scholarly journals Identification of inappropriate prescribing in a Brazilian nursing home using STOPP/START screening tools and the Beers' Criteria

2014 ◽  
Vol 50 (4) ◽  
pp. 911-918 ◽  
Author(s):  
Mariana Martins Gonzaga Nascimento ◽  
Andréia Queiroz Ribeiro ◽  
Mariana Linhares Pereira ◽  
Adriana Cristina Soares ◽  
Antônio Ignácio de Loyola Filho ◽  
...  
Keyword(s):  
Nursing Home ◽  
Medical Records ◽  
Inappropriate Medication ◽  
Inappropriate Prescribing ◽  
Cross Sectional Study ◽  
Screening Tools ◽  
Beers Criteria ◽  
Cross Sectional ◽  
The Past ◽  
Prescribing Omissions

The objective of this study was to determine the prevalence of Potentially Inappropriate Medication (PIM) use and associated factors, as well as the prevalence of Prescribing Omissions (PO). A cross-sectional study was conducted in a philanthropic Brazilian nursing home involving 46 individuals aged 60 years or older. The following information was collected from medical records and drug prescriptions: gender, age, health conditions and drugs used in the past thirty days. PIM and PO were identified according to the Beers' Criteria and the STOPP/START screening tools. Over one third (37%) of the population used at least one PIM according to the Beers' Criteria (n=17) and 60.9% according to the STOPP tool. A significant association was found between polypharmacy (use of five or more drugs) and use of PIM according to the Beers' Criteria, but not according to the STOPP. Eight residents (17.4%) were exposed to eight PO. This study allowed the diagnosis of a concerning drug utilization profile with use of a high number of PIMs. Thus, there is an evident need to implement strategies for improving geriatric prescription.

scholarly journals The Prevalence of Potentially Inappropriate Prescribing in Geriatric Patients with Psychiatric Disorders in Iraq

2020 ◽  
Vol 29 (1) ◽  
pp. 166-173
Author(s):  
Mustafa K. Mahmood ◽  
Zinah M. Anwer
Keyword(s):  
Geriatric Patients ◽  
Assessment Tool ◽  
Psychiatric Patients ◽  
Inappropriate Medication ◽  
Inappropriate Prescribing ◽  
The Elderly ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Potentially Inappropriate Prescribing ◽  
Cross Sectional

Potentially inappropriate prescribing is the prescribing of a medication that may cause more harm than benefit, the elderly population aged 65 years or older is more prone to potentially inappropriate prescribing because of alterations in their physiology, pharmacokinetics, and pharmacodynamics as well as polypharmacy and comorbidities, Beers list is a screening tool that help doctors to detect potentially inappropriate prescribing in geriatric patients and is designed to solve this problem, the aim of this study is to measure the prevalence of potentially inappropriate prescribing among psychiatric patients using the Beers criteria as an assessment tool and find the relationship between duration of hospitalization, comorbidities and polypharmacy with potentially inappropriate prescribing in elderly. This cross-sectional study was carried out using electronic medical records in Ibn Rushud psychiatry and addiction hospital in Baghdad and 369 patients were included. The mean age of the patients was (68.59 ± 3.75 years) and 177 (48%) of them had comorbidities, 100 (27.1%) of them had polypharmacy and 17 (4.6%) stayed in the hospital for more than 3 weeks, the most used drug classes were antipsychotics in (39.9%) of patients and benzodiazepines in (17.6%) of patients. The prevalence of potentially inappropriate prescribing according to Beers criteria was found to be 74.3% among study patients, the most prevalent inappropriately used drug class was benzodiazepines, and there was a significant association between the prescribing of a potentially inappropriate medication with gender (p=0.018), with comorbidities (p=0.022), and a very significant association with polypharmacy (p<0.001)

scholarly journals Comparison of Beers criteria and EU(7) potentially inappropriate medications list for the potentially inappropriate medications in Indian elderly inpatients

