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Subject = Inappropriate Prescribing;
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Displaying Results 1 - 14 of 14 on page 1 of 1
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Computerised interventions designed to reduce potentially inappropriate prescribing in hospitalised older adults: a systematic review and meta-analysis
(2018)
Dalton, Kieran; O'Brien, Gary L.; O'Mahony, Denis; Byrne, Stephen
Computerised interventions designed to reduce potentially inappropriate prescribing in hospitalised older adults: a systematic review and meta-analysis
(2018)
Dalton, Kieran; O'Brien, Gary L.; O'Mahony, Denis; Byrne, Stephen
Abstract:
Background: computerised interventions have been suggested as an effective strategy to reduce potentially inappropriate prescribing (PIP) for hospitalised older adults. This systematic review and meta-analysis examined the evidence for efficacy of computerised interventions designed to reduce PIP in this patient group. Methods: an electronic literature search was conducted using eight databases up to October 2017. Included studies were controlled trials of computerised interventions aiming to reduce PIP in hospitalised older adults (≥65 years). Risk of bias was assessed using Cochrane’s Effective Practice and Organisation of Care criteria. Results: of 653 records identified, eight studies were included—two randomised controlled trials, two interrupted time series analysis studies and four controlled before–after studies. Included studies were mostly at a low risk of bias. Overall, seven studies showed either a statistically significant reduction in the proportion of patients prescri...
http://hdl.handle.net/10468/10385
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Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomised trial (OPTI-SCRIPT study)
(2014)
Clyne, Barbara
Effectiveness of medicines review with web-based pharmaceutical treatment algorithms in reducing potentially inappropriate prescribing in older people in primary care: a cluster randomised trial (OPTI-SCRIPT study)
(2014)
Clyne, Barbara
Abstract:
<p><strong>Background: </strong>Potentially inappropriate prescribing (PIP) is common and can result in increased morbidity, adverse drug events and hospitalisations. In 2007, 36% of Irish people aged 70 years or over received at least one potentially inappropriate prescription, with an associated expenditure of €45 million. This thesis documents the design, conduct, and evaluation of a cluster randomised controlled trial (RCT) in Irish primary care focused on reducing PIP in older patients (> 70 years).</p> <p><strong>Methods: </strong>The intervention development was guided by the Medical Research Council (MRC) framework for the development and evaluation of complex interventions. Literature and information from experts were combined to define the main components of the intervention which was then tested with five GPs during the pilot and evaluated using qualitative interviews</p> <p>During the OPTI-SCRIPT trial 21 practices...
https://epubs.rcsi.ie/phdtheses/127
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Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences
(2019)
Curtin, Denis; Gallagher, Paul F.; O'Mahony, Denis
Explicit criteria as clinical tools to minimize inappropriate medication use and its consequences
(2019)
Curtin, Denis; Gallagher, Paul F.; O'Mahony, Denis
Abstract:
Polypharmacy and prescribing of potentially inappropriate medications (PIMs) are the key elements of inappropriate medication use (IMU) in older multimorbid people. IMU is associated with a range of negative healthcare consequences including adverse drug events and unplanned hospitalizations. Furthermore, prescribing guidelines are commonly derived from randomized controlled clinical trials which have specifically excluded older adults with multimorbidity. Consequently, indiscriminate application of single disease pharmacotherapy guidelines to older multimorbid patients can lead to increased risk of drug?drug interactions, drug?disease interactions and poor drug adherence. Both polypharmacy and PIMs are highly prevalent in older people and strategies to improve the quality and safety of prescribing, largely through avoidance of IMU, are needed. In the last 30?years, numerous explicit PIM criteria-based tools have been developed to assist physicians with medication management in clin...
http://hdl.handle.net/10468/9161
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Inappropriate prescribing and adverse drug events in older people
(2009)
Hamilton, Hilary J.; Gallagher, Paul F.; O'Mahony, Denis
Inappropriate prescribing and adverse drug events in older people
(2009)
Hamilton, Hilary J.; Gallagher, Paul F.; O'Mahony, Denis
Abstract:
Inappropriate prescribing (IP) in older patients is highly prevalent and is associated with an increased risk of adverse drug events (ADEs), morbidity, mortality and healthcare utilisation. Consequently, IP is a major safety concern and with changing population demographics, it is likely to become even more prevalent in the future. IP can be detected using explicit or implicit prescribing indicators. Theoretically, the routine clinical application of these IP criteria could represent an inexpensive and time efficient method to optimise prescribing practice. However, IP criteria must be sensitive, specific, have good inter-rater reliability and incorporate those medications most commonly associated with ADEs in older people. To be clinically relevant, use of prescribing appropriateness tools must translate into positive patient outcomes, such as reduced rates of ADEs. To accurately measure these outcomes, a reliable method of assessing the relationship between the administration of a...
http://hdl.handle.net/10468/3866
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Modification of Potentially Inappropriate Prescribing Following Fall-Related Hospitalizations in Older Adults.
