{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T20:01:12Z","timestamp":1792008072353,"version":"4.4.0"},"reference-count":35,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,1,3]],"date-time":"2024-01-03T00:00:00Z","timestamp":1704240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pharmacol."],"abstract":"<jats:p><jats:bold>Objective:<\/jats:bold> Polypharmacy prevalence is increasing worldwide, and it is becoming more popular among the elderly. This study aimed to compare the prevalence of potentially inappropriate medications (PIMs) using the Beers criteria (2019 edition), criteria for potentially inappropriate medications for older adults in China (Chinese criteria), Screening Tool of Older Persons\u2019 Prescriptions (STOPP), and Screening Tool to Alert to Right Treatment (START) criteria and to identify risk factors associated with PIM use.<\/jats:p><jats:p><jats:bold>Methods:<\/jats:bold> This was a cross-sectional study with a sample of 276 inpatients aged \u226565 years old from January 2020 to June 2020. A cross-sectional study was conducted to analyze PIMs based on the Beers (2019 edition), Chinese, STOPP, and START criteria. PIMs use was analysed based on four different criteria and logistic regression analysis was used to investigate independent factors associated with PIM use.<\/jats:p><jats:p><jats:bold>Results:<\/jats:bold> The mean number of medications used by the elderly population was nine (range, 0\u201328). A total of 252 patients (accounting for 91.30%) took five or more medications and 120 patients (accounting for 43.48%) took 10 or more medications. The prevalence rates of PIMs were 66.30% (183\/276), 55.07% (152\/276), 26.45% (73\/276), and 64.13% (177\/276) determined by the Beers, Chinese, STOPP, and START criteria, respectively. The top PIMs screened using the Beers, Chinese, and STOPP criteria were proton pump inhibitors, clopidogrel, and benzodiazepines, respectively. Missed use of ACEI in patients with systolic heart failure and\/or coronary artery disease was found to be the most common potential prescription omission (PPOs) analyzed using the START criteria. Logistic regression analysis showed that the strongest predictor of PIMs, as determined by all four criteria, was an increased number of medications (<jats:italic>p<\/jats:italic> &amp;lt; 0.001). Age was another risk factor for PIMs based on the STOPP criteria in our study (<jats:italic>p<\/jats:italic> &amp;lt; 0.05).<\/jats:p><jats:p><jats:bold>Conclusion:<\/jats:bold> Polypharmacy and PIMs were common in our study, and the risk of PIMs correlated with polypharmacy. Application of the Beers, Chinese, STOPP, and START criteria is a useful tool for detecting PIM use.<\/jats:p>","DOI":"10.3389\/fphar.2023.1265463","type":"journal-article","created":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T20:33:57Z","timestamp":1704486837000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":14,"title":["Evaluation of potentially inappropriate medications for the elderly according to beers, STOPP, START, and Chinese criteria"],"prefix":"10.3389","volume":"14","author":[{"given":"Xiaojuan","family":"Zhu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Feng","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahui","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jianchun","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2024,1,3]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"674","DOI":"10.1111\/jgs.15767","article-title":"American geriatrics society 2019 updated AGS beers Criteria\u00ae for potentially inappropriate medication use in older adults","volume":"67","year":"2019","journal-title":"J. Am. Geriatr. Soc."},{"key":"B2","doi-asserted-by":"publisher","first-page":"1994","DOI":"10.1111\/jcpt.13736","article-title":"Evaluation of potentially inappropriate medications in older patients admitted to the cardiac intensive care unit according to the 2019 Beers criteria, STOPP criteria version 2 and Chinese criteria","volume":"47","author":"Bai","year":"2022","journal-title":"J. Clin. Pharm. Ther."},{"key":"B3","doi-asserted-by":"publisher","first-page":"685518","DOI":"10.3389\/fphar.2021.685518","article-title":"Prevalence of polypharmacy, hyperpolypharmacy and potentially inappropriate medication use in older adults in India: a systematic review and meta-analysis","volume":"12","author":"Bhagavathula","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"187","DOI":"10.4103\/jfcm.JFCM_81_19","article-title":"Potentially inappropriate medications prescribed for older persons: a study from two teaching hospitals in Southern India","volume":"26","author":"Bhatt","year":"2019","journal-title":"J. Fam. Community Med."