PHP114 - Evaluation of Potentially Inappropriate Medications and Clinical Outcomes in Older Adults Admitted to the Medical Intensive Care Unit

Abstract

To comparatively assess the potentially inappropriate medications (PIMs) use and its impact on clinical outcomes among older adults admitted to intensive care unit (ICU) using three different screening criteria for PIMs. The analyses included 346 US older adults (≥65 years) admitted to the medical ICU of DCH Regional Medical Center in 2014. PIMs were identified using Beers Criteria (2015 and 2012 versions) and Screening Tool of Older People’s Potentially Inappropriate Prescriptions (STOPP). The proportions of PIM use at admission and discharge, and proportions of in-hospital mortality and ICU/hospital readmission among patients with PIM use were compared among the three criteria using Chi square test. Multivariate Poisson regression models assessed the associations of PIM use with hospital and ICU length of stay. Statistical significance was considered at P<0.05. The proportions of PIMs identified through three different criteria (at admission: 10.2%, 8.1%, and 5.3%; and at discharge: 9.8%, 7.4%, and 4.4% using 2015 Beers, 2012 Beers, and STOPP, respectively) were significantly different from each other (2012/2015 Beers vs. STOPP, P<0.01). PIM use at admission measured by STOPP was significantly associated with longer ICU stay (RR=1.24; 95% CI: 1.11–1.38) and hospital length of stay (RR=1.24; 95% CI: 1.16–1.33). However, PIM identified through the Beers Criteria (2015 and 2012 versions) were associated with shorter ICU and hospital length of stay. No differences were found in proportions of in-hospital mortality, ICU/hospital readmission among patients with PIM identified through three different criteria. Although the Beers Criteria demonstrated the ability to identify PIMs more frequently, patients with PIMs identified using the STOPP were associated with longer ICU and hospital length of stay. Our findings indicate that clinical interventions aiming to reduce PIMs identified by the STOPP at inpatient/ICU settings might help shorten patient’s inpatient/ICU length of stay.