Background Polypharmacy and inappropriate prescribing (IP) are well known risk factors for adverse drug reactions, which commonly cause adverse clinical outcomes in older people.
Purpose To measure the prevalence of inappropriate drug prescriptions in elderly patients who attend the emergency room and to assess the influence on emergency visits and hospitalisations of a multidisciplinary healthcare team project designed to identify and resolve them.
Material and methods Multicentric randomised controlled trial. Patients >65 years old admitted in the emergency room were randomised to a control or intervention group. Pharmacists reviewed chronic medication of patients assigned to the intervention group and identified IP according to STOPP-START criteria. The cases were discussed with emergency physicians and when judged appropriate a recommendation to modify drug treatment was sent to the primary care physician. The control group received the standard of care that did not include chronic medication review. The main outcome measure was the difference in the rate of hospitalisation and emergency visits between groups after 1 year of follow-up. We present preliminary results of IP prevalence in elderly patients.
Results Four hospitals participated in the study and 665 patients were included (342 allocated to control and 305 to the intervention group). Mean age in the control group was 78.2 years and 78.99 years in the intervention group. The total number of drugs patients were receiving at the moment of inclusion was 3.275. Of these, 17.9% were IP according to STOP-START criteria. 530 recommendations to modify treatment were send to primary care physician. 81.1% of evaluated patients had IP.
Conclusion In our study, we found a high prevalence of IP and a high number of recommendations to modify drug treatment in older people were done. The final results of the study will clarify if these interventions improve clinical outcomes.
No conflict of interest.
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