scholarly journals Ability to detect potentially inappropriate prescribing in older patients: comparative analysis between PIM-Check and STOPP/STARTv2

2021 ◽  
Author(s):  
Akram Farhat ◽  
Alice Panchaud ◽  
Amal Al-Hajje ◽  
Pierre-Olivier Lang ◽  
Chantal Csajka
Keyword(s):  
Comparative Analysis ◽  
Older Patients ◽  
Adverse Drug Events ◽  
Inappropriate Prescribing ◽  
University Hospital ◽  
Potentially Inappropriate Prescribing ◽  
Geriatric Ward ◽  
Start Criteria ◽  
Acute Geriatric Ward ◽  
Geriatric Settings

Abstract Purpose Potentially inappropriate prescribing (PIP) is a source of preventable adverse drug events. The objective of this study was a comparative analysis (quantitative and qualitative) between two tools used to detect PIP, PIM-Check and STOPP/START. Methods First, a qualitative analysis (QAC) was conducted to evaluate the concordance between the criteria, which constitute PIM-Check and the gold standard STOPP/START. Second, a retrospective comparative and observational study was performed on the list of treatment at the admission of 50 older patients hospitalized in an acute geriatric ward of a university hospital in Switzerland in 2016 using both tools. Results The QAC has shown that 50% (57 criteria) of STOPP/START criteria are fully or partially concordant with those of PIM-Check. The retrospective study was performed on 50 patients aged 87 years, suffering from 5 co-morbidities (min–max 1–11) and treated by of 8 drugs (min–max 2–16), as medians. The prevalence of the detected PIP was 80% by PIM-Check and 90% by STOPP/START. Medication review shows that 4.2 PIP per patient were detected by PIM-Check and 3.5 PIP by STOPP/START among which 1.9 PIP was commonly detected by both tools, as means. PIM-Check detected more PIP related to cardiology, angiology, nephrology, and endocrinology in older patients but missed the PIP related to geriatric syndromes (e.g., fall, dementia, Alzheimer) detected by STOPP/START. Conclusions By using PIM-Check in geriatric settings, some PIP will not be detected. It is considered as a limitation for this tool in this frail population but brings a certain complementarity in other areas of therapy not covered by STOPP/START.

scholarly journals Factors associated to potentially inappropriate prescribing in older patients according to STOPP/START criteria: MoPIM multicentre cohort study

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Marisa Baré ◽  
Marina Lleal ◽  
Sara Ortonobes ◽  
Maria Queralt Gorgas ◽  
Daniel Sevilla-Sánchez ◽  
...  
Keyword(s):  
Cohort Study ◽  
Chronic Disease ◽  
Medication Review ◽  
Older Patients ◽  
Primary Outcome ◽  
Inappropriate Prescribing ◽  
Potentially Inappropriate Prescribing ◽  
Disease Exacerbation ◽  
Factors Associated ◽  
Start Criteria

Abstract Objectives The objectives of the present analyses are to estimate the frequency of potentially inappropriate prescribing (PIP) at admission according to STOPP/START criteria version 2 in older patients hospitalised due to chronic disease exacerbation as well as to identify risk factors associated to the most frequent active principles as potentially inappropriate medications (PIMs). Methods A multicentre, prospective cohort study including older patients (≥65) hospitalized due to chronic disease exacerbation at the internal medicine or geriatric services of 5 hospitals in Spain between September 2016 and December 2018 was conducted. Demographic and clinical data was collected, and a medication review process using STOPP/START criteria version 2 was performed, considering both PIMs and potential prescribing omissions (PPOs). Primary outcome was defined as the presence of any most frequent principles as PIMs, and secondary outcomes were the frequency of any PIM and PPO. Descriptive and bivariate analyses were conducted on all outcomes and multilevel logistic regression analysis, stratified by participating centre, was performed on the primary outcome. Results A total of 740 patients were included (mean age 84.1, 53.2% females), 93.8% of them presenting polypharmacy, with a median of 10 chronic prescriptions. Among all, 603 (81.5%) patients presented at least one PIP, 542 (73.2%) any PIM and 263 (35.5%) any PPO. Drugs prescribed without an evidence-based clinical indication were the most frequent PIM (33.8% of patients); vitamin D supplement in older people who are housebound or experiencing falls or with osteopenia was the most frequent PPO (10.3%). The most frequent active principles as PIMs were proton pump inhibitors (PPIs) and benzodiazepines (BZDs), present in 345 (46.6%) patients. This outcome was found significantly associated with age, polypharmacy and essential tremor in an explanatory model with 71% AUC. Conclusions PIMs at admission are highly prevalent in these patients, especially those involving PPIs or BZDs, which affected almost half of the patients. Therefore, these drugs may be considered as the starting point for medication review and deprescription. Trial registration number NCT02830425

