%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 J Am Geriatr Soc %D 2013 %T A systematic review of the probability of repeated admission score in community-dwelling adults %A Wallace, E %A Hinchey, T %A Dimitrov, B %A Bennett, K %A Fahey, T %A Smith, SM %K Aged %K Aged, 80 and over %K Brazil %K Calibration %K Decision Support Techniques %K Europe %K Female %K Health Care Costs %K Health Services for the Aged %K Humans %K Male %K Mortality %K Patient Readmission %K Probability %K Reproducibility of Results %K Risk Assessment %K Sensitivity and Specificity %K United States %K Validation Studies as Topic %X OBJECTIVES: To perform a systematic review of the Probability of Repeated Admission (Pra) score in community-dwelling adults to assess its performance in a range of validation studies in the community setting. DESIGN: Systematic review and meta-analysis. SETTING: Primary and community care. PARTICIPANTS: Community-dwelling older people. MEASUREMENTS: The primary outcome was hospital admission; secondary outcomes were mortality, hospital days, functional decline, other health service use, and costs. RESULTS: Nine validation studies describing 11 cohorts of individuals aged 65 and older were identified. A metaanalysis of the Pra score in five cohorts (8,843 individuals) with comparable and available data revealed good discrimination performance (summary area under the receiver operating characteristic curve 69.7% (standard error 2.8%)). Pooled specificity was high (96%, 95% confidence interval (CI)=95.8–96.7%), indicating that a Pra score of 0.5 or greater effectively rules in the likelihood of admission, but pooled sensitivity was low (12%, 95% CI=10.5–13.6%). Calibration performance was good, with an overall risk ratio of 1.12 (95% CI=0.89–1.42), indicating that the Pra score reliably predicted hospital admissions. CONCLUSION: The Pra score performs well in predicting hospital admission in community-dwelling adults categorized as high risk according to the score. This tool has clinical and healthcare policy utility in terms of targeting elderly people at highest risk of hospital admission, but the low pooled sensitivity of the score indicates that it is not a reliable way of excluding hospital admission in those stratified as low risk. %B J Am Geriatr Soc %V 61 %P 357-64 %8 2013 Mar %G eng %U http://onlinelibrary.wiley.com/doi/10.1111/jgs.12150/abstract %N 3 %R 10.1111/jgs.12150 %0 Journal Article %J Med Care %D 2014 %T Risk prediction models to predict emergency hospital admission in community-dwelling adults. A systematic review %A Wallace, E %A Stuart, Ellen %A Vaughan, Niall %A Bennett, K %A Fahey, T %A Smith, SM %K community-dwelling adults %K emergency hospital admission %K risk prediction model %X Abstract BACKGROUND: Risk prediction models have been developed to identify those at increased risk for emergency admissions, which could facilitate targeted interventions in primary care to prevent these events. OBJECTIVE: Systematic review of validated risk prediction models for predicting emergency hospital admissions in community-dwelling adults. METHODS: A systematic literature review and narrative analysis was conducted. Inclusion criteria were as follows; POPULATION: community-dwelling adults (aged 18 years and above); Risk: risk prediction models, not contingent on an index hospital admission, with a derivation and ≥1 validation cohort; PRIMARY OUTCOME: emergency hospital admission (defined as unplanned overnight stay in hospital); STUDY DESIGN: retrospective or prospective cohort studies. RESULTS: Of 18,983 records reviewed, 27 unique risk prediction models met the inclusion criteria. Eleven were developed in the United States, 11 in the United Kingdom, 3 in Italy, 1 in Spain, and 1 in Canada. Nine models were derived using self-report data, and the remainder (n=18) used routine administrative or clinical record data. Total study sample sizes ranged from 96 to 4.7 million participants. Predictor variables most frequently included in models were: (1) named medical diagnoses (n=23); (2) age (n=23); (3) prior emergency admission (n=22); and (4) sex (n=18). Eleven models included nonmedical factors, such as functional status and social supports. Regarding predictive accuracy, models developed using administrative or clinical record data tended to perform better than those developed using self-report data (c statistics 0.63-0.83 vs. 0.61-0.74, respectively). Six models reported c statistics of >0.8, indicating good performance. All 6 included variables for prior health care utilization, multimorbidity or polypharmacy, and named medical diagnoses or prescribed medications. Three predicted admissions regarded as being ambulatory care sensitive. CONCLUSIONS: This study suggests that risk models developed using administrative or clinical record data tend to perform better. In applying a risk prediction model to a new population, careful consideration needs to be given to the purpose of its use and local factors. %B Med Care %V 52 %8 08/2014 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/25023919 %N 8 %9 Published Article Journal %& 751-65 %R 10.1097/MLR.0000000000000171 %0 Journal Article %J BMC Pediatrics %D 2015 %T Psychostimulant prescribing trends in a paediatric population in Ireland: a national cohort study %A Boland, F %A Galvin, R %A Reulbach, U %A Motterlini, N %A Kelly, D %A Bennett, K %A Fahey, T %K ADHD %K children %K pharmacoepidemiology %K Psychostimulant treatment %X Background: Psychotropic paediatric prescribing trends are increasing internationally. The aim of this study is to examine the prevalence and secular trends in psychotropic prescribing in Irish children and adolescents between 2002 and 2011. Methods: Data was obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive Primary Care Reimbursement Services (HSE-PCRS). Prescribing rates per 1000 eligible population and associated 95 % confidence intervals (CIs) were calculated across years (2002–2011), age groups (0–4, 5–11, 12–15 years) and gender. Rates of concomitant prescriptions for psycholeptics and antidepressants were also examined. The total expenditure costs were calculated and expressed as a percentage of the cost of all prescriptions for this age group (≤15 years). Results: In 2002, 3.77/1000 GMS population (95 % CI: 3.53–4.01) received at least one psychostimulant prescription and this rate increased to 8.63/1000 GMS population (95 % CI: 8.34–8.92) in 2011. Methylphenidate was the most frequently prescribed psychostimulant. For both males and females the prevalence of medication use was highest among the 12–15 year old group. On average, a psycholeptic medication was prescribed to 8 % of all psychostimulant users and an antidepressant was concomitantly prescribed on average to 2 %. Total expenditure rose from €89,254 in 2002 to €1,532,016 in 2011. Conclusions: The rate and cost of psychostimulant prescribing among GMS children and adolescents in Ireland increased significantly between 2002 and 2011. Further research is necessary to assess the safety, efficacy and economic impact of concomitant psychotropic prescribing in this population. %B BMC Pediatrics %V 15 %8 09/2015 %G eng %U http://www.biomedcentral.com/1471-2431/15/118 %N 118 %R DOI 10.1186/s12887-015-0435-3 %0 Journal Article %J BMC Health Services Research %D 2012 %T Proton pump inhibitors: potential cost reductions by applying prescribing guidelines %A Cahir, C %A Fahey, T %A Tilson, L %A Teljeur, C %A Bennett, K %K Cost-effective %K Generic %K Guidelines %K Proton pump inhibitors %X Background There are concerns that proton pump inhibitors (PPI) are being over prescribed in both primary and secondary care. This study aims to establish potential cost savings in a community drug scheme for a one year period according to published clinical and cost-effective guidelines for PPI prescribing. Methods Retrospective population-based cohort study in the Republic of Ireland using the Health Services Executive (HSE) Primary Care Reimbursement Services (PCRS) pharmacy claims database. The HSE-PCRS scheme is means tested and provides free health care including medications to approximately 30% of the Irish population. Prescription items are WHO ATC coded and details of every drug dispensed and claimants’ demographic data are available. Potential cost savings (net ingredient cost) were estimated according to UK NICE clinical guidelines for all HSE-PCRS claimants on PPI therapy for ≥3 consecutive months starting in 2007 with a one year follow up (n=167,747). Five scenarios were evaluated; (i) change to PPI initiation (cheapest brand); and after 3 months (ii) therapeutic switching (cheaper brand/generic equivalent); (iii) dose reduction (maintenance therapy); (iv) therapeutic switching and dose reduction and (v) therapeutic substitution (H2 antagonist). Results Total net ingredient cost was €88,153,174 for claimants on PPI therapy during 2007. The estimated costing savings for each of the five scenarios in a one year period were: (i) €36,943,348 (42% reduction); (ii) €29,568,475 (34%); (iii) €21,289,322 (24%); (iv) €40,505,013 (46%); (v) €34,991,569 (40%). Conclusion There are opportunities for substantial cost savings in relation to PPI prescribing if implementation of clinical guidelines in terms of generic substitution and step-down therapy is implemented on a national basis. %B BMC Health Services Research %V 12 %P 408 %8 11/2012 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/23163956 %N 1 %R doi:10.1186/1472-6963-12-408 %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 BMJ Qual Saf %D 2011 %T Prevalence and outcomes of use of potentially inappropriate medicines in older people: cohort study stratified by residence in nursing home or in the community %A Barnett, K %A McCowan, Colin %A Evans, J M M %A Gillespie, N D %A Davey, P G %A Fahey, T %K Age Factors %K Aged %K Aged, 80 and over %K Cohort Studies %K Drug Utilization %K Female %K Humans %K Independent Living %K Male %K Medication Errors %K Nursing Homes %K Polypharmacy %K Prescription Drugs %K Prevalence %K Scotland %K Sex Factors %X OBJECTIVES: To compare the prevalence of use of potentially inappropriate medicines (PIMs) between older patients living in their own homes versus those living in nursing or residential homes, and to test the association between exposure to PIMs and mortality. DESIGN: Cohort study stratified by place of residence. SETTING: Tayside, Scotland. PARTICIPANTS: All people aged between 66 and 99 years who were resident or died in Tayside from 2005 to 2006. MAIN OUTCOME MEASURES: The exposure variable was PIM use as defined by Beers' Criteria. All cause mortality was the main outcome measure. RESULTS: 70,299 people were enrolled in the cohort of whom 96% were exposed to any medicine and 31% received a PIM. Place of residence was not associated with overall risk of receiving PIMs, adjusted OR 0.94, 95% CI 0.87 to 1.01. Exposure to five of the PIMs (including long-acting benzodiazepines) was significantly higher in nursing homes whereas exposure to five other PIMs (including amitriptyline and NSAIDs) was significantly lower. Exposure to PIMs was similar (20-46%) across all 71 general practices in Tayside and was not associated with increased risk of mortality after adjustment for age, gender and polypharmacy (adjusted OR 0.98, 95% CI 0.92 to 1.05). CONCLUSIONS: The authors question the validity of the full list of PIMs as an indicator of safety of medicines in older people because one-third of the population is exposed with little practice variation and no significant impact on mortality. Future studies should focus on management of a shorter list of genuinely high-risk medicines. %B BMJ Qual Saf %V 20 %P 275-81 %8 2011 Mar %G eng %U http://qualitysafety.bmj.com/content/20/3/275.full %N 3 %R 10.1136/bmjqs.2009.039818 %0 Journal Article %J BMC