The Prevalence of Potentially Inappropriate Prescribing in the Elderly at the Primary Care Level in Kazakhstan

BACKGROUND: These potentially inappropriate prescribing is associated with the development of undesired medical reactions in elderly patients, and increase the frequency of hospitalizations, the number of aggravations and the cost of treatment. All of these adverse events are preventable. For detection of PIP and to prevent the adverse drug reactions (ADRs) in elderly patients, it is necessary to screen for potentially inappropriate prescribing. AIM: The aim of the study is to study the prevalence of PIP and the factors associated with these prescriptions at the level primary link in Kazakhstan. METHODS: A prospective descriptive study was carried out at the primary care level, in five clinics in Kazakhstan. The study involved 205 patients over 65 years old who received regular outpatient treatment for chronic diseases. Patients’ current diagnoses and prescription medicines were reviewed and the STOPP and START tools applied. RESULT: The prevalence of PIP in terms of STOPP criteria was 54% (114 patients). In general, we have identified 181 cases of PIP. The most commonly prescribed PIP were moxonidine (20%), glimeperide (16.5%), and PPI (20%). The prevalence of prescribing omissions in terms of START criteria was 22% (48 patients). Overall 66 cases of prescribing omissions were identified. The most commonly prescribed omissions were statins (6%) and ACE inhibitors (4%). Comparative analysis revealed a statistically significant effect of polymorbidity on the prevalence of PIP (p < 0.001) and number of prescribed medicines on the prevalence of PIP (p < 0.05). We have found a statistically significant effect of age on the presence of prescribing omissions of patients. (p < 0.001) CONCLUSION: Our results showed a high prevalence of potentially inappropriate prescribing at the primary care level in Kazakhstan. Screening tools should be incorporated into the everyday practice of primary care doctors.

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Potential inappropriate prescribing among ambulatory elderly patients in a geriatric centre in southwestern Nigeria: Beers criteria versus STOPP/START criteria

Tropical Journal of Pharmaceutical Research ◽

10.4314/tjpr.v19i5.29 ◽

2020 ◽

Vol 19 (5) ◽

pp. 1105-1111

Author(s):

Wuraola Akande-Sholabi ◽

Oluwatobi C. Ajilore ◽

Segun J. Showande ◽

Lawrence A. Adebusoye

Keyword(s):

Elderly Patients ◽

Health Care Professionals ◽

Screening Tool ◽

Data Extraction ◽

Inappropriate Prescribing ◽

Beers Criteria ◽

Potentially Inappropriate Prescribing ◽

Southwestern Nigeria ◽

Start Criteria ◽

Prescribing Omissions

Purpose: To identify potentially inappropriate prescribing in ambulatory elderly patients and compare the appropriateness of guidelines; Beers' and Screening Tool of Older Person’s Prescription (STOPP)/Screening Tool to Alert Right Treatment (START) criteria to detect potentially inappropriate prescribing among the elderly.Methods: A retrospective study was conducted using case files of 335 elderly patients aged ≥ 60 years between 1st January and 31st December 2016, using a data extraction sheet. The 2015 American Geriatrics Society (AGS)-Beers Criteria, and version 2 of the STOPP and START were subsequently used to identify the Potentially Inappropriate Prescribing (PIP) and Potential Prescribing Omissions (PPOs).Results: Mean age of patients was 69 ± 0.4 years (range 60 - 85 years) and 219 (65.4 %) were females. An average of 4.2 medications per patient prescription was found. The Beers criteria identified 26.5 % PIP, while STOPP criteria identified 57.1 % PIP. START detected 29 PPOs in 15 (4.4 %) of the patient’s prescription. The most prevalent disease conditions were hypertension 235 (70.1 %) and osteoarthritis 64 (19.3 %). Polypharmacy was significantly associated with PIP in both Beers (p = 0.002) and STOPP (p = 0.001) criteria.Conclusion: The prevalence of PIP is high among elderly patients. The STOPP/START criteria identified a higher proportion of PIP among elderly patients compared with Beers criteria. The frequency of PIP should stimulate efforts to curtail potentially inappropriate prescribing and may require the need for advocating for a national criterion to be adopted by health care professionals in Nigeria. Keywords: Potential inappropriate prescribing, Beers’ criteria, STOPP/START criteria, Elderly

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Prevention of Potentially Inappropriate Prescribing for Elderly Patients: A Randomized Controlled Trial Using STOPP/START Criteria

Clinical Pharmacology & Therapeutics ◽

10.1038/clpt.2011.44 ◽

2011 ◽

Vol 89 (6) ◽

pp. 845-854 ◽

Cited By ~ 280

Author(s):

P F Gallagher ◽

M N O'Connor ◽

D O'Mahony

Keyword(s):

Randomized Controlled Trial ◽

Elderly Patients ◽

Controlled Trial ◽

Inappropriate Prescribing ◽

Potentially Inappropriate Prescribing ◽

Randomized Controlled ◽

Start Criteria

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Potentially Inappropriate Prescribing among Elderly Patients at a Primary Care Clinic in Oman

Journal of Cross-Cultural Gerontology ◽

10.1007/s10823-019-09393-5 ◽

2019 ◽

Vol 35 (2) ◽

pp. 209-216

Author(s):

Said Al-Busaidi ◽

Ayman Al-Kharusi ◽

Mustafa Al-Hinai ◽

Ibrahim Al-Zakwani ◽

Fatma Al-Ghafri ◽

...

Keyword(s):

Primary Care ◽

Elderly Patients ◽

Inappropriate Prescribing ◽

Primary Care Clinic ◽

Potentially Inappropriate Prescribing ◽

Care Clinic

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Potentiality of STOPP/START criteria used in primary care to effectively change inappropriate prescribing in elderly patients

European Geriatric Medicine ◽

10.1016/j.eurger.2013.06.006 ◽

2013 ◽

Vol 4 (5) ◽

pp. 293-298 ◽

Cited By ~ 9

Author(s):

I. Martín Lesende ◽

I. Mendibil Crespo ◽

G. Maiz López ◽

I. Gabilondo Zelaia ◽

J.C. Aretxabaleta Parra ◽

...

Keyword(s):

Primary Care ◽

Elderly Patients ◽

Inappropriate Prescribing ◽

Start Criteria

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Polypharmacy among elderly populations

European Psychiatry ◽

10.1016/j.eurpsy.2017.02.226 ◽

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.

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