 after controlling for gender and level of polypharmacy, OR 0.39 (95% CI 0.39 to 0.4). Conclusions Accounting for the marked increase in polypharmacy, prescribing quality appears to have improved with a reduction in the odds of having PIP from 1997 to 2012. With growing numbers of people taking multiple regular medicines, strategies to address the related challenges of polypharmacy and PIP are needed. %B BMJ Open %V 5 %8 09/2015 %G eng %U http://bmjopen.bmj.com/content/5/9/e008656.full %N 9 %R 10.1136/bmjopen-2015-008656 %0 Journal Article %J BMJ Open %D 2021 %T The quality of prescribing in primary care in England - observational study of the Drug Utilisation 90% indicator using administrative GP prescribing data %A Chiedozie, C %A Murphy, ME %A Fahey, T %A Moriarty, F %B BMJ Open %V 11 %8 03/2021 %G eng %N 3 %R https://doi.org/10.1136/bmjopen-2020-043049 %0 Journal Article %J European Journal of Clinical Pharmacology %D 2014 %T Prevalence of potentially inappropriate prescribing and prescribing omissions in older Irish adults: findings from The Irish LongituDinal Study on Ageing study (TILDA) %A Galvin, R %A Moriarty, F %A Cousins, G %A Cahir, C %A Motterlini, N %A Bradley, MC %A Hughes, CM %A Bennett, K %A Smith, SM %A Fahey, T %A Kenny, RA %K older people %K Potential prescribing omissions %K potentially inappropriate prescribing %K START %K STOPP %X 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. %B European Journal of Clinical Pharmacology %8 02/2014 %G eng %U http://link.springer.com/article/10.1007/s00228-014-1651-8# %R 10.1007/s00228-014-1651-8 %0 Journal Article %J European Journal of Clinical Pharmacology %D 2016 %T Potentially inappropriate prescribing in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria %A Cooper, J %A Moriarty, F %A Ryan, C %A Smith, SM %A Bennett, K %A Fahey, T %A Wallace, E %A Cahir, C %A Williams, David %A Teeling, Mary %A Hughes, CM %X The purpose of this study is to establish the prevalence of potentially inappropriate prescribing (PIP) in middle-aged adults (45–64 years) in two populations with differing socio-economic profiles, and to investigate factors associated with PIP, using the PROMPT (PRescribing Optimally in Middle-aged People's Treatments) criteria. %B European Journal of Clinical Pharmacology %P 1–9 %G eng %U http://dx.doi.org/10.1007/s00228-015-2003-z %R 10.1007/s00228-015-2003-z %0 Journal Article %J Annals of Pharmacotherapy %D 2014 %T Potentially inappropriate prescribing and vulnerability and hospitalization in older community-dwelling patients. %A Cahir, C %A Moriarty, F %A Teljeur, C %A Fahey, T %A Bennett, K %K Beers 2012 criteria; STOPP; functional decline; health care use; older populations; potentially inappropriate prescribing; vulnerability %X BACKGROUND: The predictive validity of existing explicit process measures of potentially inappropriate prescribing (PIP) is not established. OBJECTIVE: To determine the association between PIP, and vulnerability and hospital visits in older community-dwelling patients. METHODS: This was a retrospective cohort study of 931 community-dwelling patients aged ≥70 years in 15 general practices in Ireland in 2010. PIP was defined by the Beers 2012 criteria and the Screening Tool of Older Person's Potentially Inappropriate Prescriptions (STOPP). Vulnerability was measured by the Vulnerable Elders Survey (score ≥3). The number of hospital visits was measured using patients' medical records and self-report for the previous 6 months. Multilevel logistic