Polypharmacy among elderly populations

2017 ◽  
Vol 41 (S1) ◽  
pp. S315-S315
Author(s):  
I. Leal ◽  
P. Ordás ◽  
R. Vicente ◽  
C. Avila
Keyword(s):  
Older Patients ◽  
Psychiatric Illness ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
University Hospital ◽  
Potentially Inappropriate Medications ◽  
Potentially Inappropriate Prescribing ◽  
Cross Sectional

IntroductionPotentially inappropriate prescribing, is highly prevalent among older patients hospitalized with major psychiatric illness. Inappropriate use of psychotropic medications in elderly patients has become a focus of concern.ObjectivesTo determine the prevalence of potentially inappropriate prescribing including potentially inappropriate medications (PIMs) and potential prescription omissions (PPOs), according to STOPP-START, Beers and PRISCUS criteria applied by CheckTheMeds®.AimsTo identify potentially IP, PPo and the prevalence of contraindications, interactions and precautions in older patients hospitalized with major psychiatric illness.MethodsRetrospective cross-sectional study with patients over 65 discharged from the Psychiatric acute unit of the university hospital of La Princesa (Madrid) between January 2013 and October 2015 was conducted. The CheckTheMeds® program was used to identify IP.ResultsA total of 104 elders–74 females and 30 males–were included, with a mean age of 76 years (range: 65–91). An average of 5.73 (range: 1–16) was prescribed drugs at discharge. The Ip results STOPP 81.73% (n = 85), START 43.26% (n = 45), Beers 94.23% (n = 98) y PRISCUS 40.38% (n = 42). Contraindications were described in the 21.15% of the patients, precautions in 83.65% and interactions in 83.65%. Psychotropic drugs were the most often inappropriate prescribed medicaments.ConclusionPrescribing omissions are twice as prevalent as IP in the elderly. Currently, inappropriate prescription of psychotropic agents is very common for the elderly. Application of such screening tools to prescribing decisions may reduce unnecessary medication, related adverse events, healthcare utilization and cost and nonpharmacological interventions, should be thoroughly explored.Disclosure of interestThe authors have not supplied their declaration of competing interest.

scholarly journals Potentially Inappropriate Prescribing in a Falls Clinic Using the STOPP & START Criteria

2021 ◽  
Author(s):  
Rosalind Chiam ◽  
Nor'izzati Saedon ◽  
Hui Min Khor ◽  
Sukanya A/P Subramaniam ◽  
Siti Sakinah binti Mohmad Nasir ◽  
...  
Keyword(s):  
Adverse Drug Events ◽  
Inappropriate Prescribing ◽  
Future Research ◽  
Potentially Inappropriate Prescribing ◽  
Chi Square ◽  
Clinical Registry ◽  
Potentially Inappropriate Medicines ◽  
Start Criteria ◽  
Medicines Use ◽  
The Relationship

Abstract Background Potentially inappropriate prescribing which may lead to adverse drug events and linked to polypharmacy is becoming increasingly common in older patients. Objective This study applied the STOPP/START criteria to a clinical registry to determine the burden and profile of potentially inappropriate prescribing among patients attending a falls clinic. Setting University of Malaya Medical Centre Falls Clinic Method Data of individuals aged ≥ 65 years referred to the falls and syncope clinic were extracted from the falls registry. Potentially inappropriate prescribing was determined with the STOPP/START version 2 criteria. The relationship between potentially inappropriate prescribing with polypharmacy (≥ 5 medications), comorbidities and clinical variables were determined using Pearson’s chi-square and potential confounders adjusted for with multivariate regression. Main outcome measure Potentially inappropriate medicines and/or omitted medicines using STOPP/START criteria Results Data from 421 individuals, aged 77.8 ± 6.7 years and 53.4% women, were included. Potentially inappropriate prescribing was present in 311 (74%). Potentially inappropriate medicines use accounted for 84.6% of the 325 prescriptions. 361/659 instances (54.8%) were falls-risk-increasing drugs, with vasodilators (49.3%) being the main potentially inappropriate medicine identified. Of the 177/421 with polypharmacy, 169/177 (95.5%) were exposed to ≥ one potentially inappropriate medicine. 129 instances of potentially omitted medicines were observed in 109 prescriptions (25.9%). Conclusion STOPP/START criteria are useful to identify potentially inappropriate prescribing at the falls and syncope clinic. This finding has important implications for medication review strategies at falls clinic. Future research should determine whether identifying potentially inappropriate prescribing may reduce adverse falls outcomes among patients in this setting.

scholarly journals Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the Beers criteria

2012 ◽  
Vol 10 (2) ◽  
pp. 83-91 ◽  
Author(s):  
Amalia Ubeda ◽  
M. Luisa Ferrándiz ◽  
Nuria Maicas ◽  
Cristina Gomez ◽  
Montserrat Bonet ◽  
...  
Keyword(s):  
Older Patients ◽  
Inappropriate Prescribing ◽  
Beers Criteria ◽  
Potentially Inappropriate Prescribing ◽  
Start Criteria
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