Evaluation of Potentially Inappropriate Medication Use in Patients Aged ≥ 80 Years With Atrial Fibrillation According to STOPP Criteria Version 3 and 2023 Beers Criteria

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What is Known and Objective The presence of potentially inappropriate medications (PIMs) is associated with drug‐related harmful effects, including adverse drug events, elevated rates of hospital readmissions, and higher mortality rates. Patients aged ≥ 80 years with atrial fibrillation (AF) often present with multiple comorbidities and polypharmacy; however, evidence regarding PIM usage in this specific population is still limited. Consequently, this study investigated the prevalence of PIMs in patients with AF aged ≥ 80 years and identified the factors associated with PIM use. Methods This retrospective cross‐sectional study was conducted at Beijing Tongren Hospital and included patients aged ≥ 80 years with AF who were discharged from the internal medicine wards between July 2021 and July 2024. PIMs in discharge medications were identified using the STOPP criteria Version 3 and 2023 Beers criteria. Patients who received at least one PIM were categorized into the PIM group. Consistency between the two screening tools was evaluated using the kappa test. Variables collected included gender, age, estimated glomerular filtration rate (eGFR), length of stay, age‐adjusted Charlson Comorbidity Index (aCCI), Barthel index, comorbidities, and the number of medications. Multivariable binary logistic regression was used to identify factors correlated with the incidence of PIMs. Results and Discussion Among 425 patients aged ≥ 80 years with AF, the prevalence rates of at least one PIM were 35.5% and 73.4% according to the STOPP criteria version 3 and 2023 Beers criteria, respectively. Among patients who received PIMs, the majority received only one PIM, accounting for 27.8% and 40.9% according to the STOPP criteria Version 3 and 2023 Beers criteria, respectively. Benzodiazepines, antiplatelets, and z‐drugs were the top three PIMs according to STOPP criteria version 3, whereas diuretics, rivaroxaban, and benzodiazepines were the top three PIMs according to 2023 Beers criteria. A poor concordance was observed between the two criteria ( k = 0.117, 95% confidence interval: 0.050–0.184; p = 0.01). The number of medications was associated with the prevalence of PIMs for both criteria ( p < 0.001). What is New and Conclusions The prevalence of PIMs among patients aged ≥ 80 years with AF was relatively high. The STOPP criteria Version 3 identified a lower prevalence of PIMs than the 2023 Beers criteria, and the agreement level between the two criteria was poor. The number of medications was associated with the prevalence of PIMs for both criteria.

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