(2019)
Walsh, Mary Elizabeth; Boland, Fiona; Moriarty, Frank; Fahey, Tom
Modification of Potentially Inappropriate Prescribing Following Fall-Related Hospitalizations in Older Adults.
(2019)
Walsh, Mary Elizabeth; Boland, Fiona; Moriarty, Frank; Fahey, Tom
Abstract:
<p><em>This is a post-peer-review, pre-copyedit version of an article published in Drugs & Aging.The final authenticated version is available online at: http://dx.doi.org/</em> <a href="https://doi.org/10.1007/s40266-019-00646-z" target="_blank">10.1007/s40266-019-00646-z</a></p>
<p><strong>BACKGROUND:</strong> There is strong evidence that potentially inappropriate prescribing is associated with falls in older adults. Fall-related hospitalizations should trigger medication review.</p> <p><strong>OBJECTIVES:</strong> The aim of this before-and-after cohort study was to explore patterns of relevant potentially inappropriate prescribing in older people with fall-related hospitalizations.</p> <p><strong>METHODS:</strong> Data on older adults with hospitalizations for falls, fractures and syncope between 2012 and 2016 were collected from 44 general practices ...
https://epubs.rcsi.ie/gpart/149
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Pharmacoepidemiology and economic evaluation of measures of potentially inappropriate prescribing
(2016)
Moriarty, Frank
Pharmacoepidemiology and economic evaluation of measures of potentially inappropriate prescribing
(2016)
Moriarty, Frank
Abstract:
<p>Background: Several measures of potentially inappropriate prescribing (PIP) exist, however their validity has been under-researched. The aim of this thesis was to assess measures of PIP in older and middle-aged people in primary care in terms of their applicability and relevance in Ireland, effect on patient outcomes and economic impact.</p> <p>Methods: This thesis focussed on community-dwelling adults in Ireland, aged ≥65 years (older adults) or 45-64 years (middle-aged adults). Measures of PIP, the Screening Tool for Older Persons’ Prescriptions (STOPP), the Screening Tool to Alter doctors to Right Treatment (START), and PRescribing Optimally in Middle-aged People’s Treatments (PROMPT) criteria, were applied to two national data sources, the General Medical Services (GMS) scheme dispensing database and The Irish Longitudinal Study on Ageing. Economic analysis was also conducted by developing Markov models of PIP.</p> <p>Results: The prevalence of P...
https://epubs.rcsi.ie/phdtheses/209
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Polypharmacy Rates among Patients over 45 years
(2019)
Tatum, Travis; Curry, P; Dunne, B; Walsh, K; Bennett, Kathleen
Polypharmacy Rates among Patients over 45 years
(2019)
Tatum, Travis; Curry, P; Dunne, B; Walsh, K; Bennett, Kathleen
Abstract:
<p>The original article is available at <a href="http://imj.ie/polypharmacy-rates-among-patients-over-45-years/">imj.ie</a></p>
<p>Polypharmacy, defined as receipt of ≥5 medications in any one month, is often associated with potentially inappropriate prescribing and adverse drug interactions. High levels of polypharmacy have been observed internationally and in Ireland. The Health Service Executive Primary Care Reimbursement Services (HSE-PCRS) pharmacy claims database for the GMS eligible population was used. We conducted Chi-square tests to determine the statistical significance of perceived differences in medication use among patients aged ³ 45 years. Our results establish a national benchmark for polypharmacy in gender and various age categories in the HSE-PCRS. Of the 794,628 individuals aged ≥45 years with at least one claim in 2013, 64.3% (510,946) had polypharmacy, with higher rates among women (67.0% - 293,886 - compared to 60.8% ...
https://epubs.rcsi.ie/psycholart/141
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Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients
(2011)
Hamilton, Hilary J.; Gallagher, Paul F.; Ryan, Cristin; Byrne, Stephen; O'Mahony, ...
