Background Different tools aimed for the detection of potentially inappropriate prescribing (PIPs) have been developed in the past years.
Purpose To describe and compare the prevalence of PIPs detected in institutionalised patients according to Beers, STOPP-START and PRISCUS criteria, and to identify the most involved therapeutic groups.
Material and methods Cross-sectional descriptive analysis which included a random sample of institutionalised patients, 65 years’ old or older and with active drugs in electronic prescribing (EP) at the time of data collection (May 2018).
Variables were: age, sex, Charlson comorbidity index (ChI), number of PIPs detected with each tool applied and drug involved in the PIP.
To obtain the data, medical records and EP were reviewed.
Results A total of 76 patients were analysed. Mean age was 88.39 years (±5.6), with 94.5% of patients over 80 years: 80.3% were females. Median number of drugs/patient was 9 (2–18) with 56.6% of patients between 5–10 drugs and 28.9% over 10. Mean ChI was 6.92 (±1.54), corresponding to a moderate-high comorbidity degree.
At least one PIP was detected by one of the tools in 84% (n=64) of the patients. Three-hundred and six PIPs out of 655 analysed prescriptions were detected: 140 by STOPP criteria (1.8/patient), 119 by Beers (1.56/patient) and 35 by PRISCUS (0.46/patient). START criteria detected 12 drug omissions.
PIPs detected affected 176 drugs. ‘Nervous system’ (group N) with 70.4% was the most involved pharmacotherapeutic group, followed by ‘Alimentary tract and metabolism’ (group A) with 12%. Benzodiazepines and proton pump inhibitors were the most frequent drugs. Omission of drugs (START criteria) mainly affected anti-dementia drugs.
Conclusion The analysed population had a very advanced age and a considerably high degree of polypharmacy, as comorbidity is important. In our patients, the prevalence of detected PIPs was high. STOPP criteria had the highest quantitative detection capacity. Nervous system drugs were the most frequently involved.
PIPs are a real problem in the elderly. Pharmacists’ contribution to their systematic detection can improve safety and promote the rational use of medicines.
References and/or acknowledgements No conflict of interest.