Complementary & Alternative Medicine %D 2013 %T Prescribing patterns of glucosamine in an older population: a national cohort study %A Galvin, R %A Cousins, G %A Boland, F %A Motterlini, N %A Bennett, K %A Fahey, T %K Cost-effectiveness %K Glucosamine %K Osteoarthritis %X Background: Glucosamine is commonly prescribed as a disease modulating agent in osteoarthritis. However, the evidence to date suggests that it has a limited impact on the clinical symptoms of the disease including joint pain, radiological progression, function and quality of life. The aim of this study was to examine the prescribing patterns of glucosamine from 2002–2011 in an elderly Irish national population cohort using data from the Health Service Executive Primary Care Reimbursement (HSE-PCRS) General medical services (GMS) Scheme. Methods: Patients aged ≥ 70 years on the HSE-PCRS pharmacy claims database between January 2002 and December 2011 were included. ATC code M01AX05 (glucosamine) was extracted. Prevalence rates per 1000 eligible population with 95% confidence intervals were calculated for all years and age groups (70–74 years, ≥75 years). A negative binomial regression analysis was used to determine longitudinal usage trends and compare prevalence rates across years, sex and age groups. Results: The annual patient rate of glucosamine prescribing increased significantly from 13.0/1000 eligible population (95% CI 12.6-13.4) in 2002 to 68.7/1000 population (95% CI 67.8-69.5) in 2009 before decreasing to 62.4/1000 population (95% CI 61.6-63.2) in 2011. The rate of prescribing of glucosamine varied with sex, with women receiving significantly more prescriptions than men. The cost of glucosamine also increased from 2002–2008. In 2008 total expenditure reached a high of €4.6 million before decreasing to €2.6 million in 2011. Conclusion: The national trend in prescribing of glucosamine increased significantly from 2002 to 2009 before decreasing in 2010 and 2011, in keeping with current international guidelines. There is a need for awareness among healthcare professionals and patients alike of the best available evidence to inform decision making relating to theprescription and consumption of such supplements. %B BMC Complementary & Alternative Medicine %V 13 %8 11/2013 %G eng %U http://www.biomedcentral.com/content/pdf/1472-6882-13-316.pdf %9 Published Article Journal %& 316 %R 10.1186/1472-6882-13-316 %0 Journal Article %J BMC Family Practice %D 2014 %T Prescriber variation in potentially inappropriate prescribing in older populations in Ireland %A Cahir, C %A Fahey, T %A Teljeur, C %A Bennett, K %K General Practice %K older populations %K potentially inappropriate prescribing %K Prescriber variation %K STOPP %X Abstract Background Health care policy-makers look for prescribing indicators at the population level to evaluate the performance of prescribers, improve quality and control drug costs. The aim of this research was to; (i) estimate the level of variation in potentially inappropriate prescribing (PIP) across prescribers in the national Irish older population using the STOPP criteria; (ii) estimate how reliably the criteria could distinguish between prescribers in terms of their proportion of PIP and; (iii) examine how PIP varies between prescribers and by patient and prescriber characteristics in a multilevel regression model. Methods 1,938 general practitioners (GPs) with 338,375 registered patients’ ≥70 years were extracted from the Health Service Executive Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database. HSE-PCRS prescriptions are WHO ATC coded. Demographic data for claimants’ and prescribers’ are available. Thirty STOPP indicators were applied to prescription claims in 2007. Multilevel logistic regression examined how PIP varied between prescribers and by individual patient and prescriber level variables. Results The unadjusted variation in PIP between prescribers was considerable (median 35%, IQR 30-40%). The STOPP criteria were reliable measures of PIP (average >0.8 reliability). The multilevel regression models found that only the patient level variable, number of different repeat drug classes was strongly associated with PIP (>2 drugs v none; adjusted OR, 4.0; 95% CI 3.7, 4.3). After adjustment for patient level variables the proportion of PIP varied fourfold (0.5 to 2 times the expected proportion) between prescribers but the majority of this variation was not significant. Conclusion PIP is of concern for all prescribers. Interventions aimed at enhancing appropriateness of prescribing should target patients taking multiple medications. %B BMC Family Practice %V 15 %8 04/2014 %G eng %U http://www.biomedcentral.com/1471-2296/15/59 %N 59 %9 Published Journal Article %R 10.1186/1471-2296-15-59 %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 Br J Clin Pharmacol %D 2010 %T Potentially inappropriate prescribing and cost outcomes for older people: a national population study %A Cahir, C %A Fahey, T %A Teeling, Mary %A Teljeur, C %A Feely, John %A Bennett, K %K Aged %K Aged, 80 and over %K Cohort Studies %K Costs and Cost Analysis %K Drug Prescriptions %K Female %K Humans %K Inappropriate Prescribing %K Ireland %K Male %K Medication Errors %K Polypharmacy %K Treatment Outcome %X AIMS: Optimization of drug prescribing in older populations is a priority due to the significant clinical and economic costs of drug-related illness. This study aimed to: (i) estimate the prevalence of potentially inappropriate prescribing (PIP) in a national Irish older population using European specific explicit prescribing criteria; (ii) investigate the association between PIP, number of drug classes, gender and age and; (iii) establish the total cost of PIP. METHODS: This was a retrospective national population study (n= 338 801) using the Health Service Executive Primary Care Reimbursement Service (HSE-PCRS) pharmacy claims database. The HSE-PCRS uses the WHO