Background Comorbidity and polypharmacy in conjunction with physiological changes in older people contribute to the well-documented problem of inappropriate drug prescription, a risk associated with an age group.
Purpose To find out to what extent drug prescribing is modified in older patients by using a systems-defined medicine review tool: potential drug-related problems (DRPs) and START (Screening Tool to Alert doctors to Right Treatment)/STOPP (Screening Tool of Older Person's Prescriptions) criteria, optimising the pharmaceutical validation process to detect inappropriate and omitted prescribed drugs.
Materials and methods A three-month prospective study carried out on 45 patients aged over 70, with 4 or more drug prescriptions, on medium or long hospitalisation in a nursing home with 140 beds. A database was created using all the patient's demographic data along with prescribed drugs, diagnoses and outstanding data from their medical profile. Detected potential DRPs and START-STOPP criteria were set out, differentiating the clinical category for each patient. The authors determined the total potential DRPs found in these patients, the average value per patient and prescription line, the percentage of potential DRPs as defined by START-STOPP criteria, the total of START-STOPP criteria and the average adhered to of each criteria per patient and prescription line.
Results 45 patients included, 69% were women and 31% men, aged 84 on average. Average number of prescription medicines was 6. A total of 171 potential DRPs were identified, averaging 3.8 potential DRPs per patient and 0.62 per prescription line. 147 of the potential DRPs were due to the application of START-STOPP criteria (85.9%) 3.2 and 0.52 was the number of START-STOPP criteria per patient and per prescription line respectively. 48.2% (38 patients) met START criteria (0.26 START/ prescription line) and 51.7% (37 patients) STOPP criteria (0.27 STOPP/ prescription line).
Conclusions The authors found a high number of potential DRPs. START/STOPP criteria resulted in a fast application screening tool to detect and prevent a high percentage of these DRPs.
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