},{"key":"B5","doi-asserted-by":"publisher","first-page":"407","DOI":"10.2147\/CIA.S233270","article-title":"Potentially inappropriate prescriptions in ambulatory elderly patients living in rural areas of Romania using STOPP\/START (version 2) criteria","volume":"15","author":"Buda","year":"2020","journal-title":"Clin. Interv. Aging"},{"key":"B6","doi-asserted-by":"publisher","first-page":"745688","DOI":"10.3389\/fphar.2021.745688","article-title":"Predictors of polypharmacy among elderly patients in China: the role of decision involvement, depression, and taking Chinese medicine behavior","volume":"12","author":"Chen","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B7","doi-asserted-by":"publisher","first-page":"31","DOI":"10.2165\/11534640-000000000-00000","article-title":"Potentially inappropriate medication in elderly hospitalized patients","volume":"26","author":"Corsonello","year":"2009","journal-title":"Drugs Aging"},{"key":"B8","doi-asserted-by":"publisher","first-page":"111","DOI":"10.7705\/biomedica.5787","article-title":"Prevalence and impact of potentially inappropriate medication on community-dwelling older adults","volume":"41","author":"Fern\u00e1ndez","year":"2021","journal-title":"Biomedica"},{"key":"B9","doi-asserted-by":"publisher","first-page":"72","DOI":"10.5414\/cpp46072","article-title":"STOPP (screening tool of older person\u2019s prescriptions) and START (screening tool to alert doctors to right treatment). Consensus validation","volume":"46","author":"Gallagher","year":"2008","journal-title":"Int. J. Clin. Pharmacol. Ther."},{"key":"B10","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.therap.2019.10.001","article-title":"Polypharmacy: a general review of definitions, descriptions and determinants","volume":"75","author":"Guillot","year":"2020","journal-title":"Therapie"},{"key":"B11","doi-asserted-by":"publisher","first-page":"950","DOI":"10.1097\/MLR.0000000000000587","article-title":"A systematic review of the impact of potentially inappropriate medication on health care utilization and costs among older adults","volume":"54","author":"Hyttinen","year":"2016","journal-title":"Med. Care"},{"key":"B12","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/s12877-021-02208-8","article-title":"A systematic review of the evidence for deprescribing interventions among older people living with frailty","volume":"21","author":"Ibrahim","year":"2021","journal-title":"BMC Geriatr."},{"key":"B13","doi-asserted-by":"publisher","first-page":"E130","DOI":"10.1503\/cmaj.141219","article-title":"Effect of polypharmacy, potentially inappropriate medications and anticholinergic burden on clinical outcomes: a retrospective cohort study","volume":"187","author":"Lu","year":"2015","journal-title":"CMAJ"},{"key":"B14","doi-asserted-by":"publisher","first-page":"65","DOI":"10.2147\/CIA.S190983","article-title":"Comparison of three criteria for potentially inappropriate medications in Chinese older adults","volume":"14","author":"Ma","year":"2018","journal-title":"Clin. Interv. Aging."},{"key":"B15","doi-asserted-by":"publisher","first-page":"230","DOI":"10.1186\/s12877-017-0621-2","article-title":"What is polypharmacy? A systematic review of Defifinitions","volume":"17","author":"Masnoon","year":"2017","journal-title":"BMC Geriatr."},{"key":"B16","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1016\/j.archger.2018.06.018","article-title":"Polypharmacy prevalence among older adults based on the survey of health, ageing and retirement in Europe","volume":"78","author":"Mid\u00e3o","year":"2018","journal-title":"Arch. Gerontol. Geriatr."},{"key":"B17","doi-asserted-by":"publisher","first-page":"795","DOI":"10.2147\/PPA.S247013","article-title":"Medication evaluation in Portuguese elderly patients according to beers, STOPP\/START criteria and EU(7)-PIM list-an exploratory study","volume":"14","author":"Monteiro","year":"2020","journal-title":"Patient Prefer Adherence"},{"key":"B18","doi-asserted-by":"publisher","first-page":"213","DOI":"10.1093\/ageing\/afu145","article-title":"STOPP\/START criteria for potentially inappropriate prescribing in older people: version 2","volume":"44","author":"O\u2019Mahony","year":"2015","journal-title":"Age Ageing"},{"key":"B19","doi-asserted-by":"publisher","first-page":"1464","DOI":"10.1002\/pds.4849","article-title":"Do the 2015 beers criteria predict medication-related harm in older adults? Analysis from a multicentre prospective study in the United Kingdom","volume":"28","author":"Parekh","year":"2019","journal-title":"Pharmacoepidemiol. Drug Saf."},{"key":"B20","doi-asserted-by":"publisher","first-page":"443","DOI":"10.1007\/s41999-021-00479-3","article-title":"Polypharmacy in older adults: a narrative review of definitions, epidemiology and consequences","volume":"12","author":"Pazan","year":"2021","journal-title":"Eur. Geriatr. Med."