Anatomical Therapeutic Chemical (ATC) classification system and details of every drug dispensed and claimants' demographic data are available. Thirty PIP indicators (STOPP) were applied to prescription claims for those >or=70 years in Ireland in 2007. STOPP is a physiological system based screening tool of older persons' potentially inappropriate prescriptions assessing drug-drug and drug-disease interactions, dose and duration. RESULTS: In our study population PIP prevalence was 36% (121 454 claimants). The main contributors to this were: 56 560 (17%) prescribed proton pump inhibitors at maximum therapeutic dose for >8 weeks, 29 691 (9%) prescribed non-steroidal anti-inflammatories for >3 months, 17 676 (5%) prescribed long-acting benzodiazepines for >1 month and 16 201 (5%) prescribed duplicate drugs. The main determinant of PIP was polypharmacy. The likelihood of PIP increased with a significant linear and quadratic trend (P < 0.0001) with the number of drug classes.The maximum net ingredient cost of PIP was estimated to be euro38 664 640. Total PIP expenditure was estimated to be euro45 631 319, 9% of the overall expenditure on pharmaceuticals in those >or=70 years in 2007. CONCLUSIONS: The findings identify a high prevalence of PIP in Ireland with significant cost consequences. %B Br J Clin Pharmacol %V 69 %P 543-52 %8 2010 May %G eng %U http://onlinelibrary.wiley.com/doi/10.1111/j.1365-2125.2010.03628.x/abstract %N 5 %R 10.1111/j.1365-2125.2010.03628.x %0 Journal Article %J Eur J Clin Pharmacol %D 2012 %T Potentially inappropriate prescribing and cost outcomes for older people: a cross-sectional study using the Northern Ireland Enhanced Prescribing Database %A Bradley, MC %A Fahey, T %A Cahir, C %A Bennett, K %A O'Reilly, Dermot %A Parsons, Carole %A Hughes, CM %K older people %K potentially inappropriate prescribing %K Quality Cost %K STOPP %X PURPOSE: We sought to estimate the prevalence of potentially inappropriate prescribing (PIP) in the Northern Ireland (NI) population aged ≥70 years, to investigate factors associated with PIP and to calculate total gross cost of PIP. METHODS: A retrospective cross-sectional population study was carried out in those aged ≥70 years in 2009/2010 who were in primary care in NI. Data were extracted from the Enhanced Prescribing Database, which provides details of prescribed and dispensed medications for each individual registered with a general practitioner. Twenty-eight PIP indicators from the Screening Tool of Older Persons potentially inappropriate Prescriptions (STOPP) criteria were applied to these data. PIP prevalence according to individual STOPP criteria and the overall prevalence of PIP were estimated. The relationship between PIP and polypharmacy, age and gender was examined using logistic regression. Gross cost of PIP was ascertained. RESULTS: The overall prevalence of PIP in the study population (n = 166,108) was 34 %. The most common examples of PIP identified were proton pump inhibitors at maximum therapeutic dose for >8 weeks (17,931 patients, 11 %), non-steroidal anti-inflammatory drugs >3 months (14,545 patients, 9 %) and long-term long-acting benzodiazepines (10,147 patients, 6 %). PIP was strongly associated with polypharmacy, with those receiving seven different medications being fivefold more likely to be exposed to PIP than those on zero to three medications (odds ratio 5.04, 95 % confidence interval 4.84-5.25) The gross cost of PIP was estimated to be 6,098,419 CONCLUSIONS: Consistent with other research, the prevalence of PIP was high among the study cohort, increased with polypharmacy and was associated with significant cost. %B Eur J Clin Pharmacol %V 68 %P 1425-33 %8 2012 Oct %G eng %U http://link.springer.com/article/10.1007%2Fs00228-012-1249-y %N 10 %R 10.1007/s00228-012-1249-y %0 Journal Article %J Br J Clin Pharmacol %D 2014 %T Potentially inappropriate prescribing and adverse health outcomes in community dwelling older patients %A Cahir, C %A Bennett, K %A Teljeur, C %A Fahey, T %K adverse drug events %K health care use %K HRQOL %K older populations %K potentially inappropriate prescribing %K STOPP %X Abstract AIMS: This study aimed to determine the association between potentially inappropriate prescribing (PIP) and health related outcomes [adverse drug events (ADEs), health related quality of life (HRQOL) and hospital accident and emergency (A&E) visits] in older community dwelling patients. METHODS: 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 Screening Tool of Older Person's Prescriptions (STOPP). ADEs were measured by patient self-report and medical record for the previous 6 months and reviewed by two independent clinicians. HRQOL was measured by the EQ-5D. A&E visits were measured by patients' medical records and self-report. Multilevel logistic, linear and Poisson regression examined how ADEs, HRQOL and A&E visits varied by PIP after adjusting for patient and practice level covariates: socioeconomic status, co-morbidity, number of drug classes and adherence. RESULTS: The overall prevalence of PIP was 42% (n = 377). Patients with ≥2 PIP indicators were twice as likely to have an ADE (adjusted OR 2.21; 95% CI 1.02, 4.83, P < 0.05), have a significantly lower mean HRQOL utility (adjusted coefficient -0.09, SE 0.02, P < 0.001) and nearly a two-fold increased risk in the expected rate of A&E visits (adjusted IRR 1.85; 95% CI 1.32, 2.58, P < 0.001). The number of drug classes and adherence were also significantly associated with these same adverse health outcomes. CONCLUSIONS: Reducing PIP in primary care may help lower the burden of ADEs, its associated health care use and costs and enhance quality of life in older patients. %B Br J Clin Pharmacol %V 77 %P 201-210 %8 01/2014 %G eng %U http://onlinelibrary.wiley.com/doi/10.1111/bcp.12161/abstract %N 1 %& 201 %R doi: 10.1111/bcp.12161 %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 Age Aging %D 2014 %T