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Older adults who were prescribed medications flagged as potentially inappropriate had an increased risk for mortality, with more than 80% exposed to potentially inappropriate prescribing. Potential prescribing omissions of indicated medications were also linked to increased mortality risk.<\/p>\n
METHODOLOGY:Researchers assessed potentially inappropriate prescribing and its link to long-term mortality in 1210 community-dwelling older adults (mean age, 72.9 years; 53% women) from a community-based longitudinal study in Israel, using data collected from 1999 to 2007.Participants were asked to bring their regular medications and a summary letter from their treating physician, with medication information documented on a form.Potentially inappropriate medications were identified from the 2023 American Geriatrics Society Beers Criteria and the European Screening Tool of Older Persons\u2019 Prescription (STOPP) version 3; potential prescribing omissions were identified using the Screening Tool to Alert doctors to Right Treatment version 3 criteria.Outcomes included all-cause mortality and noncancer mortality, identified using diagnostic codes. The median follow-up duration was 13 years.TAKEAWAY:On the basis of at least one criterion, 81.2% of participants took a drug listed as potentially inappropriate, and 37.9% were exposed to potentially inappropriate medications and omissions.Exposure to two or more potentially inappropriate medications using the Beers criteria was associated with an increased risk for all-cause mortality (adjusted hazard ratio [aHR], 1.31; 95% CI, 1.04-1.64).Exposure to two or more potentially inappropriate medications was linked to an increase in the risk for noncancer mortality (Beers criteria: aHR, 1.40; 95% CI, 1.09-1.80; STOPP criteria: aHR, 1.42; 95% CI, 1.12-1.81).Exposure to two or more potential prescribing omissions was linked to an increase in the risk for all-cause mortality (aHR, 1.84; 95% CI, 1.24-2.72) and for noncancer mortality (aHR, 2.00; 95% CI, 1.27-3.13), with stronger associations observed in men (P for interaction = .012).IN PRACTICE:<\/p>\n
\u201cBoth over-prescribing risky medications and under-prescribing necessary ones significantly increase mortality risk in the aging population, demonstrating the need for regular medication reviews even in healthy older adults,\u201d the authors of the study wrote.<\/p>\n
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