***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: INTRODUCTION STOPP ( Screening Tool of Older Persons '  potentially inappropriate Prescriptions ) is a new , systems-defined medicine review tool . We compared the performance of STOPP to that of established Beers ' criteria in detecting potentially inappropriate medicines ( PIMs ) and related adverse drug events ( ADEs ) in older patients presenting for hospital admission . METHODS we prospect ively studied 715 consecutive acute admissions to a university teaching hospital . Diagnoses , reason for admission and concurrent medications were recorded . STOPP and Beers ' criteria were applied . PIMs with clear causal connection or contribution to the principal reason for admission were determined . RESULTS median patient age ( interquartile range ) was 77 ( 72 - 82 ) years . Median number of prescription medicines was 6 ( range 0 - 21 ) . STOPP identified 336 PIMs affecting 247 patients ( 35 % ) , of whom one-third ( n = 82 ) presented with an associated ADE . Beers ' criteria identified 226 PIMs affecting 177 patients ( 25 % ) , of whom 43 presented with an associated ADE . STOPP-related PIMs contributed to 11.5 % of all admissions . Beers ' criteria -related PIMs contributed to significantly fewer admissions ( 6 % ) . CONCLUSION STOPP criteria identified a significantly higher proportion of patients requiring hospitalisation as a result of PIM-related adverse events than Beers ' criteria . This finding has significant implication s for hospital geriatric practice BACKGROUND Previous studies have not demonstrated a consistent association between potentially inappropriate medicines ( PIMs ) in older patients as defined by Beers criteria and avoidable adverse drug events ( ADEs ) . This study aim ed to assess whether PIMs defined by new STOPP ( Screening Tool of Older Persons ' potentially inappropriate Prescriptions ) criteria are significantly associated with ADEs in older people with acute illness . METHODS We prospect ively studied 600 consecutive patients 65 years or older who were admitted with acute illness to a university teaching hospital over a 4-month interval . Potentially inappropriate medicines were defined by both Beers and STOPP criteria . Adverse drug events were defined by World Health Organization-Uppsala Monitoring Centre criteria and verified by a local expert consensus panel , which also assessed whether ADEs were causal or contributory to current hospitalization . Hallas criteria defined ADE avoidability . We compared the proportions of patients taking Beers criteria PIMs and STOPP criteria PIMs with avoidable ADEs that were causal or contributory to admission . RESULTS A total of 329 ADEs were detected in 158 of 600 patients ( 26.3 % ) ; 219 of 329 ADEs ( 66.6 % ) were considered causal or contributory to admission . Of the 219 ADEs , 151 ( 68.9 % ) considered causal or contributory to admission were avoidable or potentially avoidable . After adjusting for age , sex , comorbidity , dementia , baseline activities of daily living function , and number of medications , the likelihood of a serious avoidable ADE increased significantly when STOPP PIMs were prescribed ( odds ratio , 1.847 ; 95 % confidence interval [ CI ] , 1.506 - 2.264 ; P < .001 ) ; prescription of Beers criteria PIMs did not significantly increase ADE risk ( odds ratio , 1.276 ; 95 % CI , 0.945 - 1.722 ; P = .11 ) . CONCLUSION STOPP criteria PIMs , unlike Beers criteria PIMs , are significantly associated with avoidable ADEs in older people that cause or contribute to urgent hospitalization Purpose Potentially inappropriate prescribing is common in older people presenting to hospital with acute illness in Irel and . The aim of this study was to determine if this phenomenon is unique to Irel and or whether it is a more widespread problem in hospitals across Europe . Methods Prospect i ve data were collected from 900 consecutive older patients admitted to six university teaching hospitals ( 150 patients per centre ) in Geneva ( Switzerl and ) , Madrid ( Spain ) , Oostende ( Belgium ) , Perugia ( Italy ) , Prague ( Czech Republic ) and Cork ( Irel and ) . 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 inappropriate 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 medications : odds ratio ( OR ) 7.22 , 95 % confidence interval ( CI ) 4.30–12.12 , p < 0.001 ] and Beers ’ criteria ( with > 10 medications : OR 4.87 , 95 % CI 3.00–7.90 , p < 0.001 ) . Increasing co-morbidity ( Charlson Index ≥2 ) and age ≥85 years significantly 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 OBJECTIVES To evaluate the association between the Drug Burden Index ( DBI ) , a measure of a person 's total exposure to anticholinergic and sedative medications that includes principles of dose-response and maximal effect and is associated with impaired physical function in community-dwelling older people , and falls in residents of residential aged care facilities ( RACFs ) . DESIGN Data were drawn from participants in a r and omized controlled trial that investigated falls and fractures . SETTING RACFs in Sydney , Australia . PARTICIPANTS Study participants ( N=602 ; 70.9 % female ) were recruited from 51 RACFs . Mean age was 85.7 ± 6.4 , and mean DBI was 0.60 ± 0.66 . MEASUREMENTS Medication history was obtained on each participant . Drugs were classified as anticholinergic or sedative and a DBI was calculated . Falls were measured over a 12-month period . Comorbidity , cognitive impairment ( Mini-Mental State Examination ) and depression ( Geriatric Depression Scale ) were determined . RESULTS There were 998 falls in 330 individuals during a follow-up period of 574.2 person-years , equating to an average rate of 1.74 falls per person-year . The univariate negative binomial regression model for falls showed incidence rate ratios of 1.69 ( 95 % confidence interval (CI)=1.22 - 2.34 ) for low DBI ( < 1 ) and 2.11 ( 95 % CI=1.47 - 3.04 ) for high DBI ( ≥1 ) when compared with those who had a DBI of 0 . After adjusting for age , sex , history of falling , cognitive impairment , depression , use of a walking aid , comorbidities , polypharmacy , and incontinence , incident rate ratios of 1.61 ( 95 % CI=1.17 - 2.23 ) for low DBI and 1.90 ( 95 % CI=1.30 - 2.78 ) for high DBI were obtained . CONCLUSION DBI is significantly and independently associated with falls in older people living in RACFs . Interventional studies design ed for this population are needed to determine whether reducing DBI , through dose reduction or cessation of anticholinergic and sedative drugs , can prevent falls OBJECTIVE To describe the process that is being undertaken to vali date a series of indicators for preventable drug-related morbidity  - originally developed in the US - for application in the UK health care system . DESIGN A two-round Delphi question naire survey after a preliminary validation of the indicators within the University of Manchester School of Pharmacy . SETTING A primary care study set in the UK . STUDY PARTICIPANTS A purposively selected sample of general practitioners with a specific responsibility for prescribing-related issues ( n = 6 ) and pharmacists actively involved in medication review in primary care ( n = 10 ) . MAIN OUTCOME MEASURES The establishment of consensus among the participants that an indicator reflected preventable drug-related morbidity in primary care . RESULTS After preliminary validation , 37 of the original 57 US indicators were retained . The Delphi panel generated 16 additional new indicators in the first round . At the end of the second round , the pre-defined level of consensus was reached for 29 indicators ( 19 of the US generated indicators ; 10 generated by the panel in the first round ) . CONCLUSIONS The Delphi results highlighted differences in both the clinical perspective and , possibly , philosophical viewpoints of health professionals practising in the UK and US health care systems . Further work , located in both primary and secondary care , is now in progress to operationalize the indicators . This process will form a key part of the refining , and hence further validation , of the indicators . The future development of prospect i ve medical-record-based indicators should facilitate a reduction in the human , clinical , and economic burden of drug-related morbidity 
    Output:
    
Whilst a wide variety of vali date d indicator sets exist , none addressed all aspects of medication-related quality of care pertinent to residential aged care .