Inappropriate prescribing in older fallers presenting to an Irish Emergency Department %A Mc Mahon, CG %A Cahir, C %A Kenny, RA %A Bennett, K %K falls %K older people %K potentially inappropriate prescribing %X Abstract BACKGROUND: certain medications increase falls risk in older people. OBJECTIVE: to assess if prescribing modification occurs in older falls presenting to an emergency department (ED). DESIGN: before-and-after design: presentation to ED with a fall as the index event. SUBJECTS: over 70's who presented to ED with a fall over a 4-year period. METHODS: dispensed medication in the 12 months pre- and post-fall was identified using a primary care reimbursement services pharmacy claims database. Screening Tool of Older Person's PIP (STOPP) and Beers prescribing criteria were applied to identify potentially inappropriate prescribing (PIP). Polypharmacy was defined as four or more regular medicines. Psychotropic medication was identified using the WHO Anatomical Therapeutic Chemical classification system. Changes in prescribing were compared using McNemar's test (significance P < 0.05). RESULTS: One thousand sixteen patients were eligible for analysis; 53.1% had at least one STOPP criteria pre-fall with no change post-fall (53.7%, P = 0.64). Beers criteria were identified in 44.0% pre-fall, with no change post-fall (41.5%, P = 0.125). The most significant individual indicators to change were neuroleptics, which decreased from 17.5 to 14.7% (P = 0.02) and long-acting benzodiazepines decreased from 10.7 to 8.6% (P = 0.005). Polypharmacy was observed in 63% and was strongly predictive of PIP, OR 4.0 (95% CI 3.0, 5.32). A high prevalence of psychotropic medication was identified pre-fall: anxiolytics (15.7%), antidepressants (26%), hypnosedatives (30%). New initiation of anxiolytics and hypnosedatives occurred in 9-15%, respectively, post-fall. CONCLUSION: a significant prevalence of PIP was observed in older fallers presenting to the ED. No substantial improvements in PIP occurred in the 12 months post-fall, suggesting the need for focused intervention studies to be undertaken in this area. %B Age Aging %V 43 %P 44-5 %8 01/2014 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/23927888 %N 1 %& 44 %R doi: 10.1093/ageing/aft114 %0 Journal Article %J J Gerontol A Biol Sci Med Sci %D 2016 %T Impact of Potentially Inappropriate Prescribing on Adverse Drug Events, Health Related Quality of Life and Emergency Hospital Attendance in Older People Attending General Practice: A Prospective Cohort Study %A Wallace, E %A McDowell, R %A Bennett, K %A Fahey, T %A Smith, SM %B J Gerontol A Biol Sci Med Sci %8 2016 %G eng %R 10.1093/gerona/glw140 %0 Journal Article %J BMC Health Services Research %D 2014 %T The development of the PROMPT (PRescribing Optimally in Middle-aged People’s Treatments) criteria %A Cooper, J %A Ryan, C %A Smith, SM %A Wallace, E %A Bennett, K %A Cahir, C %A Williams, David %A Teeling, Mary %A Hughes, CM %A PROMPT Steering Group %K Delphi technique %K Explicit criteria %K Middle-age %K multimorbidity %K Polypharmacy %K potentially inappropriate prescribing %X Abstract Background Whilst multimorbidity is more prevalent with increasing age, approximately 30% of middle-aged adults (45–64 years) are also affected. Several prescribing criteria have been developed to optimise medication use in older people (≥65 years) with little focus on potentially inappropriate prescribing (PIP) in middle-aged adults. We have developed a set of explicit prescribing criteria called PROMPT (PRescribing Optimally in Middle-aged People’s Treatments) which may be applied to prescribing datasets to determine the prevalence of PIP in this age-group. Methods A literature search was conducted to identify published prescribing criteria for all age groups, with the Project Steering Group (convened for this study) adding further criteria for consideration, all of which were reviewed for relevance to middle-aged adults. These criteria underwent a two-round Delphi process, using an expert panel consisting of general practitioners, pharmacists and clinical pharmacologists from the United Kingdom and Republic of Ireland. Using web-based questionnaires, 17 panellists were asked to indicate their level of agreement with each criterion via a 5-point Likert scale (1 = Strongly Disagree, 5 = Strongly Agree) to assess the applicability to middle-aged adults in the absence of clinical information. Criteria were accepted/rejected/revised dependent on the panel’s level of agreement using the median response/interquartile range and additional comments. Results Thirty-four criteria were rated in the first round of this exercise and consensus was achieved on 17 criteria which were accepted into the PROMPT criteria. Consensus was not reached on the remaining 17, and six criteria were removed following a review of the additional comments. The second round of this exercise focused on the remaining 11 criteria, some of which were revised following the first exercise. Five criteria were accepted from the second round, providing a final list of 22 criteria [gastro-intestinal system (n = 3), cardiovascular system (n = 4), respiratory system (n = 4), central nervous system (n = 6), infections (n = 1), endocrine system (n = 1), musculoskeletal system (n = 2), duplicates (n = 1)]. Conclusions PROMPT is the first set of prescribing criteria developed for use in middle-aged adults. The utility of these criteria will be tested in future studies using prescribing datasets. Keywords: Potentially inappropriate prescribing; Explicit criteria; Delphi technique; Middle-age; Polypharmacy; Multimorbidity %B BMC Health Services Research %V 14 %8 11/2014 %G eng %U http://www.biomedcentral.com/1472-6963/14/484 %9 Published Article Journal %R 10.1186/s12913-014-0484-6 %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 BMJ Open 2015 %D 2015 %T Benzodiazepine prescribing in children under 15 years