Table 2.
The 10 Most Common Potentially Inappropriate Prescribing Based on Drug Choice or Dosing and Drug-Disease Interaction, Detected Between 2007–2012 According to Beers Criteria 2003 and 2012
| 2012 Beers Criteria | 2003 Beers Criteria | ||
|---|---|---|---|
| Potentially Inappropriate drug choice or dosing |
PIP (%) | PIP (%) | |
| First | Digoxin doses >0.125 mg/d (5.0%) | Propoxyphene (2.4%) | |
| Second | Glyburide (2.8%) | Estrogen oral (2.1%) | |
| Third | Estrogen with or without progestins (2.6%) | Clonidine (2.1%) | |
| Fourth | Spironolactone >25 mg/d (2.4%) | Amitriptyline (1.7%) | |
| Fifth | Amitriptyline (1.8%) | Doxazosin (1.6%) | |
| Drug-Disease Interaction | |||
| First | Delirium - All TCAs, Acths, BZD, chlorpromazine, corticosteroids, H2-receptors antagonists, meperidine, sedative hypnotics, thioridazine (5.4%) | Cognitive Impairment- Barbiturates, Acths, Antispasmodics and muscle relaxants, CNS stimulants (2.0%) | |
| Second | History of falls or fractures - Anticonvulsants, antipsychotics, BZD, non-BZD hypnotics, TCA, SSRIs (4.9%) | Chronic Constipation- CCBs, Acths, and TCAs (1.1%) | |
| Third | Dementia and cognitive impairment – Acth, BZD, H2-receptors antagonists, zolpidem, antipsychotics, chronic and as-needed use (4.2%) | Blood clotting disorders or receiving anticoagulant therapy – NSAIDs, aspirin, dipyridamole, ticlopidine, clopidogrel (1.0%) | |
| Fourth | Heart Failure – NSAIDs and COX-2 inhibitors, nondihydropyridine CCBs (diltiazem, verapamil), pioglitazone, rosiglitazone, cilostazol, dronedarone (3.3%) | Stress Urinary Incontinence – Alpha blockers, Acths, TCAs, long acting BZD (0.6%) | |
| Fifth | Syncope – AChEIs, Peripheral alpha blockers (doxazosin, Prazosin, Terazosin), Tertiary TCAs, Chlorpromazine, thioridazine, and olanzapine (2.1%) | Arrhythmias - TCAs (0.4%) | |
Acths: Anticholinergics; CNS: Central Nervous System; TCA: tricyclic antidepressant; CCB: calcium channel blocker; BZD: Benzodiazepines; SSRI: Selective Serotonin Reuptake Inhibitor; NSAIDs: non-steroidal anti-inflammatory drugs; COX: cyclooxygenase; AChEI: acetylcholinesterase inhibitor.