Background Inappropriate prescribing in the elderly is a critical issue in primary care, causing a higher risk of adverse drug events and resulting in major patient safety concerns. At international level, many tools have been developed to cope with this problem and to identify Potentially Inappropriate Medications (PIMs).
Purpose The aim of this study was the application of Beers, Screening Tool of Older People’s Prescriptions (STOPP)/Screening Tool to Alert to Right Treatment (START) and Improving Prescribing in the Elderly Tool (IPET) criteria by the tracer pharmacist (TP), as a key tool in reducing PIMs and improving the quality of prescribing.
Material and methods A retrospective cohort study was conducted by the TP using Beers, STOPP/START and IPET criteria. The cohort comprised 370 elderly patients hospitalised from January to May 2015, with at least three prescriptions.
Results The average age of patients in the study was 73 years and 54.5% (209/370) of patients were males. The most common reasons for hospitalisation were cardiovascular disease (183/370) and cancer (72/370). There was an average of 4.4 comorbidities and 83.8% (310/370) of patients were in polytherapy (≥4 drugs). The prevalence of PIMs in the sample was 85.7% (317/370) according to Beers criteria, 76.5% (283/370) using STOPP criteria and 39.2% (145/370) using IPET criteria. According to Beers criteria, the most prevalent PIM, with a percentage of 72.1% (267/370), was the use of a proton-pump inhibitor, which exposes patients to Clostridium difficile infection, bone loss and fractures. According to STOPP criteria, we reported potentially constipating drugs (antimuscarinics, Fe, opioids) in 51.3% (190/370). According to IPET criteria, the use of β-blocker in patients with obstructive pulmonary disease was the predominant PIM, with a percentage of 27.3% (101/370). On the other hand, the use of START criteria allowed the detection of appropriate prescriptions, which were 151/370: the most common was the use of inhaled β2-agonists in the treatment of asthma or obstructive pulmonary disease.
Conclusion Regardless of the criteria used, our data showed that, according to Beers criteria, more than 80% of patients were exposed to PIMs. To make health professionals aware of the use of these tools and to improve care for the elderly patients, an educational brochure has been created.
References and/or acknowledgements No conflict of interest.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.