of age receiving free medical care on the General Medical Services scheme in Ireland %A O Sullivan, K %A Reulbach, U %A Boland, F %A Moschetti, I %A Kelly, D %A Bennett, K %A Fahey, T %X Objective To examine the prevalence and secular trends in benzodiazepine (BZD) prescribing in the Irish paediatric population. In addition, we examine coprescribing of antiepileptic, antipsychotic, antidepressant and psychostimulants in children receiving BZD drugs and compare BZD prescribing in Ireland to that in other European countries. Setting Data were obtained from the Irish General Medical Services (GMS) scheme pharmacy claims database from the Health Service Executive (HSE)—Primary Care Reimbursement Services (PCRS). Participants Children aged 0–15 years, on the HSE-PCRS database between January 2002 and December 2011, were included. Primary and secondary outcome measures Prescribing rates were reported over time (2002–2011) and duration (≤ or >90 days). Age (0–4, 5–11, 12–15) and gender trends were established. Rates of concomitant prescriptions for antiepileptic, antipsychotics, antidepressants and psychostimulants were reported. European prescribing data were retrieved from the literature. Results Rates decreased from 2002 (8.56/1000 GMS population: 95% CI 8.20 to 8.92) to 2011 (5.33/1000 GMS population: 95% CI 5.10 to 5.55). Of those children currently receiving a BZD prescription, 6% were prescribed BZD for >90 days. Rates were higher for boys in the 0–4 and 5–11 age ranges, whereas for girls they were higher in the 12–15 age groups. A substantial proportion of children receiving BZD drugs are also prescribed antiepileptic (27%), antidepressant (11%), antipsychotic (5%) and psychostimulant (2%) medicines. Prescribing rates follow a similar pattern to that in other European countries. Conclusions While BZD prescribing trends have decreased in recent years, this study shows that a significant proportion of the GMS children population are being prescribed BZD in the long term. This study highlights the need for guidelines for BZD prescribing in children in terms of clinical indication and responsibility, coprescribing, dosage and duration of treatment. %B BMJ Open 2015 %V 5 %G eng %U http://bmjopen.bmj.com/content/5/6/e007070.long %N 6 %R 2015;5:e007070 doi:10.1136/bmjopen-2014-007070 %0 Journal Article %J BMC Pediatrics %D 2015 %T Antidepressant prescribing in Irish children:secular trends and international comparison in the context of a safety warning %A O’Sullivan, K %A Boland, F %A Reulbach, U %A Motterlini, N %A Kelly, D %A Bennett, K %A Fahey, T %K Anti-depressants %K children %K Paediatric prescribing %K Safety warning %X Background: In 2003, the Irish Medicines Board (IMB) warned against the treatment of childhood depression with selective serotonin reuptake inhibitors (SSRIs) due to increased risk of suicide. This study examined the effect of this warning on the prevalence of anti-depressants in Irish children and compared age and gender trends and international comparisons of prescription rates. Methods: A retrospective cohort study of the Irish Health Service Executive (HSE) pharmacy claims database for the General Medical Services (GMS) scheme for dispensed medication. Data were obtained for 2002–2011 for those aged ≤15 years. Prevalence of anti-depressants per 1000 eligible population, along with 95 % confidence intervals, were calculated. A negative binomial regression analysis was used to investigate trends and compare rates across years, sex and age groups (0–4, 5–11, 12–15 years). International prescribing data were retrieved from the literature. Results: The prevalence of anti-depressants decreased from 4.74/1000 population (95 % CI: 4.47-5.01) in 2002 to 2.61/1000 population (95 % CI: 2.43-2.80) in 2008. SSRI rates decreased from 2002 to 2008. Prescription rates for contra-indicated SSRIs paroxetine, sertraline and citralopram decreased significantly from 2002 to 2005, and, apart from paroxetine, only small fluctuations were seen from 2005 onwards. Fluoxetine was the most frequently prescribed anti-depressant and rates increased between 2002 and 2011. Anti-depressant rates were higher for younger boys and older girls. The Irish prevalence was lower than the US, similar to the U.K. and higher than Germany and Denmark. Conclusions: The direction and timing of these trends suggest that medical practitioners followed the IMB advice. %B BMC Pediatrics %V 15 %G eng %U http://www.biomedcentral.com/content/pdf/s12887-015-0436-2.pdf %N 119 %R DOI 10.1186/s12887-015-0436-2 %0 Journal Article %J Pharmacoepidemiol Drug Saf %D 2012 %T Antibiotic prescribing trends in a paediatric sub-population in Ireland %A Keogh, C %A Motterlini, N %A Reulbach, U %A Bennett, K %A Fahey, T %K antimicrobial practice %K antimicrobial treatment %K children %K pharmacoepidemiology %X PURPOSE: Little is known about antibiotic prescribing in Irish children. This study aims to examine antibiotic prescribing patterns in Irish children and associated costs and to compare this with European findings. METHODS: A retrospective analysis of the Irish Health Services Executive (HSE) pharmacy claims database 2004-2009 for the General Medical Services (GMS) scheme for dispensed medications. This represents 28% of Irish children but over-represents lower socio-economic groups. Overall prescribing rates were reported over time (2004-2009), age (0-4, 5-11, 12-15 years) and gender. Statistical comparison is made using negative binomial regression. Overall prescribing rates for the most commonly prescribed drugs were calculated. Associated cost of prescribing also was calculated. European prescribing data were retrieved from the literature. RESULTS: Rates remained stable from 2004 (631/1000 GMS population; 95%CI 628-634) to 2009 (621/1000; 95%CI 618-624). An interaction effect emerged between gender and age. Rates were generally higher for girls, except for the boys aged 0-4 