Potentially inappropriate medications defined by STOPP criteria and the risk of adverse drug events in older hospitalized patients
(2011)
Hamilton, Hilary J.; Gallagher, Paul F.; Ryan, Cristin; Byrne, Stephen; O'Mahony, Denis
Abstract:
Background: Previous studies have not demonstrated a consistent association between potentially inappropriate medicines (PIMs) in older patients as defined by Beers criteria and avoidable adverse drug events (ADEs). This study aimed to assess whether PIMs defined by new STOPP (Screening Tool of Older Persons' potentially inappropriate Prescriptions) criteria are significantly associated with ADEs in older people with acute illness. Methods: We prospectively studied 600 consecutive patients 65 years or older who were admitted with acute illness to a university teaching hospital over a 4-month interval. Potentially inappropriate medicines were defined by both Beers and STOPP criteria. Adverse drug events were defined by World Health Organization- Uppsala Monitoring Centre criteria and verified by a local expert consensus panel, which also assessed whether ADEs were causal or contributory to current hospitalization. Hallas criteria defined ADE avoidability. We compared the proport...
http://hdl.handle.net/10468/3863
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Potentially inappropriate prescribing (PIP) in long-term care (LTC) patients: validation of the 2014 STOPP-START and 2012 Beers criteria in a LTC population--a protocol for a cross-sectional comparison of clinical and health administrative data.
(2015)
Bjerre, Lise M; Halil, Roland; Catley, Christina; Farrell, Barbara; Hogel, Matthew; Bla...
Potentially inappropriate prescribing (PIP) in long-term care (LTC) patients: validation of the 2014 STOPP-START and 2012 Beers criteria in a LTC population--a protocol for a cross-sectional comparison of clinical and health administrative data.
(2015)
Bjerre, Lise M; Halil, Roland; Catley, Christina; Farrell, Barbara; Hogel, Matthew; Black, Cody D; Williams, Margo; Ryan, Cristín; Manuel, Douglas G
Abstract:
<p>The original article is available at <a href="https://bmjopen.bmj.com/content/5/10/e009715.long">bmjopen.bmj.com</a></p>
<p><strong>INTRODUCTION:</strong> Potentially inappropriate prescribing (PIP) is frequent and problematic in older patients. Identifying PIP is necessary to improve prescribing quality; ideally, this should be performed at the population level. Screening Tool of Older Persons' potentially inappropriate Prescriptions/Screening Tool to Alert doctors to Right Treatment (STOPP/START) and Beers criteria were developed to identify PIP in clinical settings and are useful at the individual patient level; however, they are time-consuming and costly to apply. Only a subset of these criteria is applicable to routinely collected population-level health administrative data (HAD) because the clinical information necessary to implement these tools is often missing from databases. The performance of subsets of STOPP/...
https://epubs.rcsi.ie/spharmart/58
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Potentially inappropriate prescribing among older people in the United Kingdom.
(2014)
Bradley, Marie C; Motterlini, Nicola; Padmanabhan, Shivani; Cahir, Caitriona; Williams,...
Potentially inappropriate prescribing among older people in the United Kingdom.
(2014)
Bradley, Marie C; Motterlini, Nicola; Padmanabhan, Shivani; Cahir, Caitriona; Williams, Tim; Fahey, Tom; Hughes, Carmel M
Abstract:
<p>This article is also available at <a href="https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-14-72">https://bmcgeriatr.biomedcentral.com/articles/10.1186/1471-2318-14-72</a></p>
<p>BACKGROUND: Potentially inappropriate prescribing (PIP) in older people is associated with increases in morbidity, hospitalisation and mortality. The objective of this study was to estimate the prevalence of and factors associated with PIP, among those aged ≥70 years, in the United Kingdom, using a comprehensive set of prescribing indicators and comparing these to estimates obtained from a truncated set of the same indicators.</p> <p>METHODS: A retrospective cross-sectional study was carried out in the UK Clinical Practice Research Datalink (CPRD), in 2007. Participants included those aged ≥ 70 years, in CPRD. Fifty-two PIP indicators from the Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) criteria we...
https://epubs.rcsi.ie/gpart/96
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Potentially inappropriate prescribing among people with dementia in primary care: a retrospective cross-sectional study using the enhanced prescribing database
(2018)
Barry, Heather E.; Cooper, Janine A.; Ryan, Cristín; Passmore, A. Peter; Robinson, A. L...
Potentially inappropriate prescribing among people with dementia in primary care: a retrospective cross-sectional study using the enhanced prescribing database
(2018)
Barry, Heather E.; Cooper, Janine A.; Ryan, Cristín; Passmore, A. Peter; Robinson, A. Louise; Molloy, Gerard J.; Darcy, Carmel M.; Buchanan, Hilary; Hughes, Carmel M.
