Potentially Inappropriate Medication Use in Older Adults: Concordance Among the Chinese and AGS/Beers and STOPP...

Objectives: The aging population in China presents significant challenges related to polypharmacy and potentially inappropriate medication (PIM) use among older outpatients. This study aimed to evaluate the prevalence and risk factors of PIM use in older Chinese outpatients using the 2017 Chinese criteria, 2019 AGS/Beers criteria, and 2014 STOPP criteria, and to assess the concordance among these three criteria. Methods: A cross-sectional study was conducted using outpatient prescription data from 59 hospitals across six Chinese cities between January and December 2021. Prescriptions for patients aged ≥65 years were included. PIMs were identified using the three criteria. Concordance was evaluated using weighted kappa statistics. Multivariate logistic regression was used to identify factors associated with PIM use. Results: Among 131,894 prescriptions, PIM prevalence was 29.00%, 27.77%, and 19.85% according to the Chinese, Beers, and STOPP criteria, respectively. The most common PIM was estazolam. Concordance was moderate between the Chinese and Beers criteria (kappa = 0.58), STOPP criteria (kappa = 0.625), and good between Beers and STOPP criteria (kappa = 0.73). Factors associated with PIM use included age ≥80 years, polypharmacy, full self-payment, and diagnoses such as sleep disorders and arthritis. Conclusions: PIM use is prevalent among older outpatients in China, with varying rates across different criteria and regions. Interventions targeting high-risk groups and specific drug classes may improve medication safety in this population.