and Poisson regression was used to examine the association between PIP, and vulnerability and hospital visits after adjusting for patient and practice level covariates, socioeconomic status, comorbidity, number of drug classes, social support, and adherence. RESULTS: The prevalence of PIP determined by the Beers 2012 and STOPP criteria was 28% (n = 246) and 42% (n = 377), respectively. Patients with ≥2 PIP indicators were almost twice as likely to be classified as vulnerable (Beers adjusted odds ratio [OR] = 1.80; 95% CI = 1.08, 3.01; P < 0.05; STOPP adjusted OR = 1.86; 95% CI = 1.13, 3.04; P < 0.05). Patients with ≥2 STOPP indicators had an increased risk in the expected rate of hospital visits (adjusted incidence rate ratio = 1.32; 95% CI = 1.14, 1.54; P < 0.01). The Beers 2012 criteria were not associated with increased hospital visits. CONCLUSION: STOPP is a more sensitive measure of PIP than the Beers 2012 criteria and of clinical benefit in primary care settings. %B Annals of Pharmacotherapy %V 48 %P 1546-54 %8 09/14 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/25248541 %N 12 %9 Published Journal Article %& 1546 %R 10.1177/1060028014552821 %0 Journal Article %J British Journal of Clinical Pharmacology %D 2016 %T Potentially inappropriate prescribing according to STOPP and START and adverse outcomes in community-dwelling older people: a prospective cohort study %A Moriarty, F %A Bennett, K %A Cahir, C %A Kenny, RA %A Fahey, T %B British Journal of Clinical Pharmacology %V 82(3) %8 2016 %G eng %U http://epubs.rcsi.ie/gpart/102/ %& 849–857 %R 10.1111/bcp.12995. %0 Journal Article %J Eur J Clin Pharmacol %D 2015 %T Longitudinal prevalence of potentially inappropriate medicines and potential prescribing omissions in a cohort of community-dwelling older people %A Moriarty, F %A Bennett, K %A Fahey, T %A Kenny, RA %A Cahir, C %K ACOVE indicators %K Beers criteria %K Cohort %K potentially inappropriate prescribing %K START %K STOPP %X PURPOSE: This study aims to compare the prevalence of potentially inappropriate medicines (PIMs) and potential prescribing omissions (PPOs) using several screening tools in an Irish community-dwelling older cohort, to assess if the prevalence changes over time and to determine factors associated with any change. METHODS: This is a prospective cohort study of participants aged ≥65 years in The Irish Longitudinal Study on Ageing (TILDA) with linked pharmacy claims data (n = 2051). PIM and PPO prevalence was measured in the year preceding participants' TILDA baseline interviews and in the year preceding their follow-up interviews using the Screening Tool for Older Persons' Prescriptions (STOPP), Beers criteria (2012), Assessing Care of Vulnerable Elders (ACOVE) indicators and the Screening Tool to Alert doctors to Right Treatment (START). Generalised estimating equations were used to determine factors associated with change in prevalence over time. RESULTS: Depending on the screening tool used, between 19.8 % (ACOVE indicators) and 52.7 % (STOPP) of participants received a PIM at baseline, and PPO prevalence ranged from 38.2 % (START) to 44.8 % (ACOVE indicators), while 36.7 % of participants had both a PIM and PPO. Common criteria were aspirin for primary prevention (19.6 %) and omission of calcium/vitamin D in osteoporosis (14.7 %). Prevalence of PIMs and PPOs increased at follow-up (PIMs range 22-56.1 %, PPOs range 40.5-49.3 %), and this was associated with patient age, female sex, and numbers of medicines and chronic