Risk Factors and Specific Prescriptions Related to Inappropriate Prescribing among Japanese Elderly Home Care Patients

Abstract

Purpose: This study explored risk factors, risk diseases and specific prescriptions related to inappropriate prescribing (IP) as identified by the criteria of the Screening Tool of Older Persons' potentially inappropriate Prescriptions (STOPP) and Screening Tool to Alert doctors to Right Treatment (START) among elderly home care patients in Japan. Methods: This cross-sectional study enrolled all patients aged 65 years or older who received regular home visiting services. Results: This study included 430 patients (276 females). Of the study population, 34.0% had at least one potentially inappropriate medications (PIMs) and 60.0% had at least one incidence of potential prescribing omissions (PPOs). Risk factors or risk diseases for receiving PIMs were hypertension (Regression Coefficient 0.89, P < 0.001, 95% CI 0.53-1.25), constipation (0.95, < 0.001, 0.58-1.31), osteoarthritis (1.02, < 0.001, 0.56-1.48), recent history of fall (0.90, < 0.001, 0.46-1.33) and number of drug (0.11, < 0.001, 0.07-0.15), while those for PPOs were osteoporosis (0.66, < 0.001, 0.47-0.85), atrial fibrillation (0.23, 0.047, 0.00-0.45), diabetes mellitus (0.78, < 0.001, 0.60-0.97), peripheral artery occlusive disease (0.41, 0.002, 0.15-0.68), cerebral infarction/transient ischemic attack (0.76, < 0.001, 0.58-0.94), chronic obstructive pulmonary disease (0.61, < 0.001, 0.32-0.90), heart failure (0.44, 0.004, 0.14-0.73), bronchial asthma (0.52, < 0.046, 0.01-1.04) and coronary artery disease (1.21, < 0.001, 1.03-1.40). Conclusion: Risk factors or risk diseases for IP included polypharmacy and several underlying medical conditions. Specific prescriptions associated with PIMs and PPOs were identified.