2019 ◽  
Vol 8 (5) ◽  
pp. 1106
Author(s):  
Manoj H. Thummar ◽  
Tejas K. Patel ◽  
Varsha Y. Godbole ◽  
Manoj Kumar Saurabh
Keyword(s):  
Internal Medicine ◽  
Elderly Patients ◽  
Inappropriate Medication ◽  
Cross Sectional Study ◽  
Beers Criteria ◽  
Potentially Inappropriate Medications ◽  
Cross Sectional ◽  
Elderly Inpatients ◽  
Internal Medicine Wards ◽  
Inappropriate Medications

Background: Use of inappropriate medication is an important problem in present geriatric clinical practice. No specific potentially inappropriate medications (PIM) tools are available considering the availability of drugs in India. Aim and objective were to assess prevalence and pattern of potentially inappropriate medication (PIM) use in elderly inpatients by updated Beers criteria 2015 and EU(7) PIM list 2015.Methods: This cross-sectional study was carried out on medical records of elderly patients (≥65 yrs) admitted in the internal medicine wards and intensive care units (ICU) over a period of 6 weeks. The medications were evaluated for the PIM use as per Beers criteria and EU(7) PIM list.Results: A total of 225 patients (mean age- 71.48 yrs) were admitted in internal medicine wards and ICU during study period. Total 184 PIM belonged to 33 different medications were used during study period. The prevalence of PIM in internal medicine wards and ICUs were 51.96% and 57.14%, respectively. The prevalence of PIM was significantly higher with the EU(7) PIM list than Beers criteria (49.77% vs. 21.77%) [p<0.0001]. The commonly prescribed PIM were dextromethorphan (13.33%), ranitidine (11.11%) and glipizide (10.22%).Conclusions: Elderly patients frequently receive PIM. EU(7) PIM list identifies more PIM among elderly inpatients than Beers criteria.

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 Omeprazole prescriptions for older adults in health care units in Curitiba, Brazil: an analysis based on Beers Criteria

2021 ◽  
Vol 15 ◽  
Author(s):  
Juliana Sambugaro ◽  
Hudson Prestes dos Santos ◽  
Linda Tieko Kakitani Morishita ◽  
Alexandra Ingrid dos Santos Czepula
Keyword(s):  
Older Adults ◽  
Health Care ◽  
Medical Records ◽  
Income Level ◽  
Cross Sectional Study ◽  
Study Data ◽  
Beers Criteria ◽  
Periodic Review ◽  
Cross Sectional

OBJECTIVE: To evaluate omeprazole prescriptions for older adults based on the Beers Criteria, with an analysis of indications and duration of use longer than eight weeks. METHODS: In this retrospective cross-sectional study, data were collected from the electronic medical records of older adults with an omeprazole prescription seen at two health care units in Curitiba, Brazil, between June and August 2019. Data were subjected to descriptive statistical analysis, Student t and χ2 tests. RESULTS: Medical records of 386 patients were analyzed, and 69.95% were female. The mean age was 71 (SD, 8.15) years. Most patients had incomplete primary education (50.52%) and income level ranging from one to two Brazilian minimum monthly wages (39.90%). No indication for omeprazole prescription was found in 23.83% of medical records. Use longer than eight weeks was predominant for all indications in 96.60% of medical records. Duration of use more extended than the Beers Criteria recommendation was independent of sex (p = 0.327), education (p = 0.805), and income level (p = 0.629). A relationship between polypharmacy and long-term drug use was demonstrated (p < 0.001). CONCLUSION: The results of this study suggest the need for periodic review of omeprazole prescriptions considering deprescribing when they appropriate.

scholarly journals PRESCRIBING PATTERN IN GERIATRIC PATIENTS IN MEDICAL OPD OF A TERTIARY CARE TEACHING HOSPITAL

2021 ◽  
pp. 132-134
Author(s):  
KANIKA KHAJURIA ◽  
VIJAY KHAJURIA
Keyword(s):  
Prescription Drugs ◽  
Geriatric Patients ◽  
Inappropriate Medication ◽  
Tertiary Care ◽  
Cross Sectional Study ◽  
Brand Names ◽  
Beers Criteria ◽  
Prescribing Pattern ◽  
Geriatric Population ◽  
Cross Sectional