Abstract:
Background: Little is known about prescribing appropriateness for community-dwelling people with dementia (PWD). Objective: To estimate potentially inappropriate prescribing (PIP) prevalence among PWD in primary care in Northern Ireland, and to investigate associations between PIP, polypharmacy, age, and gender. Methods: A retrospective cross-sectional study was conducted, using data from the Enhanced Prescribing Database. Patients were eligible if a medicine indicated for dementia management was dispensed to them during 1 January 2013-31 December 2013. Polypharmacy was indicated by use of &gt;= 4 repeat medications from different drug groups. A subset of the Screening Tool of Older Persons Potentially Inappropriate Prescriptions (STOPP) criteria, comprising 36 indicators, was applied to the dataset. Overall prevalence of PIP and the prevalence per each STOPP criterion was calculated as a proportion of all eligible persons in the dataset. Logistic regression was used to inve...
http://hdl.handle.net/10379/10365
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Prescribing in Ireland : assessing indicators of prescribing quality and efficiency in older populations.
(2012)
Cahir, Caitriona
Prescribing in Ireland : assessing indicators of prescribing quality and efficiency in older populations.
(2012)
Cahir, Caitriona
Abstract:
<p><strong>Objectives</strong></p> <p>This thesis aimed to assess indicators of prescribing appropriateness and efficiency in those aged > 70 years in Ireland by: (i) estimating the prevalence and cost of potentially inappropriate prescribing (PIP); (ii) estimating the potential cost savings, by applying clinical guidelines, for the PIP indicator with the highest prevalence rate; (iii) examining the variation in PIP between GPs; and (iv) assessing the association between PIP and adverse health outcomes.</p> <p><strong>Methods</strong></p> <p>A retrospective national population study determined the prevalence and cost of PIP in the national population aged > 70 years in Ireland in 2007 by applying a modified version of the recently developed Screening Tool of Older Person’s potentially inappropriate Prescriptions (STOPP) to the Health Services Executive Primary Care Reimbursement Services (HSE-PCRS) pharmacy clai...
https://epubs.rcsi.ie/phdtheses/68
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STOPP/START criteria for potentially inappropriate prescribing in older people: version 2
(2014)
O'Mahony, Denis; O'Sullivan, David; Byrne, Stephen; O'Connor, Marie N.; ...
STOPP/START criteria for potentially inappropriate prescribing in older people: version 2
(2014)
O'Mahony, Denis; O'Sullivan, David; Byrne, Stephen; O'Connor, Marie N.; Ryan, Cristin; Gallagher, Paul F.
Abstract:
Purpose: screening tool of older people’s prescriptions (STOPP) and screening tool to alert to right treatment (START) criteria were first published in 2008. Due to an expanding therapeutics evidence base, updating of the criteria was required. Methods: we reviewed the 2008 STOPP/START criteria to add new evidence-based criteria and remove any obsolete criteria. A thorough literature review was performed to reassess the evidence base of the 2008 criteria and the proposed new criteria. Nineteen experts from 13 European countries reviewed a new draft of STOPP & START criteria including proposed new criteria. These experts were also asked to propose additional criteria they considered important to include in the revised STOPP & START criteria and to highlight any criteria from the 2008 list they considered less important or lacking an evidence base. The revised list of criteria was then validated using the Delphi consensus methodology. Results: the expert panel agreed a final l...
http://hdl.handle.net/10468/3690
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Strategies to prevent potentially inappropriate prescribing and adverse drug reactions in older patients
(2015)
Cullinan, Shane
Strategies to prevent potentially inappropriate prescribing and adverse drug reactions in older patients
(2015)
Cullinan, Shane
Abstract:
INTRODUCTION: Potentially inappropriate prescribing (PIP) is a major contributor to adverse drug reactions and overall increased healthcare costs. The aim of this thesis was to identify, develop and implement strategies with the potential to prevent PIP and ADRs in older patients. METHODS: A systematic review of the qualitative literature (Meta-synthesis); A qualitative study in Irish hospitals; A randomised controlled trial (RCT) to assess the impact of an online educational module on doctors’ prescribing knowledge and confidence; Exploration of the potential for a frailty index score to enable doctors identify patients at increased risk of PIP and ADRs; Exploration of the potential for the SHiM tool to enable doctors to optimise prescribing for older patients. RESULTS: The meta-synthesis identified four key concepts: (i) Desire to please the patient; (ii) Feeling of being forced to prescribe; (iii) Tension between experience and guidelines; (iv) Prescriber fear. Similar themes als...
http://hdl.handle.net/10468/2176
Displaying Results 1 - 14 of 14 on page 1 of 1
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