conditions. CONCLUSIONS: Sub-optimal prescribing is common in older patients. Ongoing prescribing review to optimise care is important, particularly as patients get older, receive more medicines or develop more illnesses. %B Eur J Clin Pharmacol %V 71 %P 473-82 %8 04/2015 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/25666030 %N 4 %9 Published Journal Article %& 473 %R 10.1007/s00228-015-1815-1 %0 Journal Article %J BMJ Open %D 2021 %T Integrating clinical pharmacists within general practice: protocol for a pilot cluster randomised controlled trial %A Croke, A %A Moriarty, F %A Boland, F %A McCullagh, L %A Cardwell, K %A Smith, SM %A Clyne, B %B BMJ Open %V 11 %8 03/2021 %G eng %R http://dx.doi.org/10.1136/bmjopen-2020-041541 %0 Journal Article %J BJGP Open %D 2021 %T GPs’ perceptions of their relationship with the pharmaceutical industry: a qualitative study %A Larkin, J %A Pericin, I %A Collins, M %A Smith, SM %A Byrne, D %A Moriarty, F %B BJGP Open %V 5 %8 10/2021 %G eng %N 5 %R https://doi.org/10.3399/BJGPO.2021.0057 %0 Journal Article %J Age and Aging %D 2021 %T Factors associated with initiation of bone-health medication among older adults in primary care in Ireland %A Walsh, M %A Nerdrum, M %A Fahey, T %A Moriarty, F %B Age and Aging %8 03/2021 %G eng %U https://academic.oup.com/ageing/advance-article/doi/10.1093/ageing/afab033/6161551?guestAccessKey=fe9828a3-cb6c-4ce3-89f0-19435e846e37 %R https://doi.org/10.1093/ageing/afab033/ %0 Journal Article %J HRB Open Research %D 2021 %T Efficacy and safety of sacubitril/valsartan in the treatment of heart failure: protocol for a systematic review incorporating unpublished clinical study reports [version 2; peer review: 3 approved]. %A Byrne, D %A Fahey, T %A Moriarty, F %B HRB Open Research %V 3:5 %8 04/2021 %G eng %R https://doi.org/10.12688/hrbopenres.12951.2 %0 Journal Article %J HRB Open Research %D 2020 %T The effectiveness of integrating clinical pharmacists within general practice to optimise prescribing and health outcomes in primary care patients with polypharmacy: A protocol for a systematic review [version 2; peer review: 2 approved]. %A Croke, A %A James, O %A Clyne, B %A Moriarty, F %A Cardwell, K %A Smith, SM %B HRB Open Research %V 2:32 %8 03/2020 %G eng %R https://doi.org/10.12688/hrbopenres.12966.2 %0 Journal Article %J British Journal of Clinical Pharmacology %D 2020 %T Cognitive decline associated with anticholinergics, benzodiazepines and Z-drugs: Findings from The Irish Longitudinal Study on Ageing (TILDA) %A Moriarty, F %A Savva, GM %A Grossi, CM %A Bennett, K %A Fox, C %A Maidment, I %A Loke, YK %A Steel, N %A Kenny, RA %A Richardson, K %B British Journal of Clinical Pharmacology %8 12/2020 %G eng %R www.doi.org/10.1111/bcp.14687 %0 Journal Article %J Preventative Medicine %D 2021 %T Aspirin prescribing for cardiovascular disease in middle-aged and older adults in Ireland: Findings from The Irish Longitudinal Study on Ageing %A Moriarty, F %A Barry, A %A Kenny, RA %A Fahey, T %B Preventative Medicine %8 03/2021 %G eng %R https://doi.org/10.1016/j.ypmed.2021.106504 %0 Generic %D 2015 %T Prevalence of potentially inappropriate medicines and potential prescribing omissions over time in cohort of a community-dwelling older people. All Ireland Pharmacy Conference January 2015 %A Moriarty, F %A Bennett, K %A Fahey, T %A Kenny, RA %A Cahir, C %K community-dwelling older people %K Potential prescribing omissions %K potentially inappropriate medicines %G eng %U