years. The preferred choice of agents changed across years, with co-amoxiclav becoming the most prescribed drug in 2009 (308/1000; 95%CI 306-310). The total cost of antibiotics increased from €4.4 million in 2004 to €6.0 million in 2009. Higher overall rates of antibiotic prescribing emerged compared with available European data. Differences were observed between prescribing of some first-line and second-line drugs. CONCLUSIONS: Age and gender trends are consistent with international literature. However, Ireland has higher overall prescribing rates relative to some European countries. This suggests that a quality improvement in prescribing intervention is warranted. Copyright © 2012 John Wiley & Sons, Ltd. %B Pharmacoepidemiol Drug Saf %V 21 %P 945-52 %8 2012 Sep %G eng %U http://onlinelibrary.wiley.com/doi/10.1002/pds.2346/abstract %N 9 %R 10.1002/pds.2346 %0 Journal Article %J European Journal of Emergency Medicine %D 2013 %T Adverse outcomes in older adults attending emergency department: systematic review and meta-analysis of the Triage Risk Stratification Tool. %A Cousins, G %A Bennett, K %A Dillon, Grace %A Smith, SM %A Galvin, R %K Aged %K emergency service %K systematic review %K triage/methods %X Abstract The objective of this study was to assess the predictive ability of the Triage Risk Stratification Tool (TRST) in identifying older adults at risk of adverse outcomes [return to emergency department (ED), hospitalization, or a composite outcome] within 30 and 120 days following discharge from ED. A systematic search was conducted to identify studies validating the TRST in older adults aged at least 65 years discharged from ED. The methodological quality of selected studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. A score of at least 2 was used to identify high-risk patients. A bivariate random effects model was applied to generate pooled estimates of sensitivity and specificity. The discriminative ability of the tool was assessed using the c statistic. Heterogeneity was assessed graphically and statistically using the variance of the logit-transformed sensitivity and specificity. Six studies (3233 patients) were included. With a cutoff of at least 2, the pooled sensitivity of the TRST for a composite outcome at 30 days was 0.58 (95% confidence interval 0.52-0.65), the specificity was 0.61 (95% confidence interval 0.58-0.64). Similar values were obtained for the composite outcome at 120 days and the individual outcomes at both timepoints. The c statistic was consistently low across the outcomes and timepoints. There was little heterogeneity across studies. In conclusion, the TRST is limited in its ability to discriminate between older adults with or without an adverse outcome following discharge from ED. The low levels of heterogeneity gives us confidence that the pooled estimates reflect the predictive ability of the TRST in clinical practice. %B European Journal of Emergency Medicine %V 20 %P 230-9 %8 08/2013 %G eng %U http://www.ncbi.nlm.nih.gov/pubmed/23510897 %N 4 %9 Published Article Journal %& 230 %R 10.1097/MEJ.0b013e3283606ba6 %0 Generic %D 2011 %T Variations in General Practice prescribing patterns in Ireland: preliminary result. Faculty of Public Health Medicine Winter Scientific Meeting 2011, RCPI, 14 December 2011, Dublin %A Motterlini, N %A Dimitrov, B %A Bradley, MC %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Motterlini_Practice%20Variation_Poster%20WSM2011.pdf %0 Generic %D 2016 %T Variation in prescribing of anti-diabetic medications, including newer injectable medications, in Ireland in 2013 and 2014. RCSI Research Day 25th February 2016 %A Murphy, M %A Bennett, K %A Fahey, T %A Smith, SM %G eng %0 Generic %D 2010 %T Trends in Systemic Antibiotic Prescribing for Children in Ireland. 26th International Conference on Pharmacoepidemiology and Therapeutic Risk Management, 19-22 August 2010, ICPE, Brighton UK %A Keogh, C %A Reulbach, U %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Claire%20Keogh_SSM%202010_Antibiotic%20prescring%202004-2009.pdf %0 Generic %D 2013 %T Psychological influences on hormonal therapy medication taking behaviour in women with breast cancer. Irish Cancer Survivorship Research Day, Dublin, September 2013 %A Moore, A %A Barron, TI %A Kennedy, J %A Cahir, C %A Bennett, K %G eng %0 Generic %D 2013 %T Prevalence of potentially inappropriate prescribing in older irish adults, TILDA 2013 Conference, 13 March 2013, Dublin %A Galvin, R %A Cousins, G %A Cahir, C %A Motterlini, N %A Bradley, MC %A Hughes, CM %A Bennett, K %A Fahey, T %A Kenny, RA %G eng %U http://www.hrbcentreprimarycare.ie/ppt/PIP poster_TILDA.pdf %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 2011 %T Prescribing patterns of cartilage constituents in a national elderly population. Faculty of Public Health Medicine Winter Scientific Meeting 2011, Royal College of Physicians, 14 December 2011, Dublin %A Galvin, R %A Cousins, G %A Motterlini, N %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Glucosamine.ppt %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 2013 %T Medication adherence and adverse health outcomes in community dwelling older patients. International Society for Pharmacoeconomics and Outcomes Research (ISPOR), 16th Annual European Congress, Dublin, November 2013 (Best general poster research presentati %A Cahir, C %A Fahey, T %A Teljeur, C %A Bennett, K %G eng %0 Generic %D 2012 %T GP variability in the prescribing of potentially inappropriate medication in older populations in Ireland. 