*Purpose: While the Beers criteria (BC) and STOPP criteria (SC) have been validated in several patient populations to reduce medication use leading to adverse drug events, it has not been assessed in older kidney transplant recipients. Therefore, the purpose of this study was to apply the BC and SC in older kidney transplant recipients, assess potentially inappropriate prescribing (PIP), and evaluate opportunities for improving prescribing practices.

*Methods: This retrospective, dual center study included recipients >65 years old who received a kidney transplant between May 1, 2014 and March 1, 2018 at UNCMC or YNHH. Dual solid organ transplants were excluded. The primary endpoint was the number of PIP medications using BC and SC on admission. Secondary endpoints included types of PIP using BC and SC, the change in number of identified PIP on admission compared to discharge, the difference in the number of PIP using SC compared to the BC, and number of recipients with multiple PIP based on SC compared to BC on admission.

*Results: A total of 121 recipients were evaluated. For the primary endpoint, 60 medications (5% of total on admission) were listed on the SC compared to 106 medications (8% of total on admission) listed on the BC. The main types of PIP on SC included aspirin at doses greater than 150 mg per day (14%), drugs that adversely affect fallers (37%), and duplicate drug classes (16%). The main types of PIP on BC included central alpha-blockers (13%), sliding scale insulin (22%), and proton pump inhibitors (21%). When comparing PIP on admission to discharge, there was a 38% decrease (60 on admission, 37 on discharge) in the number medications on discharge using the SC, while there was a 9% increase (106 on admission, 116 on discharge) in the number of medications on discharge using the BC. There were more recipients with PIP medications on BC (70.2%, n=85) when compared to SC (28.9%, n=35); they were found to have these medications either on admission or discharge. Out of the recipients who had PIP medications, the number of PIP on the BC compared to the SC on admission were 85.9% vs 91.4% (p=0.55) for >1, 32.9% vs 37.1% (p=0.68) for >2, and 4.7% vs 22.9% (p<0.05) had >3.

*Conclusions: When evaluating older kidney transplant recipients, they were more likely to be on a medication listed in the BC during admission compared to the SC and have a newly added medication in the BC upon discharge. Both criteria are applicable in this population; however, further analysis is needed on these criteria’s impact on adverse drug events.

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