Objectives: Geriatric population is increasing globally and they suffer from multiple disorders necessitating administration of number of drugs. The objective of the present study was to examine the prescribing pattern in geriatric patients in a medical OPD. Methods: An observational, cross-sectional study was conducted in medical OPD of Government Medical College, Jammu, over a period of a month after approval of the Institutional Ethics Committee. Patients above 65 years of age who gave consent were included in the study. The prescriptions were analyzed for demographic profile (age and gender), average number of drugs per prescription, drugs by generic or brand names, fixed drug combinations (FDCs), and percentage of potentially inappropriate as per Beers criteria. Results: A total of 200 patients were included comprised 64% of males and 36% of females. The most of patients were in the age group of 65–69 years (37.5%). A total of 200 prescriptions contained 1128 drugs amounting to average 5.64 number of drugs per prescription. Maximum prescriptions had 1–5 drugs (61%) followed by 6–10 drugs (38.5%). Majority of drugs were prescribed by brand name (93.26%) and only 6.73% of drugs were prescribed by generic name. About 10.46% FDCs were prescribed. Maximum drugs prescribed were from respiratory system (20.3.1%), followed by GIT (18.4%), antimicrobials (17.2%), cardiovascular (10.99%), NSAIDs (9.3%), and vitamins (8.4%). Forty-one drugs (20.5%) in patients were potentially in appropriate drugs based Beers criteria and belonged mostly to anticholinergic, antihistaminic, sedatives, NSAIDs, and H2 blockers. Conclusions: The present study demonstrates that polypharmacy and potentially inappropriate medication are still present in OPD prescription of geriatric population. Generic prescribing still lacks. Application of Beers criteria and increasing awareness about polypharmacy should be encouraged.

Suicidal Ideation Among Medical Students in Dammam, Saudi Arabia

Crisis ◽  
2020 ◽  
pp. 1-6
Author(s):  
Mohammed Madadin ◽  
Ritesh G. Menezes ◽  
Maha A. Alassaf ◽  
Abdulaziz M. Almulhim ◽  
Mahdi S. Abumadini ◽  
...  
Keyword(s):  
Saudi Arabia ◽  
Medical Students ◽  
Suicidal Ideation ◽  
General Health Questionnaire ◽  
Cross Sectional Study ◽  
Eastern Province ◽  
Cross Sectional ◽  
The Past ◽  
Depression Subscale ◽  
History Of

Abstract. Background: Medical students are at high risk of suicidal ideation. Aim: We aimed to obtain information on suicidal ideation among medical students in Dammam located in the Eastern Province of Saudi Arabia. Method: This cross-sectional study was conducted at the College of Medicine affiliated with Imam Abdulrahman Bin Faisal University in the Eastern Province of Saudi Arabia. Suicidal ideation in the past 12 months was assessed based on responses to four questions in the depression subscale of the General Health Questionnaire 28 (GHQ-28). In addition, data were collected to examine the association of suicidal ideation with various factors. Results: We found that 1 in 3 medical students in the study had suicidal ideation in the past 12 months, while around 40% had lifetime suicidal ideation. Suicidal ideation was associated with feelings of parental neglect, history of physical abuse, and dissatisfaction with academic performance. Limitations: The cross-sectional nature of this study limits its ability to determine causality regarding suicidal ideation. Conclusion: These rates are considerably high when compared with rates from studies in other countries around the world. This study provides a reference in the field of suicidology for this region of Saudi Arabia.

scholarly journals Knowledge and perceptions of cardiopulmonary resuscitation amongst New Zealand podiatrists: a web-based survey

