TY - JOUR
T1 - Potentially Inappropriate Antihypertensive Prescriptions to Elderly Patients: Results of a Prospective, Observational Study.
T2 - Results of a Prospective, Observational Study
AU - Márquez, Paola H.Ponte
AU - Torres, Olga H.
AU - San-José, Anonio
AU - Vidal, Xavier
AU - Agustí, Antonia
AU - Formiga, Francesc
AU - López-Soto, Alfonso
AU - Ramírez-Duque, Nieves
AU - Fernández-Moyano, Antonio
AU - Garcia-Moreno, Juana
AU - Arroyo, Juan A.
AU - Ruiz, Domingo
AU - San-José, Antonio
AU - Agustí, Antonia
AU - Vidal, Xavier
AU - Aguilera, Cristina
AU - Balların, Elena
AU - Pérez, Eulalia
AU - Barbe, José
AU - Bocanegra, Carmen Pérez
AU - Toscano, Ainhoa
AU - Pal, Carme
AU - Teixidor, Teresa
AU - Fernández-Moyano, Antonio
AU - Hernández, Mercedes Gómez
AU - de la Rosa Morales, Rafael
AU - Martínez, María Nicolas Benticuaga
AU - López-Soto, Alfonso
AU - Bosch, Xavier
AU - Palau, María José
AU - Rovira, Joana
AU - Navarro, Margarita
AU - Formiga, Francesc
AU - Chivite, David
AU - Roson, Beatriz
AU - Vallano, Antonio
AU - Cabot, Carme
AU - García, Juana
AU - Ballesteros, Isabel
AU - Torres, Olga H.
AU - Ruiz, Domingo
AU - Turbau, Miquel
AU - Ponte, Paola
AU - Ortiz, Gabriel
AU - Ramírez-Duque, Nieves
AU - Cobas, Paula Carlota Rivas
AU - Gil, Paloma
N1 - Publisher Copyright:
© 2017, Springer International Publishing Switzerland.
PY - 2017/6
Y1 - 2017/6
N2 - Introduction: Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. Objectives: The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. Methods: An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person’s Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3). Primary care and hospital electronic records were reviewed for HTN diagnoses, antihypertensive treatment and blood pressure readings. Results: Of 672 patients, 532 (median age 85 years, 56% female) had HTN. 21.6% received antihypertensive monotherapy, 4.7% received no hypertensive treatment, and the remainder received a combination of antihypertensive therapies. The most frequently prescribed antihypertensive drugs were diuretics (53.5%), angiotensin-converting enzyme inhibitors (ACEIs) (41%), calcium antagonists (32.2%), angiotensin receptor blockers (29.7%) and beta-blockers (29.7%). Potentially inappropriate prescription was observed in 51.3% of patients (27.8% overprescription and 35% underprescription). The most frequent inappropriately prescribed drugs were calcium antagonists (overprescribed), ACEIs and beta-blockers (underprescribed). ACEI and beta-blocker underprescriptions were independently associated with heart failure admissions [beta-blockers odds ratio (OR) 0.53, 95% confidence interval (CI) 0.39–0.71, p < 0.001; ACEIs OR 0.50, 95% CI 0.36–0.70, p < 0.001]. Conclusion: Potentially inappropriate prescription was detected in more than half of patients receiving antihypertensive treatment. Underprescription was more frequent than overprescription. ACEIs and beta-blockers were frequently underprescribed and were associated with heart failure admissions.
AB - Introduction: Previous studies of antihypertensive treatment of older patients have focused on blood pressure control, cardiovascular risk or adherence, whereas data on inappropriate antihypertensive prescriptions to older patients are scarce. Objectives: The aim of the study was to assess inappropriate antihypertensive prescriptions to older patients. Methods: An observational, prospective multicentric study was conducted to assess potentially inappropriate prescription of antihypertensive drugs, in patients aged 75 years and older with arterial hypertension (HTN), in the month prior to hospital admission, using four instruments: Beers, Screening Tool of Older Person’s Prescriptions (STOPP), Screening Tool to Alert Doctors to the Right Treatment (START) and Assessing Care of Vulnerable Elders 3 (ACOVE-3). Primary care and hospital electronic records were reviewed for HTN diagnoses, antihypertensive treatment and blood pressure readings. Results: Of 672 patients, 532 (median age 85 years, 56% female) had HTN. 21.6% received antihypertensive monotherapy, 4.7% received no hypertensive treatment, and the remainder received a combination of antihypertensive therapies. The most frequently prescribed antihypertensive drugs were diuretics (53.5%), angiotensin-converting enzyme inhibitors (ACEIs) (41%), calcium antagonists (32.2%), angiotensin receptor blockers (29.7%) and beta-blockers (29.7%). Potentially inappropriate prescription was observed in 51.3% of patients (27.8% overprescription and 35% underprescription). The most frequent inappropriately prescribed drugs were calcium antagonists (overprescribed), ACEIs and beta-blockers (underprescribed). ACEI and beta-blocker underprescriptions were independently associated with heart failure admissions [beta-blockers odds ratio (OR) 0.53, 95% confidence interval (CI) 0.39–0.71, p < 0.001; ACEIs OR 0.50, 95% CI 0.36–0.70, p < 0.001]. Conclusion: Potentially inappropriate prescription was detected in more than half of patients receiving antihypertensive treatment. Underprescription was more frequent than overprescription. ACEIs and beta-blockers were frequently underprescribed and were associated with heart failure admissions.
UR - http://www.scopus.com/inward/record.url?scp=85018846555&partnerID=8YFLogxK
U2 - 10.1007/s40266-017-0452-z
DO - 10.1007/s40266-017-0452-z
M3 - Article
C2 - 28432600
SN - 1170-229X
VL - 34
SP - 453
EP - 466
JO - Drugs and Aging
JF - Drugs and Aging
IS - 6
ER -