http://www.hrbcentreprimarycare.ie/ppt/FMoriarty AIPC Poster.pdf %0 Generic %D 2013 %T Potentially inappropriate prescribing and its association with Instrumental Activities of Daily Living (IADL) impairment in older people. Society for Pharmacoeconomics and Outcomes Research (ISPOR), 16th Annual European Congress, Dublin, November 2013 (Be %A Moriarty, F %A Cahir, C %A Fahey, T %A Bennett, K %X Award for Best Student Poster Research Presentation at ISPOR 2013 %G eng %U http://www.hrbcentreprimarycare.ie/ppt/FMoriartyIADL.pdf %0 Generic %D 2014 %T Potentially inappropriate prescribing and its association with Instrumental Activities of Daily Living (IADL) impairment in older people. AUDGPI Cork 6-7 March 2014 %A Moriarty, F %A Cahir, C %A Fahey, T %A Bennett, K %G eng %U http://www.hrbcentreprimarycare.ie/ppt/FMoriartyIADL.pdf %0 Generic %D 2013 %T Potentially inappropriate prescribing and adverse health outcomes in community dwelling older populations. TILDA Scientific Advisory Board Meeting 16 May 2013, Trinity College, Dublin %A Moriarty, F %A Cahir, C %A Richardson, Kathryn %A Fahey, T %A Kenny, RA %A Bennett, K %G eng %U http://www.hrbcentreprimarycare.ie/ppt/PIPHealthOutcomesTILDA.pdf %0 Generic %D 2014 %T Potentially inappropriate medicines and potential prescribing omissions in older people and their association with health care utilization: a retrospective cohort study. ISPOR, 17th Annual European Congress, Amsterdam, November 2014. %A Moriarty, F %A Cahir, C %A Fahey, T %A Bennett, K %X Award for Best Student Poster Research Presentation at ISPOR 2014 %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Poster FMoriarty PIP Healthcare Utilization.pdf %0 Generic %D 2022 %T What is the impact of multimorbidity on out-of-pocket healthcare expenditure among community-dwelling older adults in Ireland? A cross-sectional study. Rural WONCA, University of Limerick, June 2022 %A Larkin, J %A Walsh, B %A Moriarty, F %A Clyne, B %A Harrington, P %A Smith, SM %G eng %0 Generic %D 2022 %T What is the impact of multimorbidity on out-of-pocket healthcare expenditure among community-dwelling older adults in Ireland? A cross-sectional study. SAPC ASM, University of Central Lancashire, July 2022 %A Larkin, J %A Walsh, B %A Moriarty, F %A Clyne, B %A Harrington, P %A Smith, SM %G eng %0 Generic %D 2015 %T Trends in polypharmacy and prescribing appropriateness from 1997 to 2012. Health Services Research and Pharmacy Practice (HSRPP) Conference, Belfast, 16/17th April 2015. Frank Moriarty Awarded Best Oral Presentation %A Moriarty, F %A Hardy, C %A Bennett, K %A Smith, SM %A Fahey, T %G eng %0 Generic %D 2015 %T Trends and interaction of potentially inappropriate prescribing and polypharmacy over 15 years in Ireland: a repeated cross-sectional study. Society for Social Medicine 59th Annual Scientific Meeting 2-4th September 2015 %A Moriarty, F %A Hardy, C %A Bennett, K %A Smith, SM %A Fahey, T %G eng %0 Generic %D 2015 %T The rise and fall of potentially inappropriate prescribing: trends and interaction with polypharmacy over 15 years in Ireland. Society for Academic Primary Care 44th Annual Conference, University of Oxford, 8th July 2015 %A Moriarty, F %A Hardy, C %A Bennett, K %A Smith, SM %A Fahey, T %G eng %0 Generic %D 2016 %T Potentially inappropriate prescribing (PIP) in two populations with differing socio-economic profiles: a cross-sectional database study using the PROMPT criteria. SPHeRE conference, RCSI, 29 February 2016 2016. %A Moriarty, F %A Cooper, J %A Bennett, K %A