Application of three different sets of explicit criteria for assessing inappropriate prescribing in older patients: a nationwide prevalence study of ambulatory care visits in Taiwan.
OBJECTIVE
To investigate the national prevalence of potentially inappropriate medications (PIMs) prescribed in ambulatory care clinics in Taiwan according to three different sets of regional criteria and the correlates of PIM use.


DESIGN
Cross-sectional study.


SETTING
This analysis included older patients who visited ambulatory care clinics in 2009 and represented half of the older population included on the Taiwanese National Health Insurance Research Database.


PARTICIPANTS
We identified 1,164,701 subjects who visited ambulatory care clinics and were over 65 years old in 2009.


PRIMARY AND SECONDARY OUTCOME MEASURES
PIM prevalence according to the 2012 Beers criteria, the PIM-Taiwan criteria and the PRISCUS criteria was estimated separately, and characteristics of PIM users were explored. Multivariate logistic regression analysis was used to determine patient factors associated with the use of at least one PIM. Leading PIMs for each set of criteria were also listed.


RESULTS
The prevalence of having at least one PIM at the patient level was highest with the Beers criteria (86.2%), followed by the PIM-Taiwan criteria (73.3%) and the PRISCUS criteria (66.9%). Polypharmacy and younger age were associated with PIM use for all three sets of criteria. The leading PIMs detected by the PIM-Taiwan and PRISCUS criteria were all included in the 2012 Beers criteria. Non-COX-selective non-steroidal anti-inflammatory drugs in the Beers criteria and benzodiazepines in the PIM-Taiwan and PRISCUS criteria accounted for most leading PIMs.


CONCLUSIONS
The prevalence of PIMs was high among older Taiwanese patients receiving ambulatory care visits. The prevalence of PIM and its associated factors varied according to three sets of criteria at the population level.
['Chang|Chirn-Bin|CB|', 'Yang|Shu-Yu|SY|', 'Lai|Hsiu-Yun|HY|', 'Wu|Ru-Shu|RS|', 'Liu|Hsing-Cheng|HC|', 'Hsu|Hsiu-Ying|HY|', 'Hwang|Shinn-Jang|SJ|', 'Chan|Ding-Cheng|DC|']
D000368:Aged D000369:Aged, 80 and over D000553:Ambulatory Care D003430:Cross-Sectional Studies D016208:Databases, Factual D005260:Female D006801:Humans D057970:Inappropriate Prescribing D016015:Logistic Models D008297:Male D015999:Multivariate Analysis D009313:National Health Programs D019338:Polypharmacy D000067561:Potentially Inappropriate Medication List D012307:Risk Factors D013624:Taiwan
Ambulatory care potentially inappropriate medications Beers criteria PIM-Taiwan criteria PRISCUS criteria