Análisis poblacional de la prescripción potencialmente inadecuada en ancianos según criterios STOPP/START (estudio STARTREC)

Esteve, Isabel; Mora, J.R. Marsal; Galindo-Ortego, Gisela; Galvan-Santiago, L; Serrano-Godoy, Marcos; Ribes-Murillo, Esther; Real-Gatius, Jordi

doi:10.1016/j.aprim.2016.02.013

Cited by 35 publications

(20 citation statements)

References 27 publications

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“…Our results coincide with those of the majority of previous studies, placing BZDs and PPIs among the most frequently detected PIP with explicit criteria [ 14 – 16 , 41 , 49 , 51 ]. The percentage of patients in our sample who used BZDs for more than four weeks (STOPP v2) was similar to that obtained by Blanco Reina [ 13 ] (36.6% vs. 38.6%).…”

Section: Discussionsupporting

confidence: 92%

“…For the 2015 version, the data obtained is slightly higher than those reported by previous studies in a hospital population (53.5%) [47], and similar to studies conducted with insurance databases (72.8%) [14,48]. With STOPP, this study obtained prevalence of 57.4% and 43.6% using STOPP 2014 and 2008, respectively, which is higher than those reported by prior studies [49,50] using previous STOPP versions in the primary care setting and in the European population (36% and 39%, respectively). In those who used the 2014 version, the prevalence ranged between 8.7 and 40.4% [16,41]; in a polymedicated geriatric primary care population in Kuwait, similar results were found (55.7%) [21].…”

Section: Plos Onesupporting

confidence: 60%

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Potentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study

et al. 2020

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Background Multimorbidity is a global health challenge that is associated with polypharmacy, increasing the risk of potentially inappropriate prescribing (PIP). There are tools to improve prescription, such as implicit and explicit criteria. Objective To estimate the prevalence of PIP in a population aged 65 to 74 years with multimorbidity and polypharmacy, according to American Geriatrics Society Beers Criteria ® (2015, 2019), the Screening Tool of Older Person's Prescription-STOPP-criteria (2008, 2014), and the Medication Appropriateness Index-MAI-criteria in primary care. Methods This was an observational, descriptive, cross-sectional study. The sample included 593 community-dwelling elderly aged 65 to 74 years, with multimorbidity and polypharmacy, who participated in the MULTIPAP trial. Socio-demographic, clinical, professional, and

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Section: Discussionsupporting

confidence: 92%

Section: Plos Onesupporting

confidence: 60%

Potentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study

et al. 2020

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“…Some countries like Belgium have published guidance on how to prescribe for older people [ 25 ]. In Spain, potentially inappropriate prescribing in older people have been reviewed in accordance with the STOPP/START criteria [ 48 ]. This would be one of the strategies that could help to optimize drug therapy.…”

Section: Discussionmentioning

confidence: 99%

Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Cadenas

Diez

Fernández

et al. 2021

IJERPH

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In Spain, there has been a progressive increase in aging. Specifically, Leon has been one of the Spanish provinces with the highest aging index. Polypharmacy is highly prevalent among the elderly, with significant consequences for safety. The aim of this study was to assess the consumption of drugs in a nursing home in the province of Leon and establish the relationship between polypharmacy and the most common comorbid diseases. A descriptive, observational, and cross-sectional study design was used. Residents’ information and treatments were collected by reviewing on medical charts, completed with clinical information obtained from the physician of the nursing home. The mean age of residents was 86.8 years, and 63.8% were female. Mean medical consumption amounted to 7.02 prescriptions. Polypharmacy was observed in 54.9% of residents, and excessive polypharmacy in 22.1%. The most commonly used medications (ATC classification) were those acting on the cardiovascular system (84.4%) and the nervous system (82.8%). A high-level of drug consumption was observed in the nursing home. Interventions should focus on those residents hospitalized the last year and with recent contact with a general practitioner. There is a need to develop a comprehensive monitoring system to assess the quality of prescriptions for nursing home residents.

