Table 4 Main potentially inappropriate medicines (PIM) and potentially prescribing omissions (PPO) in patients aged 85 years and over compared with those aged 75 to 84 years
Disease or condition | Drug | 85 years and over % | 75 – 84 years % | p |
|---|---|---|---|---|
Beers list PIM | ||||
Syncope or falls | Short- to intermediate-acting benzodiazepine and tricyclic antidepressants | 10.7 | 9.8 | 0.712 |
Independent diagnosis | Long-acting benzodiazepines | 10.5 | 12.7 | 0.268 |
STOPP list PIM | ||||
Drugs that adversely affect those prone to falls | Benzodiazepines | 18.4 | 13.2 | 0.090 |
Central nervous system and psychotropic drugs | Long-term (i.e. >1 month), long-acting benzodiazepines | 9.5 | 11.7 | 0.687 |
Cardiovascular system | Aspirin at dose >150 mg day | 8.6 | 4.9 | 0.106 |
Cardiovascular system | Aspirin with no history of coronary, cerebral or peripheral arterial symptoms or occlusive arterial event | 7.8 | 7.5 | 0.909 |
START list PPO | ||||
Cardiovascular system | ACE inhibitor with chronic heart failure | 12.8 | 13.5 | 0.750 |
Cardiovascular system | Warfarin in the presence of chronic atrial fibrillation | 12.8 | 10.3 | 0.343 |
Musculoskeletal system | Calcium and vitamin D supplement in patients with known osteoporosis | 11.3 | 5.6 | 0.013 |
Endocrine system | Antiplatelet therapy in diabetes mellitus if one or more coexisting major cardiovascular risk factor present | 8.8 | 10.3 | 0.530 |
ACOVE 3 list PPO | ||||
Osteoporosis | IF a VE has osteoporosis, THEN he or she should be prescribed calcium and vitamin D supplements | 13.3 | 5.7 | 0.002 |
Hypertension | IF a VE with HTN has a history of HF, left ventricular hypertrophy, IHD, chronic kidney disease, or cardiovascular accident, THEN he or she should be treated with an ACE inhibitor or ARB | 12.6 | 9.9 | 0.289 |
Stroke and atrial fibrillation | IF a VE has chronic atrial fibrillation and is at medium to high risk for stroke, THEN anticoagulation should be offered. | 10.7 | 8.1 | 0.242 |
Hypertension | IF a VE with HTN has IHD, THEN treatment with a beta-blocker should be recommended or documentation of why it should not be provided. | 10.6 | 4.3 | 0.002 |
Osteoporosis | IF a female VE has osteoporosis, THEN she should be treated with bisphosphonates, raloxifene, calcitonin, hormone replacement therapy, or teriparatide | 10.5 | 7.4 | 0.163 |