[Potentially inappropriate prescriptions in the ambulatory treatment of elderly patients]

Rev Calid Asist. 2014 Jan-Feb;29(1):22-8. doi: 10.1016/j.cali.2013.08.001. Epub 2013 Oct 23.
[Article in Spanish]

Abstract

Introduction: The aim of this study was to establish the percentage of potentially inappropriate prescriptions, according to STOPP/START criteria, in the ambulatory treatments of patients over 65 years admitted to an internal medicine unit, and to identify the most common prescription errors.

Material and methods: A prospective, observational study was performed between October and December 2012. The variable recorded were,age, gender, Charlson comorbidity index, reason for hospitalisation and pharmacological ambulatory treatment.

Results: Data from 131 patients were collected (Mean age: 80.2 years; 58.8% male, mean Charlson comorbidity index: 2; mean number of medications per patient: 8.6). Main reasons for hospitalisation: decompensated heart failure, respiratory infection, exacerbated COPD, urinary tract infection, pneumonia, and unintended weight loss. There were 121 potentially inappropriate prescriptions detected in 73 patients (55.7%). The most common STOPP criteria were therapeutic duplicities. The most common START criteria were the omission of statins and antiplatelets in primary prevention for cardiovascular risk in patients with diabetes mellitus and at least one cardiovascular risk factor.

Conclusions: The percentage of patients with inappropriate prescriptions was similar to those obtained in similar studies. Over 50% of elderly patients had at least one inappropriate prescription. This warrants a joint search for errors by excess and by default in the prescription of medications, with the aim of performing a more complete evaluation of prescription practice and to achieve optimization of therapy in elderly patients, especially the most fragile.

Keywords: Anciano frágil; Frail elderly; Inappropriate prescribing; Medication use; Prescripciones inapropiadas; Utilización de medicamentos.

Publication types

  • English Abstract
  • Observational Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Ambulatory Care / statistics & numerical data*
  • Diagnosis-Related Groups
  • Drug Prescriptions / standards
  • Drug Prescriptions / statistics & numerical data*
  • Drug Therapy, Computer-Assisted*
  • Drug Utilization / statistics & numerical data
  • Female
  • Frail Elderly*
  • Guideline Adherence
  • Hospitals, General / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Inappropriate Prescribing / prevention & control
  • Inappropriate Prescribing / statistics & numerical data*
  • Male
  • Medication Errors / prevention & control
  • Platelet Aggregation Inhibitors / therapeutic use
  • Polypharmacy
  • Practice Guidelines as Topic
  • Spain

Substances

  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Platelet Aggregation Inhibitors