Prevalence and predictors of potentially inappropriate prescribing using codified STOPP-START and Beers criteria: a retrospective cohort study in Ontario's older population
We studied medication use in Ontario adults aged 65+ years to identify both potentially harmful or unnecessary prescriptions and important medications that were missing, using established prescribing guidelines. Among nearly 3 million Ontarians, 75% were prescribed at least 1 potentially inappropriate medication with the pneumococcal vaccine (76% of cases) being the most commonly missing medication. Those most at risk included adults over 85 years of age, women, long-term care residents, and people with frailty or no prior medication review. These findings show how health data can efficiently identify prescribing gaps, helping target interventions like improved vaccine programs or medication reviews to enhance safety for older adults.
Authors
- Barbara Farrell (ORCID: https://orcid.org/0000-0002-2388-5353)
- Tim Ramsay (ORCID: https://orcid.org/0000-0001-8478-8170)
- Cristín A. Ryan (ORCID: https://orcid.org/0000-0002-6037-4413)
- Caitríona Cahir (ORCID: https://orcid.org/0000-0002-7137-5737)
- Steven Hawken (ORCID: https://orcid.org/0000-0002-3341-9022)
- Roland Halil
- Douglas G. Manuel (ORCID: https://orcid.org/0000-0003-0912-0845)
- Lise M. Bjerre (ORCID: https://orcid.org/0000-0003-3634-3585)
- Kasim E. Abdulaziz (ORCID: https://orcid.org/0000-0002-6072-0822)
- Christina Catley (ORCID: https://orcid.org/0000-0002-7893-030X)
- Ulrika Gillespie (ORCID: https://orcid.org/0000-0003-2181-4719)
- Kednapa Thavorn (ORCID: https://orcid.org/0000-0003-4738-8447)
- Glenys Smith
Institutions
- Uppsala University (SE)
- University of Ottawa (CA)
- Trinity College Dublin (IE)
- Children's Hospital of Eastern Ontario (CA)
- Ottawa Hospital (CA)
- Ottawa Public Health (CA)
- Bruyère (CA)
- Institut du Savoir Montfort (CA)
Publication Details
- Journal
- Journal of Clinical Epidemiology
- Published
- 2025-08-18
- DOI
- https://doi.org/10.1016/j.jclinepi.2025.111932
- Citations
- 2
- Primary Topic
- Pharmaceutical Practices and Patient Outcomes
- Type
- article
- Field-Weighted Citation Impact
- 2.45