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Angela Brenton-Rule ◽  
Daniel Harvey ◽  
Kevin Moran ◽  
Daniel O’Brien ◽  
Jonathon Webber
Keyword(s):  
New Zealand ◽  
Cardiopulmonary Resuscitation ◽  
Life Support ◽  
Survival Rates ◽  
Sudden Cardiac Arrest ◽  
Cross Sectional Study ◽  
Trial Registration ◽  
Cross Sectional ◽  
Web Based ◽  
The Past

Abstract Background Podiatrists in New Zealand have a duty of care to assist patients in an emergency, and current cardiopulmonary resuscitation (CPR) certification is a requirement for registration. However, it is unknown how competent and confident podiatrists are in administering CPR and how they would respond in an emergency. Having a health professional who has a competent knowledge of CPR and skills in basic life support, can improve survival rates from sudden cardiac arrest. Therefore, the aim of this study was to survey New Zealand podiatrists to determine their CPR knowledge and qualifications; beliefs about the application of CPR; and perceptions of their competency in CPR. Methods This cross-sectional study used a web-based survey. Participants were New Zealand registered podiatrists with a current annual practising certificate. The 31-item survey included questions to elicit demographic information, CPR practice and attitudes, and CPR knowledge. Responses were collected between March and August 2020. Results 171 podiatrists responded to the survey. 16 % of the podiatrists (n = 28) had performed CPR in an emergency, with a 50 % success rate. Participants were predominantly female (n = 127, 74 %) and working in private practice (n = 140,82 %). Nearly half of respondents were younger than 40 years (n = 75,44 %) and had less than 10 years of clinical experience (n = 73, 43 %). Nearly all (n = 169,97 %) participants had received formal CPR training in the past two years, with 60 % (n = 105) receiving training in the past 12 months. Most respondents (n = 167,98 %) self-estimated their CPR ability as being effective, very effective, or extremely effective. Participants’ knowledge of CPR was variable, with the percentage of correct answers for CPR protocol statements ranging between 20 and 90 %. Conclusions This study provides the first insight into New Zealand podiatrists’ CPR knowledge and perceptions. Podiatrists were found to have high levels of CPR confidence but demonstrated gaps in CPR knowledge. Currently, New Zealand registered podiatrists require biennial CPR re-certification. However, resuscitation authorities in New Zealand and overseas recommend an annual update of CPR skills. Based on this study’s findings, and in line with Australia and the United Kingdom, the authors recommend a change from biennial to annual CPR re-certification for podiatrists in New Zealand. Trial registration The study was registered with the Australian New Zealand Clinical Trials Registry (ACTRN12620001144909).

scholarly journals Comparison of adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing potentially inappropriate medication use in Hong Kong older patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Huanyu ZHANG ◽  
Eliza L. Y. WONG ◽  
Samuel Y. S. WONG ◽  
Patsy Y. K. CHAU ◽  
Benjamin H. K. YIP ◽  
...  
Keyword(s):  
Older Adults ◽  
Hong Kong ◽  
Older Patients ◽  
Inappropriate Medication ◽  
Female Gender ◽  
Potentially Inappropriate Medication ◽  
Multivariable Logistic Regression Analysis ◽  
Beers Criteria ◽  
Medical Conditions ◽  
Cross Sectional

