Evidence map›Paper›PMID 39739457›Full record

ArticleJournal of the American Geriatrics Society2025

Incidence of Potentially Inappropriate Prescribing: Longitudinal Investigation of Outpatient EHR Prescriptions.

Steven M Albert, Xiaotong Li, Sandra L Gill-Kane, Jacob Lombardi, Krishi Akenapalli, Richard D Boyce

Erratum issuedAbstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
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

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors.

Steven M AlbertDepartment of Behavioral and Community Health Science, School of Public Health, Pittsburgh, Pennsylvania, USA.
Xiaotong LiDepartment of Pharmacy and Therapeutics, School of Pharmacy, Pittsburgh, Pennsylvania, USA.
Sandra L Gill-KaneDepartment of Pharmacy and Therapeutics, School of Pharmacy, Pittsburgh, Pennsylvania, USA.
Jacob LombardiDepartment of Pharmacy and Therapeutics, School of Pharmacy, Pittsburgh, Pennsylvania, USA.
Krishi AkenapalliDepartment of Pharmacy and Therapeutics, School of Pharmacy, Pittsburgh, Pennsylvania, USA.
Richard D BoyceDepartment of Pharmacy and Therapeutics, School of Pharmacy, Pittsburgh, Pennsylvania, USA.

Funding

University of Pittsburgh Clinical and Translational Science InstituteUL1TR001857 · NCATS · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI REIS, STEVEN E · 2016 to 2025
$129.3M
VARIABILITY, STABILITY & SMOOTHNESS OF WALKINGP30AG024827 · NIA · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · PI JENNIFER S BRACH · 2004 to 2026
$28.6M
Jewish Healthcare FoundationNCATS NIH HHS UL1 TR001857NIA NIH HHS P30 AG024827University of Pittsburgh School of Public Health
6 · The paper itself

Abstract

importanceThe incidence of potentially inappropriate medication (PIM) prescribing among older adults is not as well studied as its prevalence. Estimates of factors associated with PIM incidence, such as patient age, sex, race-ethnicity, medication subsidy support, and comorbidity, are also limited.

objectiveTo estimate the incidence of PIM prescribing in older adult outpatients, as well as the incidence and predictors for each PIM class, in a large outpatient electronic health records (EHR) cohort.

designRetrospective study of PIM prescribing among outpatients with encounters leading to prescription orders, 2015-2018, excluding prevalent cases.

settingOutpatients receiving care from a multi-site health system in western Pennsylvania.

participants342,405 patients, contributing 893,754 person-years of follow-up. MAIN OUTCOMES AND MEASURES: The incidence of PIM prescribing based on automated coding of 2019 Beers criteria. A multivariable Poisson regression model was estimated to assess the impact of age, sex, race-ethnicity, comorbidity, and medication subsidy (PACE/PACENET) on PIM risk. For each PIM class, the association between predictors and time to PIM prescribing was evaluated using proportional hazard models.

resultsThe incidence rate (IR) for 1 or more PIM was 193.5 per 1000 person-years, led by short- and intermediate-acting benzodiazepines (37.6), first-generation antihistamines (32.8), and skeletal muscle relaxants (22.0). The incidence of PIM prescribing was 15% higher among white patients and 35% lower among males. High comorbidity (Charlson score ≥ 3) was associated with a 59% higher risk. Participation in the PACE/PACENET program, a medication subsidy program, was associated with an 83% increase in incidence. Each additional year of age was associated with a 1.2% reduction in incidence. CONCLUSIONS AND RELEVANCE: This study establishes benchmarks for the incidence of PIM prescribing in outpatients and identifies important disparities in PIM risk, which vary by PIM class.

Indexed as

Electronic Health RecordsInappropriate PrescribingOutpatientsPotentially Inappropriate Medication ListAgedAged, 80 and overFemaleHumansIncidenceLongitudinal StudiesMalePennsylvaniaPractice Patterns, Physicians'Retrospective Studieselectronic health recordinappropriate prescribingincidencemedicationsoutpatients

Identifiers

PMID39739457
PMCPMC11907745

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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.