BACKGROUND Prescribing for older people is complex, and many studies have highlighted that appropriate prescribing in this cohort is not always achieved. However, the long-term effect of inappropriate prescribing on outcomes such as hospitalisation and mortality has not been demonstrated. The aim of this study was to determine the level of potentially inappropriate prescribing (PIP) for participants of the Life and Living in Advanced Age: A Cohort Study in New Zealand (LiLACS NZ) study at baseline and examine the association between PIP and hospitalisation and mortality at 12-months follow-up. METHODS PIP was determined using STOPP/START. STOPP identified potentially inappropriate medicines (PIMs) prescribed, START identified potential prescribing omissions (PPOs). STOPP/START were applied to all LiLACS NZ study participants, a longitudinal study of ageing, which includes 421 Māori aged 80-90 years and 516 non-Māori aged 85 years. Participants' details (e.g. age, sex, living arrangements, socioeconomic status, physical functioning, medical conditions) were gathered by trained interviewers. Some participants completed a core questionnaire only, which did not include medications details. Medical conditions were established from a combination of self-report, review of hospital discharge and general practitioner records. Binary logistic regression, controlled for multiple potential confounders, was conducted to determine if either PIMs or PPOs were associated with hospital admissions and mortality (p < 0.05 was considered significant). RESULTS Full data were obtained for 267 Māori and 404 non-Māori. The mean age for Māori was 82.3(±2.6) years, and 84.6(±0.53) years for non-Māori. 247 potentially inappropriate medicines were identified, affecting 24.3% Māori and 28.0% non-Māori. PIMs were not associated with 12-month mortality or hospitalisation for either cohort (p > 0.05; adjusted models). 590 potential prescribing omissions were identified, affecting 58.1% Māori and 49.0% non-Māori. PPOs were associated with hospitalisation (p = 0.001 for Māori), but were not associated with risk of mortality (p > 0.05) for either cohort within the 12-month follow-up (adjusted models). CONCLUSION PPOs were more common than PIMs and were associated with an increased risk of hospitalisation for Māori. This study highlights the importance of carefully considering all indicated medicines when deciding what to prescribe. Further follow-up is necessary to determine the long-term effects of PIP on mortality and hospitalisation.

中文翻译：

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开处方的质量可以预测八岁以下人群的住院情况：高龄者的生活和生活：新西兰的一项队列研究（LiLACS NZ）。

背景技术针对老年人的处方是复杂的，并且许多研究强调了在该人群中并不总是实现适当的处方。然而，尚未证明不适当处方对诸如住院和死亡率等结局的长期影响。这项研究的目的是确定高龄生活和生活参与者的潜在不适当处方（PIP）水平：基线的新西兰队列研究（LiLACS NZ）研究，并检查了PIP与住院和治疗之间的关联。 12个月随访时的死亡率。方法使用STOPP / START确定PIP。STOPP确定了处方中可能不适当的药物（PIM），START确定了潜在的处方遗漏（PPO）。STOPP / START应用于所有LiLACS NZ研究参与者，对老龄化的纵向研究，其中包括421名80-90岁的毛利人和516名85岁的非毛利人。参加者的详细信息（例如年龄，性别，生活安排，社会经济状况，身体机能，医疗状况）由受过训练的访问员收集。一些参与者仅填写了核心问卷，其中未包含用药详细信息。通过自我报告，出院检查和全科医生记录相结合来建立医疗条件。进行了针对多个潜在混杂因素控制的二元logistic回归分析，以确定PIM或PPO是否与住院和死亡相关（p <0.05被认为是显着的）。结果获得了267个毛利人和404个非毛利人的全部数据。毛利人的平均年龄为82.3（±2.6）岁，为84.6（±0）岁。53）年（非毛利人）。确定了247种可能不适当的药物，影响24.3％的毛利人和28.0％的非毛利人。PIMs与这两个队列的12个月死亡率或住院率均无关（p> 0.05；调整后的模型）。确定了590个可能的处方遗漏，影响了58.1％的毛利人和49.0％的非毛利人。PPO与住院相关（毛利人，p = 0.001），但与12个月随访中的任何一个队列的死亡风险均不相关（p> 0.05）（调整后的模型）。结论PPO比PIM更为常见，并且与毛利人住院的风险增加有关。这项研究强调了在决定开处方时应仔细考虑所有适应症药物的重要性。