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Potentially inappropriate prescribing among older residents in a geriatric hospital in Israel.
Int J Clin Pharm. 2013 Oct;35(5):677-82
Authors: Frankenthal D, Lerman Y, Kalendaryev E, Lerman Y
Abstract
BACKGROUND: STOPP/START ("screening tool of older persons potentially inappropriate prescriptions"/"screening tool to alert doctors to right treatment") criteria were formulated to identify potentially inappropriate prescriptions (PIP) and potential prescription omissions (PPO) in older people.
OBJECTIVE: To determine the prevalence of PIP and PPO using STOPP/START criteria and to identify associated risk factors.
METHOD: Data were prospectively collected from 382 residents' records in an Israeli geriatric hospital. The study population included subjects ≥ 65 years of age who were taking at least one medication. Data on demographics, medical histories, current diagnoses, current medications and biochemistry results were collected and analyzed. STOPP/START criteria were applied to each medical file.
RESULTS: A total of 359 residents comprised the study group (mean age [± SD] 82.7 ± 8.7, 66.6 % females). STOPP identified 430 instances of PIP in 243 (67.7 %) residents, and START identified 151 PPO in 122 (34 %) residents. The number of medications (OR: 1.2, 95 % CI 1.11-1.3), falls (OR: 1.16, 95 % CI 1.021-1.32) and hospitalizations (OR: 1.25, 95 % CI 1.025-1.53) were identified as predictors for STOPP-defined PIP. The Charlson Comorbidity Index (OR: 1.4, 95 % CI 1.17-1.7) was associated with START-defined PPO.
CONCLUSION: A high prevalence of PIP/PPO was found among geriatric patients and was associated with number of medications, falls, hospitalizations and Charlson Comorbidity Index score.
PMID: 23661173 [PubMed - indexed for MEDLINE]