},{"key":"B21","doi-asserted-by":"publisher","first-page":"777655","DOI":"10.3389\/fphar.2021.777655","article-title":"Effectiveness of interventions to reduce potentially inappropriate medication in older patients: a systematic review","volume":"12","author":"Rodrigues","year":"2021","journal-title":"Front. Pharmacol."},{"key":"B22","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1186\/s12872-017-0623-1","article-title":"Potentially inappropriate home medications among older patients with cardiovascular disease admitted to a cardiology service in USA","volume":"17","author":"Sheikh-Taha","year":"2017","journal-title":"BMC Cardiovasc. Disord."},{"key":"B23","doi-asserted-by":"publisher","first-page":"158","DOI":"10.1111\/jep.13107","article-title":"GheOP 3 S tool and START\/STOPP criteria version 2 for screening of potentially inappropriate medications and omissions in nursing home residents","volume":"26","author":"Stojanovi\u0107","year":"2020","journal-title":"J. Eval. Clin. Pract."},{"key":"B24","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1007\/s00508-020-01801-y","article-title":"Clinical pharmacist interventions in cardiovascular disease pharmacotherapy in elderly patients on excessive polypharmacy: a retrospective pre-post observational multicentric study","volume":"133","author":"Stuhec","year":"2021","journal-title":"Wien Klin. Wochenschr"},{"key":"B25","doi-asserted-by":"publisher","first-page":"11387","DOI":"10.1038\/s41598-022-15657-x","article-title":"Clinical pharmacist interventions in ambulatory psychogeriatric patients with excessive polypharmacy","volume":"12","author":"Stuhec","year":"2022","journal-title":"Sci. Rep."},{"key":"B26","doi-asserted-by":"publisher","first-page":"e27494","DOI":"10.1097\/MD.0000000000027494","article-title":"Polypharmacy and potentially inappropriate medications among elderly patients in the geriatric department at a single-center in China: a retrospective cross-sectional study","volume":"100","author":"Tao","year":"2021","journal-title":"Med. (Baltim.)."},{"key":"B27","doi-asserted-by":"publisher","first-page":"e14348","DOI":"10.1111\/ijcp.14348","article-title":"Potentially inappropriate medications in Chinese older outpatients in tertiary hospitals according to beers criteria: a cross-sectional study","volume":"75","author":"Tian","year":"2021","journal-title":"Int. J. Clin. Pract."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1415","DOI":"10.1007\/s00228-015-1954-4","article-title":"Potentially inappropriate prescribing in community-dwelling older people across Europe: a systematic literature review","volume":"71","author":"Tommelein","year":"2015","journal-title":"Eur. J. Clin. Pharmacol."},{"key":"B29","doi-asserted-by":"publisher","first-page":"1871","DOI":"10.2147\/CIA.S218849","article-title":"Relationship between potentially inappropriate medications and the risk of hospital readmission and death in hospitalized older patients","volume":"14","author":"Wang","year":"2019","journal-title":"Clin. Interv. Aging."},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3760\/cma.j.issn.1008-5734.2018.01.002","article-title":"Criteria of potentially inappropriate medication for older adults in China edition","volume":"20","author":"Wang","year":"2017","journal-title":"ADRJ"},{"key":"B31","doi-asserted-by":"publisher","first-page":"1185","DOI":"10.1080\/14740338.2018.1546841","article-title":"An update on the clinical consequences of polypharmacy in older adults: a narrative review","volume":"17","author":"Wastesson","year":"2018","journal-title":"Expert Opin. Drug Saf."},{"key":"B32","volume-title":"Guidelines for ATC classifification and DDD assignment","year":"2003"},{"key":"B33","volume-title":"International statistical classification of diseases and health related problems (The) ICD-10","year":"2014"},{"key":"B34","doi-asserted-by":"publisher","first-page":"f7033","DOI":"10.1136\/bmj.f7033","article-title":"Polypharmacy: a necessary evil","volume":"347","author":"Wise","year":"2013","journal-title":"BMJ"},{"key":"B35","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.2147\/CIA.S146009","article-title":"Potentially inappropriate medications in hospitalized older patients: a cross-sectional study using the beers 2015 criteria versus the 2012 criteria","volume":"12","author":"Zhang","year":"2017","journal-title":"Clin. Interv. Aging."}],"container-title":["Frontiers in Pharmacology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2023.1265463\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,5]],"date-time":"2024-01-05T20:34:02Z","timestamp":1704486842000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fphar.2023.1265463\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,3]]},"references-count":35,"alternative-id":["10.3389\/fphar.2023.1265463"],"URL":"https:\/\/doi.org\/10.3389\/fphar.2023.1265463","relation":{},"ISSN":["1663-9812"],"issn-type":[{"value":"1663-9812","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,1,3]]},"article-number":"1265463"}}