Abstract Background The Hong Kong-specific criteria have been established in 2019 to assess potentially inappropriate medication (PIM) use in older adults and improve the local prescribing quality. The aim of this study was to compare the adaptive versions of the Hong Kong-specific criteria and 2015 Beers criteria for assessing the prevalence and correlates of PIM use in Hong Kong older patients. Methods A cross-sectional study was performed from January 1, 2014 to December 31, 2014 using the Hospital Authority (HA) database. A total of 489,301 older patients aged 65 years and older visiting general outpatient clinics (GOPCs) during the study period were included in the study. Two categories of PIM use included in the Hong Kong-specific criteria and 2015 Beers criteria, i.e. PIMs independent of diagnoses and PIMs considering specific medical conditions, were adapted to assess the prevalence of PIM use among the study sample. Characteristics of PIM users and the most frequently prescribed PIMs were investigated for each set of the criteria. Factors associated with PIM use were identified using the stepwise multivariable logistic regression analysis. Results The adaptive Hong Kong-specific criteria could detect a higher prevalence of patients exposed to at least one PIM than that assessed by the adaptive Beers criteria (49.5% vs 47.5%). Meanwhile, the adaptive Hong Kong-specific criteria could identify a higher rate of patients exposed to PIMs independent of diagnoses (48.1% vs 46.8%) and PIMs considering specific medical conditions (7.3% vs 4.9%) compared with that of the adaptive Beers criteria. The most frequently prescribed PIMs detected by the adaptive Beers criteria were all included in the adaptive Hong Kong-specific criteria. The strongest factor associated with PIM use was number of different medications prescribed. Patients with female gender, aged 65 ~ 74 years, a larger number of GOPC visits, and more than six diagnoses were associated with greater risk of PIM use, whereas advancing age was associated with lower risk of PIM use. Conclusions The adaptive Hong Kong-specific criteria could detect a higher prevalence of PIM use than the adaptive Beers criteria in older adults visiting GOPCs in Hong Kong. It is necessary to update the prevalence and correlates of PIM use regularly in older adults to monitor the burden of PIM use and identify vulnerable patients who need further interventions.

scholarly journals Perspectives of Healthcare Professionals Regarding Factors Associated with Antimicrobial Resistance (AMR) and Their Consequences: A Cross Sectional Study in Eastern Province of Saudi Arabia

Antibiotics ◽  
2021 ◽  
Vol 10 (7) ◽  
pp. 878
Author(s):  
Mohamed A. Baraka ◽  
Amany Alboghdadly ◽  
Samar Alshawwa ◽  
Asim Ahmed Elnour ◽  
Hassan Alsultan ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Inappropriate Prescribing ◽  
Healthcare Providers ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Key Factors ◽  
Eastern Province ◽  
Cross Sectional ◽  
Factors Associated ◽  
Factors Influencing

Factors reported in the literature associated with inappropriate prescribing of antimicrobials include physicians with less experience, uncertain diagnosis, and patient caregiver influences on physicians’ decisions. Monitoring antimicrobial resistance is critical for identifying emerging resistance patterns, developing, and assessing the effectiveness of mitigation strategies. Improvement in prescribing antimicrobials would minimize the risk of resistance and, consequently, improve patients’ clinical and health outcomes. The purpose of the study is to delineate factors associated with antimicrobial resistance, describe the factors influencing prescriber’s choice during prescribing of antimicrobial, and examine factors related to consequences of inappropriate prescribing of antimicrobial. A cross-sectional study was conducted among healthcare providers (190) in six tertiary hospitals in the Eastern province of Saudi Arabia. The research panel has developed, validated, and piloted survey specific with closed-ended questions. A value of p < 0.05 was considered to be statistically significant. All data analysis was performed using the Statistical Package for Social Sciences (IBM SPSS version 23.0). 72.7% of the respondents have agreed that poor skills and knowledge are key factors that contribute to the inappropriate prescribing of antimicrobials. All of the respondents acknowledged effectiveness, previous experience with the antimicrobial, and reading scientific materials (such as books, articles, and the internet) as being key factors influencing physicians’ choice during antimicrobial prescribing. The current study has identified comprehensive education and training needs for healthcare providers about antimicrobial resistance. Using antimicrobials unnecessarily, insufficient duration of antimicrobial use, and using broad spectrum antimicrobials were reported to be common practices. Furthermore, poor skills and knowledge were a key factor that contributed to the inappropriate use and overuse of antimicrobials, and the use of antimicrobials without a physician’s prescription (i.e., self-medication) represent key factors which contribute to AMR from participants’ perspectives. Furthermore, internal policy and guidelines are needed to ensure that the antimicrobials are prescribed in accordance with standard protocols and clinical guidelines.

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