PHARMACOEPIDEMIOLOGY AND PRESCRIPTION Prevalence of potentially inappropriate prescribing in an acutely ill population of older patients admitted to six European hospitals Paul Gallagher & Pierre Olivier Lang & Antonio Cherubini & Eva Topinková & Alfonso Cruz-Jentoft & Beatriz Montero Errasquín & Pavla Mádlová & Beatrice Gasperini & Hilde Baeyens & Jean-Pierre Baeyens & Jean-Pierre Michel & Denis O’Mahony Received: 5 December 2010 /Accepted: 3 May 2011 # Springer-Verlag 2011 Abstract Purpose Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Ireland. The aim of this study was to determine if this phenomenon is unique to Ireland or whether it is a more widespread problem in hospitals across Europe. Methods Prospective data were collected from 900 consec- utive older patients admitted to six university teaching hospitals (150 patients per centre) in Geneva (Switzerland), Madrid (Spain), Oostende (Belgium), Perugia (Italy), Prague (Czech Republic) and Cork (Ireland). Age, gender, comorbidity, cognitive status, prescription medicines taken before admission and baseline haematological, biochemical and electrocardiographic data were recorded. STOPP and Beers’ criteria were applied to detect potentially inappro- priate medicines (PIMs). START criteria were applied to detect potentially inappropriate prescribing omissions (PPOs). Results The overall PIM prevalence rate was 51.3% using STOPP criteria, varying from 34.7% in Prague to 77.3% in Geneva, and 30.4% using Beer’ s criteria, varying from 22.7% in Prague to 43.3% in Geneva. Using START criteria, the overall PPO prevalence rate was 59.4%, ranging from 51.3% in Cork to 72.7% in Perugia. Polypharmacy predicted the presence of PIMs using STOPP criteria [with>10 medica- tions: odds ratio (OR) 7.22, 95% confidence interval (CI) 4.30–12.12, p <0.001] and Beers’ criteria (with>10 medi- cations: OR4.87, 95% CI 3.00–7.90, p <0.001). Increasing co-morbidity (Charlson Index ≥2) and age ≥85 years signif- icantly predicted PPOs. Conclusion Potentially inappropriate drug prescribing and the omission of beneficial drugs are highly prevalent in acutely ill hospitalized older people in six European centres. Keywords Inappropriate prescribing . Elderly . STOPP/ START . Beers’ criteria P. Gallagher (*) : D. O’Mahony Department of Geriatric Medicine, Cork University Hospital, Wilton, Cork, Ireland e-mail: pfgallagher77@eircom.net P. O. Lang : J.-P. Michel Rehabilitation and Geriatric Department, Geneva Medical School and University Hospitals, Geneva, Switzerland A. Cherubini : B. Gasperini Department of Clinical and Experimental Medicine, Institute of Gerontology and Geriatrics, University of Perugia Medical School, Perugia, Italy E. Topinková : P. Mádlová Department of Geriatric Medicine, First Faculty of Medicine, Charles University, Prague, Czech Republic A. Cruz-Jentoft : B. Montero Errasquín Department Servicio de Geriatría, Hospital Universitario Ramón y Cajal, Madrid, Spain H. Baeyens Department of Geriatric Medicine, AZ Alma, Eeklo, Belgium J.-P. Baeyens Department of Geriatric Medicine, AZ Damiaan, Oostende, Belgium Eur J Clin Pharmacol DOI 10.1007/s00228-011-1061-0