Assessing potentially inappropriate prescribing (PIP) and predicting patient outcomes in Ontario's older population: a population-based cohort study applying subsets of the STOPP/START and Beers' criteria in large health administrative databases.
Bottom Line: The aim of this study is to describe the occurrence of PIP in Ontario's older population (aged 65 years and older), and to assess the health outcomes and health system costs associated with PIP-more specifically, the association between PIP and the occurrence of ED visits, hospitalisations and death, and their related costs.Ethical approval was obtained from the Ottawa Health Services Network Ethical Review Board and from the Bruyère Research Institute Ethics Review Board.Dissemination will occur via publication, presentation at national and international conferences, and ongoing exchanges with regional, provincial and national stakeholders, including the Ontario Drug Policy Research Network and the Ontario Ministry of Health and Long-Term Care.
Affiliation: Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada Bruyère Research Institute, Ottawa, Ontario, Canada ICES@ uOttawa, Ottawa, Ontario, Canada School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.Show MeSH
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Mentions: The index date of a patient's recruitment into the study cohort will be the date of the first prescription dispensed following the beginning of the accrual period (1 April 2003). Patients will be excluded if they do not have a valid OHIP number. This includes individuals whose healthcare is provided by other plans (eg, First Nations people living on reserves, members of the Canadian Armed Forces and refugee claimants) and is therefore not captured by Institute for Clinical Evaluative Sciences (ICES) data. Patients will also be excluded if they were not OHIP-eligible for at least 1 year prior to the index date, or 1 year after the index date, or if they do not have continuous OHIP coverage between these two dates; this is necessary to ensure that predictors and outcomes of PIP can be adequately captured. Patients not dispensed any prescription medication will not be included in the study. The selection of the study cohort is shown graphically in figure 2. Based on these criteria, we estimate that in excess of two million patients will contribute data to our study (see Methods section, ‘Validation and power’, for calculations leading to this estimate).
Affiliation: Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada Bruyère Research Institute, Ottawa, Ontario, Canada ICES@ uOttawa, Ottawa, Ontario, Canada School of Epidemiology, Public Health and Preventive Medicine, University of Ottawa, Ottawa, Ontario, Canada.