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Article

Prevalence and Predictors of Potentially Inappropriate Prescribing in Middle-Aged Adults: Repeated Cross-Sectional Study

Amandeep Khatter, Frank Moriarty, Mark Ashworth, Stevo Durbaba and Patrick Redmond
British Journal of General Practice 18 February 2021; BJGP.2020.1048. DOI: https://doi.org/10.3399/BJGP.2020.1048
Amandeep Khatter
1School of Population Health and Environmental Sciences, Guy’s Campus, King’s College London, London, UK
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Frank Moriarty
2School of Pharmacy and Biomolecular Sciences, RCSI, Dublin, Ireland
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Mark Ashworth
1School of Population Health and Environmental Sciences, Guy’s Campus, King’s College London, London, UK
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Stevo Durbaba
1School of Population Health and Environmental Sciences, Guy’s Campus, King’s College London, London, UK
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Patrick Redmond
1School of Population Health and Environmental Sciences, Guy’s Campus, King’s College London, London, UK
3Department of General Practice, RCSI, Dublin, Ireland
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Abstract

Background: Potentially inappropriate prescribing (PIP) is common in older adults and known to be associated with polypharmacy and multimorbidity. Less is known about the prevalence and causes of PIP in middle-aged adults. Aim: To determine the prevalence and predictors of PIP in middle-aged adults. Design and Setting: A repeated cross-sectional study was conducted using primary care data in London. Method: PIP was defined using the PRescribing Optimally in Middle-aged People’s Treatment (PROMPT) criteria. Prescribing and demographic data were extracted from Lambeth DataNet (LDN), a pseudonymised database of all patients registered at general practices in Lambeth, for those aged 45-64 years prescribed ≥1 medicines in each year, 2014-2019 (n=46,633-52,582). Prevalence and trends over six years were investigated, including the association of PIP with polypharmacy, multimorbidity, deprivation, gender and age. Results: The prevalence of PIP decreased from 20% in 2014 to 18% in 2019. The most prevalent PROMPT criteria in 2019 were the use of ≥2 drugs from the same pharmacological class (7.6%), use of NSAIDs for >3 months (7%) and use of PPIs above recommended maintenance dosages for >8 weeks (3%). Over the study period, the prevalence of multimorbidity increased (47-52%), and polypharmacy remained stable (27%). Polypharmacy, multimorbidity, deprivation and age were independently associated with PIP. Conclusions: Almost a fifth of middle-aged adults prescribed medicines are exposed to PIP, as defined by the PROMPT criteria. This is likely to be linked with exposure to avoidable adverse drug events. The PROMPT criteria may provide a useful aid in interventions to optimise prescribing.

  • General Practice
  • Polypharmacy
  • Multimorbidity
  • Inappropriate Prescribing
  • Middle-Aged
  • Received November 23, 2020.
  • Accepted February 12, 2021.
  • Copyright © 2021, The Authors

This article is Open Access: CC BY license (https://creativecommons.org/licenses/by/4.0/)

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Prevalence and Predictors of Potentially Inappropriate Prescribing in Middle-Aged Adults: Repeated Cross-Sectional Study
Amandeep Khatter, Frank Moriarty, Mark Ashworth, Stevo Durbaba, Patrick Redmond
British Journal of General Practice 18 February 2021; BJGP.2020.1048. DOI: 10.3399/BJGP.2020.1048

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Accepted Manuscript
Prevalence and Predictors of Potentially Inappropriate Prescribing in Middle-Aged Adults: Repeated Cross-Sectional Study
Amandeep Khatter, Frank Moriarty, Mark Ashworth, Stevo Durbaba, Patrick Redmond
British Journal of General Practice 18 February 2021; BJGP.2020.1048. DOI: 10.3399/BJGP.2020.1048
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Keywords

  • general practice
  • Polypharmacy
  • Multimorbidity
  • Inappropriate Prescribing
  • Middle-Aged

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