Evidence map›Paper›PMID 28667818›Full record

ArticleBritish journal of clinical pharmacology2017

Hospitalization rates during potentially inappropriate medication use in a large population-based cohort of older adults.

Stefan Varga, Matthew Alcusky, Scott W Keith, Sarah E Hegarty, Stefano Del Canale, Marco Lombardi, Vittorio Maio

Open access · bronzeAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in British journal of clinical pharmacology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 1 pooled it
3.7field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

28 citing papers in PubMed, 1 synthesis or guideline pooled it, 54 citations in OpenAlex.

  1. Pooled it
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  7. Prevalence and factors associated with potentially inappropriate medications in elderly stroke patients: A comparison of Beers 2019 and 2023 criteria.Saudi pharmaceutical journal : SPJ : the official publication of the Saudi Pharmaceutical Society · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 2 countries.

Stefan VargaCollege of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.
Matthew AlcuskyUniversity of Massachusetts Medical School, Worcester, MA, USA.ORCID http://orcid.org/0000-0001-5604-721X
Scott W KeithDivision of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA.
Sarah E HegartyDivision of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, PA, USA.
Stefano Del CanaleLocal Health Authority of Parma, Parma, Italy.
Marco LombardiLocal Health Authority of Parma, Parma, Italy.
Vittorio MaioCollege of Population Health, Thomas Jefferson University, Philadelphia, PA, USA.ORCID http://orcid.org/0000-0001-9971-6989
Thomas Jefferson University · USUniversity of Parma · ITUniversity of Massachusetts Chan Medical School · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

BACKGROUND AND

aimsThe temporal relationship between potentially inappropriate medication (PIM) use and hospitalization remains uncertain. We examined whether current PIM use increases the rate of hospitalization and estimated the rate of hospitalization during exposure to individual PIMs.

methodsA retrospective population-based cohort study of 1 480 137 older adults was conducted using the 2003-2013 Italian Emilia-Romagna Regional administrative healthcare database (~4.5 million residents), which includes demographic, hospital and outpatient prescription information. Each day of follow-up was defined as exposed/unexposed to PIMs that 'should always be avoided', according to the Maio criteria, an Italian modified version of the Beers criteria. The study outcome was all-cause hospitalizations. Crude PIM-related hospitalization rates were calculated for individual PIMs. Repeated-events Cox proportional hazards models with time-dependent covariates estimated adjusted hazard ratios for hospitalization during PIM exposure, as defined by three versions of the Maio criteria (v2007, v2011, v2014).

resultsDuring >10 million person-years of follow-up, 54.2% of individuals used ≥1 PIM and 10.9% of all person-time was exposed to v2014 PIMs. Among 1 604 901 hospitalizations, 15.6% occurred during v2014 PIM exposure. Crude hospitalization rates during v2014 PIM-exposed and unexposed person-time were 228.1 and 152.1 per 1000 person-years, respectively. The PIM with the highest rate of hospitalization was ketorolac, while nonsteroidal anti-inflammatory drugs had the most exposure time. The hazard of hospitalization was 16% greater (hazard ratio = 1.16; 95% confidence interval 1.14, 1.18) among patients exposed to v2014 PIMs. The v2007 and v2011 estimates were similar.

conclusionsIn this large population-based cohort of older adults, we found a 16% increased hospitalization risk associated with PIM exposure.

Indexed as

AgedAged, 80 and overFemaleFollow-Up StudiesHospitalizationHumansInappropriate PrescribingItalyMalePotentially Inappropriate Medication ListProportional Hazards ModelsRetrospective Studieshospitalizationolder adultspharmacoepidemiologyprescribing

Identifiers

PMID28667818
PMCPMC5651328
OpenAlexW2734113620

What OpenQuestion holds

Textmetadata
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.