Multi-Criteria Assessment of Potentially Inappropriate Medications in Hospitalized Indian Older Adults: Comparing BEERS, STOPP, and FORTA

This study compared potentially inappropriate medications (PIMs) using three criteria (BEERS 2019, STOPP v2, and FORTA 2021) in hospitalized older adults in Southern India. In this cross-sectional study of 597 patients (mean age: 72.80 ± 7.41 years), PIM prevalence was remarkably high across all criteria: BEERS (99.33%), STOPP (99.16%), and FORTA (99.83%). The mean PIMs per patient were: BEERS (3.89 ± 1.84), STOPP (3.77 ± 1.92), and FORTA (7.94 ± 3.22). Cohen’s kappa showed fair agreement between BEERS and STOPP criteria (κ = 0.252, p < .001), but poor agreement with FORTA. Bland–Altman analysis indicated acceptable agreement between each tool and mean standardized PIM value. The number of medications during hospitalization was the only significant predictor of PIM use in both BEERS (OR = 2.504, p = .008) and STOPP criteria (OR = 1.685, p = .008). Results highlight the need for systematic medication review.