41st Annual Scientific Meeting of the Society of Academic Primary Care. 2 – 4 October 2012, Glasgow, Scotland %A Cahir, C %A Bennett, K %A Teljeur, C %A Fahey, T %G eng %0 Generic %D 2015 %T Does the EQ-5D capture the effect of physical and mental health on subjective well-being among older people. IAGG-ER Congress 2015, Dublin %A Sexton,Eithne %A Cahir, C %A Fahey, T %A Bennett, K %G eng %0 Generic %D 2010 %T Antibiotic Prescribing in Irish Children Receiving Free Medical Care. The Society for Social Medicine, 6-8 September 2010, Belfast %A Keogh, C %A Reulbach, U %A Motterlini, N %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Claire%20Keogh_SSM%202010_Antibiotic%20prescring%202004-2009.pdf %0 Generic %D 2016 %T Variation in prescribing of anti-diabetic medications, including newer injectable medications, in Ireland in 2013 and 2014. AUDGPI 10th March 2016 %A Murphy, M %A Bennett, K %A Fahey, T %A Smith, SM %G eng %0 Generic %D 2016 %T Variation in prescribing of anti-diabetic medications, including newer injectable medications, in Ireland in 2013 and 2014. SPHeRE Research Day 29th February 2016 %A Murphy, M %A Bennett, K %A Fahey, T %A Smith, SM %G eng %0 Generic %D 2016 %T Variation in prescribing of anti-diabetic medications, including newer injectable medications, in Ireland in 2013 and 2014. SAPC 6th -8th of July 2016 Dublin Castle/RCSI. (Elevator Pitch) %A Murphy, M %A Bennett, K %A Fahey, T %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 Risk prediction models to predict emergency hospital admission in community-dwelling adults: a systematic review. SPHeRE Conference, RCSI Dublin, January 2015 %A Wallace, E %A Stuart, Ellen %A Vaughan, Niall %A Bennett, K %A Fahey, T %A Smith, SM %G eng %0 Generic %D 2014 %T Risk prediction models to predict emergency hospital admission in community-dwelling adults AUDGPI Cork 6-7 March 2014 %A Wallace, E %A Stuart, Ellen %A Vaughan, Niall %A Bennett, K %A Fahey, T %A Smith, SM %G eng %U http://hrbcentreprimarycare.ie/ppt/Emma Wallace AUDGPI 2014.pdf %0 Generic %D 2014 %T Risk prediction models to predict emergency hospital admission in community dwelling adults: a systematic review. NAPCRG New York 21-24 Nov 2014 %A Wallace, E %A Stuart, Ellen %A Vaughan, Niall %A Bennett, K %A Fahey, T %A Smith, SM %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 2013 %T Prescribing patterns of glucosamine in an elderly population: A national cohort study. AUDGPI Annual Scientific Meeting 2013, University of Limerick, 8 March 2013. Limerick %A Galvin, R %A Cousins, G %A Boland, F %A Motterlini, N %A Bennett, K %A Fahey, T %G eng %0 Generic %D 2011 %T Prescribing patterns of cartilage constituents in a national elderly population. Irish Gerontological Society Meeting, 9-10 September, 2011 Aviva Stadium, Dublin %A Galvin, R %A Cousins, G %A Motterlini, N %A Bennett, K %A Fahey, T %G eng %U http://hrbcentreprimarycare.ie/ppt/Glucosamine_RG.ppt %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 2009 %T Potentially inappropriate prescribing and cost outcomes for older people: a national population study. HRB Centre for Primary Care Research seminar on older people. Winter Scientific Meeting of the Faculty of Public Health Medicine, 9 December 2009, RCSI %A Cahir, C %A Fahey, T %A Teeling, Mary %A Teljeur, C %A Feely, John %A Bennett, K %G eng %U http://www.hrbcentreprimarycare.ie/ppt/CahirC/PrescribingOlderPopCC-10Sept09.ppt %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 2009 %T Measuring and evaluating indicators of appropriate prescribing in older populations. 12th Annual Scientific Meeting of the Association of University Departments of General Practice in Ireland, 27 February 2009 RCSI, Dublin %A Cahir, C %A Teeling, Mary %A Feely, John %A Byrne, S %A Fahey, T %A Bennett, K %G eng %U http://www.hrbcentreprimarycare.ie/ppt/CahirC/AUDGPPrescribingCC270209.ppt %0 Generic %D 2016 %T Impact of potentially inappropriate prescribing on adverse health outcomes in community-dwelling older people: a prospective cohort study. SAPC 6th-8th of July 2016 Dublin Castle/RCSI. %A Wallace, E %A McDowell, R %A Bennett, K %A Fahey, T %A Smith, SM %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 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 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 2014 %T Benzodiazpine prescribing in Irish children. SAPC July 9-11 2014 Edinburgh %A O Sullivan, K %A Reulbach, U %A Boland, F %A Kelly, D %A Bennett, K %A Fahey, T %G eng %0 Generic %D 2010 %T Antibiotic prescribing in Irish children: Describing rates and trends and comparing with EU prescribing behaviour, 8 December 2010, Faculty of Public Health Medicine, Dublin %A Keogh, C %A Motterlini, N %A Reulbach, U %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Keogh_Winter scientific meeting Dec 2010.ppt %0 Generic %D 2010 %T Antibiotic Prescribing in Irish children: A Preliminary Analysis. 13th Annual Scientific Meeting of the Association of University Departments of General Practice in Ireland, 19 March 2010, RCSI, Dublin, Ireland %A Keogh, C %A Reulbach, U %A Motterlini, N %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/KeoghC/C%20Keogh%20AUDGPI%20Abstract_antibiotic%20prescribing.pdf %0 Generic %D 2010 %T Trends in psychostimulant prescribing in Irish children. Patient Safety and Quality Drug Prescribing Meeting, 12 May 2010, Dublin %A Reulbach, U %A Motterlini, N %A Keogh, C %A Bennett, K %A O'Dowd, T %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Presentation%20Public%20Health%20Study%20Day.ppt %0 Generic %D 2010 %T Rates and Trends in Antibiotic Prescribing in Irish Children Receiving Free Medical Care. Patient Safety and Quality Drug Prescribing Meeting, 12 May 2010, Dublin %A Keogh, C %A Reulbach, U %A Motterlini, N %A Bennett, K %A Fahey, T %G eng %U http://www.hrbcentreprimarycare.ie/ppt/Quality%20in%20prescribing_Antibiotics%20in%20Irish%20children.ppt %0 Generic %D 2009 %T Potentially inappropriate prescribing and cost outcomes for older people: a national population study. HRB Centre for Primary Care Research seminar on older people, 10 September 2009, HRB Centre for Primary Care Research, Dublin %A Cahir, C %A Fahey, T %A Teeling, Mary %A Teljeur, C %A Feely, John %A Bennett, K %G eng %U http://www.hrbcentreprimarycare.ie/ppt/CahirC/PrescribingOlderPopCC-10Sept09.ppt