Background Potentially inappropriate prescriptions (PIP) cause an elevated number of hospital admissions in multipathological polymedicated geriatric patients. An important percentage of this population lives in nursing homes, where pharmacological treatments should have greater control than in the case of non-institutionalised elderly patients (non-IEP).
Purpose To compare the prevalence of PIP between institutionalised elderly patients (IEP) and non-IEP admitted to a third-level hospital at the moment of admission, and to identify the most inadequately prescribed pharmacological groups in those patients by using STOPP/START criteria.
Material and methods A retrospective, observational study was conducted in elderly patients over 80 years’ old. A random sample of 218 patients was taken from a population of the total of elderly patients admitted to the Geriatric Unit of the hospital in 2017. A review of the medical discharge reports was carried out to obtain the patient demographic characteristics, number of prescribed drugs and PIP identified at the moment of admission. PIPs were classified according to STOPP/START criteria (2014 version).
Results Two-hundred and eighteen patients were included (70.5% females) with a median age of 94 (SD=3.4). An average of 8.8 prescribed drugs/patient (SD=3.2) was found. 92.3% of the patients had at least one PIP at admission, higher than the percentage found in similar studies (76.8%1).
Average of 2.9 PIP/patient: 2.8 PIP/non-IEP (SD=1.8) and 3.2 PIP/IEP (SD=1.5), resembling data observed in other studies: 2.9 PIP/non-IEP,2 and 3.5 PIP/IEP.3
84.4% of patients had at least one STOPP criteria, a higher rate than obtained in other studies (54.44%–58%5). The most frequent drugs were drugs without indication and central nervous system drugs that can cause falls.
40.4% of patients had at least one START criteria, similar to the percentage found in the literature (44.54%–46%5). The omission of cardiovascular system drugs and calcium and vitamin D supplements in patients with osteoporosis were the most prevalent.
Conclusion There is a high prevalence of PIP in elderly patients admitted to hospital regardless of where they come from (nursing homes or their own home). A higher control of prescriptions appears to be needed in nursing homes.
References and/or acknowledgements 1. Martin JH et al. (2018) http://dx.doi.org/10.1136/ejhpharm-2017–001262
2. Ahmad A, et al. (2014) DOI:10.2147/PPA.S48357
3. Finkers F et al. (2007) DOI:10.1111/j.1365–2710.2007.00849.x
4. Bo M, et al. (2018) DOI:10.1111/ggi.13542
5. Argoullon L, et al. (2018) DOI:10.1684/pnv.2018.0726
No conflict of interest.
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