Adequacy of the pharmacological prescription during the admission in a geriatric hospital. Clinical experiencie with STOPP/START criteria

• Published in: Journal of healthcare quality research Vol. 35; no. 2; p. 95
• Main Authors: Gómez-Cortijo, R, Flotats-Dam, P, Iparraguirre-Azcona, M K, Cubí-Montanyà, D, Sabartés-Fortuny, O, Castellarnau-Font, A, Oller-Sales, I, Arnau, A
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.03.2020
• Subjects: Criterios STOPP-START; STOPP-START criterias; Drug-related side effects and adverse reactions; Prescripción potencialmente inadecuada; Aged; Efectos secundarios y reacciones adversas medicamentosas; Personas mayores; Potentially inappropriate medications
• ISSN: 2603-6479
• DOI: 10.1016/j.jhqr.2020.02.001

The elderly patient is particularly vulnerable to potentially inappropriate prescription (PIP) due to physiological reasons, comorbidity, polypharmacy or the different pharmacokinetics/pharmacodynamics of drugs. The aim of this study was to determine the prevalence of PIP according to the STOPP-START criteria in patients over 65 years admitted into a geriatric hospital, as well as to appraise its acceptance by geriatricians. Retrospective observational study. Patients older than 65 years consecutively admitted to medium/long-stay units were included. The study information was obtained by reviewing the clinical record of the patients. The PIP according to the STOPP-START criteria were assessed by the geriatrician, who decided whether or not to modify the medication and recorded the reasons. 247 patients were included, mean age was 82.6 years (SD 7.3), 72.1% of patients were female and a median of 7 drugs (25-75 percentile: 4-9). 78.9% (95%CI: 73.3-83.9) of patients had at least one PIP STOPP-START at admission, 44.9% (95%CI: 38.6-51.4) PIP-STOPP and 59.5% (95%CI: 53.1-65.7) PIP-START. At hospital discharge, the prevalence of PIP-STOPP-START was 46.2% (95%CI: 39.8-52.6), 19.0% (95%CI: 14.3-24.5) of PIP-STOPP and 34.4% (95%CI: 28.5-40.7) PIP-START. The comprehensive geriatric assessment and the use of the STOPP-START criteria can significantly reduce the prevalence of PIP among patients admitted to a geriatric hospital. Nevertheless, issues such as frailty, multimorbidity and functional goals would be taken into account in the appropriateness of the prescription.