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Abstract
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Background Prescribing potentially inappropriate medications (PIMs) and omitting essential drugs are a common problem in elderly. Application of Beers criteria and screening tool of older persons' potentially inappropriate prescriptions (STOPP) in primary care setting has not been studied broadly.
Purpose To identify PIMs using Beers and STOPP criteria. The START (Screening Tool to Alert doctors to the Right Treatment) criteria were applied to detect potential prescribing omission in elderly patients in Primary Care.
Material and methods A descriptive, observational study was carried out for patients over 65 years, with more than 6 medications who attended in 5 Medical Centres Primary Care between October 2013 and June 2014. The patients were randomly selected to participate in the study. The patient demographic data including medical histories, current diagnoses and current medications were recorded by a pharmacist. PIMs have been defined as patient who met any of the Beers 2012, STOPP or START criteria.
Results Number of patients: 270. Average age: 80 years. Total prescribed medications: 2.758, average 10, 2 per patient. The highest prevalence was related to drugs for the cardiovascular system, inhibitors of proton pump, statins and omeprazole. There were 49%, 59%, 20% PIMs found using Beers, STOPP and START criteria, respectively. The most common PIMs using Beers and STOPP criteria were short-acting benzodiazepine prescribed to elderly patient with a history of falls (31% vs. 24%). The STOPP criteria were duplicate drugs prescriptions among (24%), higher doses than 150 mg/day of aspirin (7%). Common PPOs identified included antiplatelet for diabetes with high cardiovascular risk index (18%), vitamin D and calcium supplements for known osteoporosis patients (17%).
Conclusion STOPP/START criteria showed higher MPIs detection capability than Beers criteria. This study confirms the high prevalence of PIMs among older adults comparing prior studies (16.3-62.5%). This can be explained by the diversity in the severity of disease in the study subjects.
Reference Beers, STOPP/START Criteria ReferenceNo conflict of interest.
Language: en |