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“…The prevalence of patients with PIP is high, although it differs among studies, many of which are aimed at hospitalized, institutionalized, or immobilized elderly patients [8]. In the primary care setting in Europe, the PIP prevalence varies between 36% in Ireland [9] and 39% or 40.4% reported in 2 studies in Spain [10,11]. The existence of PIP has been related to a higher risk of being hospitalized [12], greater use of health emergency services and family doctor visits, reduced functionality [13], and increased mortality rates [14].…”

Section: Introductionmentioning

confidence: 99%

Use of an Electronic Clinical Decision Support System in Primary Care to Assess Inappropriate Polypharmacy in Young Seniors With Multimorbidity: Observational, Descriptive, Cross-Sectional Study (Preprint)

Rogero-Blanco¹,

López-Rodríguez²,

Sanz-Cuesta³

et al. 2019

Preprint

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BACKGROUND Multimorbidity is a global health problem that is usually associated with polypharmacy, which increases the risk of potentially inappropriate prescribing (PIP). PIP entails higher hospitalization rates and mortality and increased usage of services provided by the health system. Tools exist to improve prescription practices and decrease PIP, including screening tools and explicit criteria that can be applied in an automated manner. OBJECTIVE This study aimed to describe the prevalence of PIP in primary care consultations among patients aged 65-75 years with multimorbidity and polypharmacy, detected by an electronic clinical decision support system (ECDSS) following the 2015 American Geriatrics Society Beers Criteria, the European Screening Tool of Older Person’s Prescription (STOPP), and the Screening Tool to Alert doctors to Right Treatment (START). METHODS This was an observational, descriptive, cross-sectional study. The sample included 593 community-dwelling adults aged 65-75 years (henceforth called young seniors), with multimorbidity (≥3 diseases) and polypharmacy (≥5 medications), who had visited their primary care doctor at least once over the last year at 1 of the 38 health care centers participating in the Multimorbidity and Polypharmacy in Primary Care (Multi-PAP) trial. Sociodemographic data, clinical and pharmacological treatment variables, and PIP, as detected by 1 ECDSS, were recorded. A multivariate logistic regression model with robust estimators was built to assess the factors affecting PIP according to the STOPP criteria. RESULTS PIP was detected in 57.0% (338/593; 95% CI 53-61) and 72.8% (432/593; 95% CI 69.3-76.4) of the patients according to the STOPP criteria and the Beers Criteria, respectively, whereas 42.8% (254/593; 95% CI 38.9-46.8) of the patients partially met the START criteria. The most frequently detected PIPs were benzodiazepines (BZD) intake for more than 4 weeks (217/593, 36.6%) using the STOPP version 2 and the prolonged use of proton pump inhibitors (269/593, 45.4%) using the 2015 Beers Criteria. Being a woman (odds ratio [OR] 1.43, 95% CI 1.01-2.01; P=.04), taking a greater number of medicines (OR 1.25, 95% CI 1.14-1.37; P<.04), working in the primary sector (OR 1.91, 95% CI 1.25-2.93; P=.003), and being prescribed drugs for the central nervous system (OR 3.75, 95% CI 2.45-5.76; P<.001) were related to a higher frequency of PIP. CONCLUSIONS There is a high prevalence of PIP in primary care as detected by an ECDSS in community-dwelling young seniors with comorbidity and polypharmacy. The specific PIP criteria defined by this study are consistent with the current literature. This ECDSS can be useful for supervising prescriptions in primary health care consultations.

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Análisis poblacional de la prescripción potencialmente inadecuada en ancianos según criterios STOPP/START (estudio STARTREC)

Abstract: In our Health Region, at least 50% of the population aged 70 or older has one or more PIP, according to STOPP/START criteria.

Cited by 35 publications

References 27 publications

Potentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study

Potentially inappropriate prescriptions according to explicit and implicit criteria in patients with multimorbidity and polypharmacy. MULTIPAP: A cross-sectional study

Prevalence and Associated Factors of Polypharmacy in Nursing Home Residents: A Cross-Sectional Study

Use of an Electronic Clinical Decision Support System in Primary Care to Assess Inappropriate Polypharmacy in Young Seniors With Multimorbidity: Observational, Descriptive, Cross-Sectional Study (Preprint)

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