Potentially inappropriate prescribing in institutionalised older patients in Spain: the STOPP-START criteria compared with the STOPP-START criteria compared with
2012
Objective: The aims of this study were to identify
potentially inappropriate prescribing using the Beers
and STOPP criteria. The START criteria were
applied to detect prescription omission in the
geriatric population. We compared the utility of
these criteria in institutionalised older people.
Methods: Descriptive study reviewing the
medication and clinical records of 81 residents
(aged 65 years and more) by pharmacists in a
nursing home in the Lleida region (Spain).
Results: The mean patients´ age was 84 (SD=8)
years, with an average of 5 drugs per resident (total
prescriptions: 416 medicines). The Beers criteria
identified potentially inappropriate medication use in
25% of patients and 48% of patients used at least 1
inappropriate medication according to STOPP
criteria. The most frequent potentially inappropriate
medications for both criteria were long-acting
benzodiazepines and NSAIDs. START detected 58
potential prescribing omissions in 44% of patients.
Calcium-vitamin D supplementation in osteoporosis
was the most frequent rule (15%), but omissions
corresponding to the cardiovascular system implied
23% of patients.
Conclusion: The STOPP-START criteria reveal
that potentially inappropriate prescribing (PIP) is a
highly prevalent problem among Spanish nursing
home residents, and a statistically significant
positive correlation was found between the number
of medicines prescribed and the number of PIP
detected in this study. The STOPP criteria detect a
larger number of PI medications in this geriatric
population than the Beers criteria. The prescribing
omissions detected by the START criteria are
relevant and require intervention. Pharmacists´
review of medications may help identify potentially inappropriate prescribing and, through an
interdisciplinary approach, working with physicians
may improve prescribing practices among geriatric
residents of nursing homes
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