Cahir, C %A Hughes, CM %A Fahey, T %G eng %0 Generic %D 2015 %T Potentially inappropriate prescribing in a middle-aged population: a cross-sectional study in Northern Ireland using the Enhanced Prescribing Database. Health Services Research & Pharmacy Practice Conference April 2015 %A Cooper, J %A Moriarty, F %A Ryan, C %A Smith, SM %A Wallace, E %A Bennett, K %A Cahir, C %A Williams, David %A Teeling, Mary %A Fahey, T %A Hughes, CM %G eng %0 Generic %D 2016 %T Potentially inappropriate prescribing and healthcare utilisation in older people: a cohort study using marginal structural models. Health Services Research & Pharmacy Practice (HSRPP) conference, University of Reading, 7-8 April 2016. %A Moriarty, F %A Bennett, K %A Cahir, C %A Kenny, RA %A Fahey, T %G eng %0 Generic %D 2014 %T Potentially Inappropriate Prescribing - a good barometer of Medication Safety? 28 June 2014 Royal Marine, Hotel Dun Laoghaire %A Moriarty, F %G eng %U http://www.hrbcentreprimarycare.ie/ppt/FMoriarty Med Errors Conf 26062014.pdf %0 Generic %D 2014 %T Potentially inappropriate medicines and potential prescribing omissions in older people and their association with healthcare utilization: a retrospective cohort study NAPCRG New York 21-24 Nov 2014 %A Moriarty, F %A Fahey, T %A Cahir, C %A Bennett, K %G eng %0 Generic %D 2014 %T Potentially inappropriate medicines and potential prescribing omissions in older people Prevalence and association with healthcare use 22nd April 2014 St James’s %A Moriarty, F %G eng %U http://www.hrbcentreprimarycare.ie/ppt/FrankM St James's seminar.pdf %0 Generic %D 2021 %T Integrating clinical pharmacists within general practice: protocol for a pilot cluster randomised controlled trial. Oral presentation at Annual Joint Scientific Meeting of the AUDGPI and ICGP (Virtual) Conference. March 2021 %A Croke, A %A Moriarty, F %A Boland, F %A McCullagh, L %A Cardwell, K %A Smith, SM %A Clyne, B %G eng %0 Generic %D 2016 %T How does potentially inappropriate prescribing measured by STOPP and START relate to healthcare utilisation in older people? A cohort study. SAPC 6th -8th of July 2016 Dublin Castle/RCSI. (Elevator Pitch) %A Moriarty, F %A Bennett, K %A Cahir, C %A Kenny, RA %A Fahey, T %G eng %0 Generic %D 2021 %T GPs’ perceptions of their relationship with the pharmaceutical industry: a qualitative study. Oral presentation at Annual Joint Scientific Meeting of the AUDGPI and ICGP (Virtual).Conference. March 2021 %A Larkin, J %A Pericin, I %A Collins, M %A Smith, SM %A Byrne, D %A Moriarty, F %G eng %0 Generic %D 2015 %T Determining the Relationship between Potentially Inappropriate Medications and Quality of Life in a Cohort of Older People. SPHeRE Conference, RCSI Dublin, January 2015 %A Moriarty, F %A Bennett, K %A Cahir, C %A Kenny, RA %A Fahey, T %G eng %0 Generic %D 2015 %T Determining the relationship between potentially inappropriate medications and quality of life in a cohort of older people.IAGG-ER Congress 2015, Dublin %A Moriarty, F %A Bennett, K %A Cahir, C %A Kenny, RA %A Fahey, T %G eng %0 Generic %D 2022 %T Clinical Study Reports published by the European Medicines Agency 2016-2018: A cross-sectional analysis. Presented by David Byrne at EBM Live, Oxford July 2022 %A Byrne, D %A Prendergast, C %A Fahey, T %A Moriarty, F %G eng %0 Generic %D 2016 %T Potentially inappropriate prescribing: tools, trends and a target for medicines optimisation. 4th National Medicines Forum, Royal College of Physicians of Ireland, 16 May 2016 %A Moriarty, F %G eng